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  1. #1
    Super Moderator Newmexican's Avatar
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    Medicare billions going to Castro, Cuba?

    WATCHDOGS: Solons worry Medicare billions going to Castro, Cuba

    June 22, 2012


    U.S. Sen. Tom Coburn (Photo by Mark Wilson/Getty Images)

    Two U.S. senators and a representative worry that billions of tax dollars could be going to Cuba and other foreign countries via criminal schemes designed to defraud Medicare and Medicaid.

    The schemes often involve the use of “nominees,” individuals who are paid to be fronts for the actual owners of corporate entities being used in the fraudulent operation. By concealing the identities of true owners, the approach invites its use to funnel tax dollars out of the country.

    In a letter made public yesterday to Marilyn Tavenner, acting administrator of the Center for Medicare and Medicaid, senators Orrin Hatch, R-UT, and Tom Coburn, R-OK, were joined by Rep. Peter Roskam, R-IL, said they fear billions of tax dollars are being lost annually as a result.

    “Clearly, the program vulnerabilities that facilitate billions of dollars to be stolen from the Medicare program each year also allow for some of that money to be funneled to foreign countries,” the three congressmen said.

    “While the fraud itself is unacceptable, the loss of American dollars to foreign countries because of flaws in our system is totally unacceptable. The American people deserve the peace of mind to know that federal officials are doing everything they can to safeguard taxpayers’ dollars and the Medicare program.”
    “Thus far, it does not appear that CMS has addressed the concept of nominee owners, false storefronts, and shell companies in any of its enrollment regulations or its Provider Screening statement of work,” they said.

    Earlier this week, federal officials in Miami charged Oscar Sanchez in connection with a criminal operation that resulted in an estimated $31 million going to Cuban banks.

    “Prosecutors say Oscar Sanchez, 46, was a key leader in a group that funneled $31 million in Medicare dollars into banks in Havana — the first such case that directly traces money fleeced from the beleaguered program into the Cuban banking system,” the Miami Herald reported Monday.

    “Most of the money moved through an intricate web of foreign shell companies before ending up in Cuba, to avoid being detected in the United States, said investigators,” the Herald said.

    Also earlier this week, federal officials announced the capture of two other individuals who had been involved in multi-million dollar frauds with overseas connections. In one, Irina Shelikhova was arrested Monday at JFK Airport in New York when shetried to re-enter the country from the Ukraine.

    “From approximately March 2005 until July 2010, Shelikhova and her co-conspirators allegedly paid cash kickbacks to Medicare beneficiaries to induce them to receive unnecessary physicians’ services, physical therapy, and diagnostic tests at the medical clinics,” according to the Inspector-General of the Department of Health and Human Services.

    “The co-conspirators created fraudulent medical records for these beneficiaries and then filed false claims with Medicare for these medical services, which either were never provided or were not medically necessary,” the HHS IG said.
    Shelikhova and her co-conspirators are believed to have defrauded Medicare of as much as $70 million.

    In the second case, federal officials arrested Miguel Cabello last week when he attempted to re-enter the country through Champlain, New York.
    Cabello fled the country to Cuba in July 2008 after being indicted on health care fraud charges. “Cabello submitted approximately $2.1 million in fraudulent Medicare claims on behalf of south-Florida-based OB Pharmacy, Inc., and he received approximately $1.3 million in Medicare payments,” according to the HHS IG.

    “Before Cabello’s involvement, OB Pharmacy, a durable medical equipment company that specialized in aerosol medications, submitted $151,572 in Medicare claims and was paid approximately $58,653.

    “Around April 2008, Cabello became vice-president of OB Pharmacy. Investigators have concluded that OB Pharmacy submitted claims to Medicare for services that were not rendered, including approximately 10 claims for deceased beneficiaries.
    “Investigators interviewed physicians who stated that they did not know the OB Pharmacy patients in question nor did they prescribe the medication purportedly provided to them.”

    In their letter to Tavenner, Hatch, Coburn and Roskam cited a University of Miami report that quoted a former Cuban intelligence officer saying there are “strong indications” that the Castro government aids Medicare fraud, especially in South Florida, and provides safe harbor for individuals involved in those efforts.
    “If confirmed, this indicates that Medicare program dollars are not only funding international criminal syndicates, but may be helping prop up the Castro government,” the congressmen said.

    Back in April, Hatch and Coburn were joined in another letter to Tavenner by representatives Charles Boustenay, R-LA, and Wally Herger, R-CA, on the nominees issue, and expressed concern then that the problem was not being addressed.
    The HHS IG “has expressed concerns regarding the use of nominee owners and recommended that CMS take aggressive action to identify them,” they wrote. “Thus far, it does not appear that CMS has addressed the concept of nominee owners, false storefronts, and shell companies …”
    WATCHDOGS: Solons worry Medicare billions going to Castro, Cuba | WashingtonExaminer.com

    Where are the Federal employees that are paid to audit the transactions and make sure that the companies that were billing were real companies? they must have been having a long lunch with the ones that were supposed to be monitoring the banks and insider trading.

    I think that we have a unionized federal employment system that makes it impossible to get rid of incompetence.

    Stop worrying abut how much medicare grandma might consume and stop the FRAUD and maybe she won't have to take the pill instead of receiving treatment.
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  2. #2
    Super Moderator Newmexican's Avatar
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    In My Opinion, from the Miami Herald.

    Medicare fraud’s men in Havana

    By Myriam Marquez

    mmarquez@MiamiHerald.com

    If the feds’ case sticks, Oscar L. Sanchez will be convicted as a cash-for-Cuba financier of fraudsters, “a capitalist for Cuban banks,” as prosecutors wrote in a court motion, accusing the 46-year-old South Florida man of conspiracy to commit money laundering for a group that funneled $63 million of stolen Medicare payments to Havana banks. You think the Cuban government was in on it?


    For the skeptics, I have two words: Robert Vesco.


    The fugitive American financier was accused of securities fraud in the 1970s and after trying to buy his own island from the country of Antigua, popped up in Havana in 1982, protected by the communist regime from extradition to the United States. Alas, the commie honeymoon didn’t last once Vesco’s millions seemed to run out. Cuba arrested him in 1996 for “fraud and illicit economic activity . . . acts prejudicial to the economic plans and contracts of the state.” He didn’t last long in prison, dying of lung cancer a few months later.


    Sanchez’s acts, federal prosecutors say, have been prejudicial to U.S. taxpayers, by about $31 million, which is the amount the federal government says it tracked from 2005 to 2009 through a complicated web of foreign shell companies Sanchez created using his check-cashing business to funnel the Medicare payments from the United States to Canada, Trinidad and eventually Cuba. The money in at least two accounts deposited in the Trinidad bank in Havana came with instructions to be wired into the Cuban banking system.


    Still, prosecutors say there’s no direct evidence linking the Cuban regime and the Castro brothers to the plot.


    Well, no kidding. After 53 years of elaborate schemes, murder and mayhem from Angola to Venezuela, Fidel and Raúl have gotten pretty good at it. But the bottom line really isn’t that complicated if the doubters care to seek the truth. Nothing happens in Cuba without the consent of the Castros. Certainly nothing having to do with money, and certainly not millions of dollars in deposits in Cuban government-controlled banks. Was the Cuban government taking a cut?


    You betcha. And that’s no conspiracy theory. It’s simple mathematics -- and history.
    More than one high-level defector has testified before Congress and gone on Spanish-language TV over the years to detail fraud schemes and spying operations, all in an effort to keep the revolution going, with American money, no less.


    Just last week, as the Cuban government was reported by The Associated Press to “bristle” at any hint that it would be involved in a Medicare fraud scheme, Cuba’s Foreign Ministry had another “bristling” episode -- this time bristling against the Dutch. ING Bank NV announced earlier this month that it would pay $619 million to end a case against it involving billions of dollars secretly moved through American banks on behalf of “Cuban and Iranian concerns in violation of U.S. sanctions.”


    In 2004 a Swiss bank got slapped with a $100 million fine for buying and selling more U.S. dollars from Cuba than the regime could have earned from its sputtering economic affairs.


    Sanchez’s is the first case that makes a direct link between Medicare fraud and Cuba benefiting from it. But the benefits have always been apparent.


    In 2008, The Miami Herald’s “Medicare Racket” investigation by reporter Jay Weaver found that at least half of South Florida’s Medicare fugitives were believed to be back in Cuba, sipping mojitos. About 60 Cuban scammers, many of them arriving in Miami in the 1990s, collectively billed more than a billion dollars from taxpayers through medical storefronts with phantom patients. As federal investigators started to get close to the action, about two dozen of those scammers took off to Cuba.


    Does anyone believe that the regime had no clue these millionaires had moved back or that the government isn’t getting its share? Does anyone wonder how many of these guys work for Cuba’s state security?


    While Sanchez was a target of this latest ongoing investigation, prosecutors say dozens of crooked Medicare providers — who offered HIV and medical equipment services — were in on the laundering scheme. “The defendants’ money laundering operation was faster, more efficient, and financially benefited everyone involved, including [Sanchez], who charged a fee for his services,” prosecutors wrote.


    Sanchez pleaded not guilty on Friday. U.S. Magistrate Jonathan Goodman was wise to deny bail to such a flight risk. Fool us once, shame on you. Fool us 61 times, and counting, shame on us.


    Read more here: Medicare fraud’s men in Havana - Myriam Marquez - MiamiHerald.com
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  3. #3
    Super Moderator Newmexican's Avatar
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    CAPTURED: Irina Shelikhova




    • In October 2011, an indictment was handed down charging Irina Shelikhova and co-conspirators with Conspiracy To Commit Health Care Fraud, Conspiracy To Pay Health Care Kickbacks, Health Care Fraud, Money Laundering, and Money Laundering Conspiracy. Investigators believe that Shelikhova was the primary player in a scheme to defraud Medicare of more than $70 million.
    • According to the indictment, Shelikhova was an authorized signatory on the bank accounts of a conglomerate of medical clinics in the New York City area. Shelikhova managed the daily operations of the medical clinics and worked with co-conspirators to direct individuals who conducted financial transactions for the medical clinics.
    • From approximately March 2005 until July 2010, Shelikhova and her co-conspirators allegedly paid cash kickbacks to Medicare beneficiaries to induce them to receive unnecessary physicians' services, physical therapy, and diagnostic tests at the medical clinics. The co-conspirators created fraudulent medical records for these beneficiaries and then filed false claims with Medicare for these medical services, which either were never provided or were not medically necessary.
    • In July 2010, Shelikhova fled the United States and was suspected to be residing in Ukraine. On June 14, 2012, she was arrested by the Federal Bureau of Investigation as she attempted to enter the United States at JFK Airport in New York. Shelikhova was taken into custody and will be brought to court to face charges stemming from the indictment.
    • Captured Fugitives | OIG Most Wanted Fugitives | Fraud | Office of Inspector General | U.S. Department of Health and Human Services
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  4. #4
    Super Moderator Newmexican's Avatar
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    Two more that fled to Cuba after scamming 110 million dollars

    OIG Fugitives: Maricel B. Hernandez & Eugenio R. Hernandez



    • In December 2007, a 38-count indictment was filed charging Eugenio R. Hernandez, Maricel B. Hernandez, and Jorge Ramirez with conspiracy to commit health care fraud, health care fraud, money laundering conspiracy, and money laundering.
    • According to court documents, Eugenio Hernandez was the reported owner of S.L. Medical Center, Inc.; Maricel Hernandez was the reported owner of Care Medical Office, Inc.; and Jorge Ramirez was the reported owner of the Rehabilitation Institute and Science Clinic, Inc. All three companies operated in the greater Miami area and purportedly provided infusion therapy to Medicare patients suffering from blood disorders and other conditions.
    • Investigators believe that these companies billed Medicare more than $110 million between April and December 2005 for infusion therapy services that were never provided to patients. After receiving payments from Medicare, the defendants allegedly laundered the fraudulently obtained funds through various shell companies to conceal the scheme to defraud and use the funds for their personal benefit.
    • Eugenio and Maricel Hernandez fled the country and are believed to be residing in Cuba.
    • Ramirez was captured in December 2008 at Miami International Airport. He pleaded guilty to one count of health care fraud and is serving his nearly 6-year jail sentence. Ramirez was also ordered to pay over $4 million in restitution.

    Profiles | OIG Most Wanted Fugitives | Fraud | Office of Inspector General | U.S. Department of Health and Human Services


    Reveiw the most wanted fugitives to see what countries Medicare money is going to

    http://oig.hhs.gov/fraud/fugitives/index.asp
    Last edited by Newmexican; 06-24-2012 at 07:11 AM.
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