As I prepare to speak to members of the Laboratory Products Association meeting on ethics, I ran across this news release from the Department of Justice about yet another health care fraud. I am pleased that so many folks in the health related field are ethical and have a strong desire to do the right thing – or make the right choices. As I visited with LPA members this evening, I got that very real sense, as many didn’t know that I was their final event speaker, that they welcomed the opportunity to feature ethics and ethics training so that they could help others (employees, vendors, etc) know the value of making positive choices – even in the face of economic uncertainty.
The unfortunate thing is that the “bad apples” tend to spoil the whole bunch by giving a bad name to segments of an industry. The news release was issued on April 28th, 2010 and represents yet another example of people who find greed and lack of ethics eventually has a consequence. Tomorrow, when I deliver my keynote presentation, the first words out of my mouth will be – “Every choice has a consequence!” In the case of Doris Vinitski and John Lachman they are just beginning to understand the effect between choices and consequences.
Houston-area residents Doris Vinitski and John Lachman pleaded guilty today in connection with their roles in a durable medical equipment Medicare fraud scheme, the Departments of Justice and Health and Human Services (HHS) announced.
According to court documents, Vinitski, 45, was the owner of Onward Medical Supply, a Houston-area durable medical equipment company. Lachman, 45, operated the day-to-day business for several years, and Vicki Phillips, 53, was a patient recruiter for Onward. Vinitski and Lachman, who is Vinitski’s estranged husband, each pleaded guilty today before U.S. District Court Judge Nancy Atlas of the Southern District of Texas to one count of conspiracy to commit health care fraud. Phillips pleaded guilty on April 21, 2010, to one count of conspiracy to defraud the United States and to paying health care kickbacks.
Onward began billing Medicare for fraudulent durable medical equipment in 2003, according to court documents. Vinitski and Lachman admitted they paid kickbacks, sometimes $1,000 per patient, to recruiters who brought patients to Onward. Lachman and Vinitski then would bill Medicare for durable medical equipment that these patients did not need or never received.
Phillips admitted that she recruited Medicare beneficiaries for the purpose of allowing Onward to submit claims to Medicare for durable medical equipment, including power wheelchairs and orthotic devices. Phillips also admitted she received kickbacks from Onward for each patient she recruited whose claims were reimbursed by Medicare.
Lachman and Phillips are scheduled to be sentenced on Aug. 16, 2010. Vinitski is scheduled to be sentenced on Aug. 17, 2010. Lachman and Vinitski face a maximum penalty of 10 years in prison and a $250,000 fine. Phillips faces a maximum penalty of five years in prison and a $250,000 fine.
Seven additional defendants allegedly involved in the scheme – Dr. Howard Grant, Clinton Lee, Michael Kalu Obasi, Darnell Willis, Ju-Ying Cian, Obisike Nwankwo and John Nasky Okonkwo – are scheduled for trial on May 17, 2010. The charges against these defendants are merely allegations and they are presumed innocent until proven guilty.
The guilty pleas were announced by Assistant Attorney General Lanny A. Breuer of the Criminal Division; U.S. Attorney José Angel Moreno of the Southern District of Texas; Richard C. Powers, Special Agent-in-Charge of the FBI’s Houston office; Special Agent-in-Charge Mike Fields of the Dallas Regional Office of the HHS Office of Inspector General (OIG), Office of Investigations; and Texas Attorney General Greg Abbott on behalf of the Texas Attorney General’s Medicaid Fraud Control Unit (MFCU).
The cases were prosecuted by Assistant Chief John S. (Jay) Darden and Trial Attorneys Jennifer L. Saulino and O. Benton Curtis III of the Criminal Division’s Fraud Section. The cases were investigated by the FBI, HHS-OIG and MFCU.
The case was brought as part of the Medicare Fraud Strike Force, supervised by the U.S. Attorney’s Office for the Southern District of Texas and the Criminal Division’s Fraud Section. Since their inception in March 2007, Strike Force operations in seven districts have obtained indictments of more than 560 individuals who collectively have falsely billed the Medicare program for more than $1.2 billion. In addition, HHS’s Centers for Medicare and Medicaid Services, working in conjunction with the HHS-OIG, are taking steps to increase accountability and decrease the presence of fraudulent providers.
To learn more about the Health Care Fraud Prevention and Enforcement Action Team (HEAT), go to: www.stopmedicarefraud.gov
To commit a fraud, typically three components must exist: (1) need; (2) opportunity and (3) rationalization. The question here is what triggered the “need” component and how did they “rationalize” their behavior.
People who, perhaps, are close to those involved are encouraged to comment so we can flush out the underlying motives in this unfortunate fraud.
YOUR COMMENTS ARE WELCOME!