Thursday, June 30, 2022

Unlicensed to Defraud

Unlicensed insurance agents are not allowed to engage in the sale, solicitation, or negotiation of insurance, but that didn’t stop Costa Mesa, Calif. resident Karyl Lynn Reed from allegedly collecting insurance premiums on nonexistent workers’ compensation policies. The 57-year-old supposedly defrauded multiple businesses out...

Same Story, Different Day

Just as the acclaimed movie Groundhog Day portrays a monotonous, unpleasant, and repetitive situation, the growing number of articles about COVID-19 fraud related to the Paycheck Protection Program (PPP) is becoming rather tedious to sort through. While the stories we see each day may...

Heart Breaker

Moses deGraft-Johnson, a well renowned heart surgeon who immigrated to the U.S. as a child from Ghana, surrendered his medical licenses and pleaded guilty to 58 counts of healthcare fraud in 2020. (So much for the American Dream. He blew it.) (It’s every parent's dream...

Hail Mary Pass

The median wage for all National Football League (NFL) players is $860,000. Evidently that was not enough for a former player, Joshua J. Bellamy, 32 of St. Petersburg, Fla. (Perhaps he didn’t put enough away in savings while he was a wide receiver for...

Just Hang Up the Phone

“I love telemarketing calls,” said no one, ever. If only scores of beneficiaries of Medicare and the Civilian Health and Medical Program of the Department of Veterans Affairs (“CHAMPVA”) had just hung up the phone, you wouldn’t be reading about this $134 million healthcare...

Things to Avoid

There are a few things that family medicine practitioner Dr. Ahmad Ismail of Bonifay, Fla., should have avoided. He shouldn’t have lied on two years of tax returns, nor should he have forgotten to live by the physician ethical principle of “do no harm.”...

Don’t Even Try It

Tricare covers the cost of compounded drugs, which are a combination of two or more drugs prepared by a pharmacist for a patient’s individual needs. (Of course, the compounded medication needs to be medically necessary to qualify for Tricare coverage.) Jonah Miller, 48, of...

Pandemic Pie

Ever had a craving for pie? Perhaps apple pie a la mode or pumpkin pie with whipped cream sounds delicious to you at this time of the year. There’s a relatively new flavor of pie that has gained the attention of many unscrupulous individuals...

Brace for Prison

Patsy “Pat” Joseph Truglia, 53, of Parkland, Fla.,  pleaded guilty to two counts of conspiracy to commit health care fraud and one count of making a false statement in a matter involving a health care benefit program. Truglia faces a maximum penalty of 15...

A Failed Eight-man Defense

Alberto Orian Gonzalez-Delgado, 46, of Miami, Fla., has been sentenced after conspiring to commit health care fraud and wire fraud. Co-conspirators including Eduardo Rubal, 41, Vicente Gonzalez Acosta, 50, Alexander Fernandez, 49, Yaxing Tapanes, 24, Jose Carlos Valladares Rivera, 43, Hector Suarez Gonzalez, 45, and...
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