False Advertising

13463126 - pensioner read countless papers and is very focused

False advertising is an unethical sales tactic used to encourage consumers to engage in a transaction they might otherwise pass up. As reported in the Times Ledger, today’s ”Fraud of the Day” describes how a doctor in New York used false advertising to lure senior citizens into two of his clinics and then used their Medicare numbers to fraudulently bill the program for more than $15 million.

The article states the 59-year-old doctor offered free non-medical services to seniors so they could use unsuspecting victims’ Medicare numbers to bill for services that were not medically necessary or provided. (Beware of that magic word, ” free.”) Some of the ”free” services offered were recreational massages, facials, meals, prizes and social events. (It sounds more like a senior citizens’ center to me.)

In order to receive these ”free” services, the seniors had to see a doctor first. After examining a patient, one of the doctors at the clinic would then prescribe unnecessary physical therapy and bill Medicare for services that were never provided. Over a period of four-and-a-half years, the doctor and his five co-conspirators submitted approximately $16.6 million in bogus claims to Medicare. The doctor, who was licensed in three states, received about $4.5 million.

The fraudster pleaded guilty to conspiracy to commit health care fraud and was sentenced to one year and a day in prison. He was also ordered to pay $2.2 million in restitution. (What about the other $2.3 million?)

The doctor’s fraudulent scheme was described by the prosecuting attorney as operating ”…with the relentless efficiency of an assembly line.” It looks like the doctor will be spending the next year waiting in a few lines as well, but I doubt that he will be getting any free massages or prizes for his patience.

Source: Today’s ”Fraud of the Day” is based on an article titled, ”Flushing Doc Gets Year in Fraud Case,” written by Alex Robinson and published by the Times Ledger on February 7, 2014.

A Flushing doctor was sentenced to a year in prison last week after he pleaded guilty to participating in a scheme that prosecutors said fraudulently billed Medicare for more than $15 million, the U.S. attorney in Brooklyn said.

Hoi Yat Kam, 59, was charged, along with five others, of bilking Medicare for services they were not providing and were not medically necessary, according to the indictment, filed by the office of Loretta Lynch, the U.S. attorney for the Eastern District.

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Larry Benson, Senior Director of Strategic Alliances, LexisNexis Risk Solutions - Government

Larry Benson is responsible for developing strategic partnerships and solutions for the government vertical. His expertise focuses on how government programs are defrauded by criminal groups, and the approaches necessary to prevent them from succeeding.

Mr. Benson has 30 years of experience in sales and business development. Before joining LexisNexis® Risk Solutions, he spent 12 years founding and managing two software technology startups. During the 1990s he spent 10 years as a Regional Director helping to grow a New England-based technology company from 300 employees to 7,000. He started his career with Martin Marietta Aerospace working on laser guided weapons and day/night vision systems.

A sought-after speaker and accomplished writer, Mr. Benson is the principal author of “Fraud of the Day,” a website dedicated to educating government officials about how criminals are defrauding government programs. He has co-authored WTF? Where’s the Fraud? How to Unmask and Stop Identity Fraud’s Drain on Our Government, and Data Personified, How Fraud is Changing the Meaning of Identity.

Benson holds a Bachelor of Science in Physics from Albright College, and earned two graduate degrees – a Master of Business Administration from Florida Institute of Technology, and a Master of Science in Engineering from Lehigh University.