Showing posts with label Federal. Show all posts
Showing posts with label Federal. Show all posts

Wednesday, July 20, 2016

Grassley introduces legislation to combat senior fraud

Editor's note: Sen. Chuck Grassley could start combating financial fraud against seniors by investigating the architects of fraud, The Probate Court of Cook County.  Chuck, begin by finding out who forged and cashed Alice R. Gore's 18 annuity checks.  Needless to say, the court did not wish to look into the fraud because they are part of the crime.  Lucius Verenus, Schoolmaster, ProbateSharks.com

Grassley introduces legislation to combat senior fraud
Friday, July 15, 2016 2:45 PM

Senate Judiciary Committee Chairman Chuck Grassley has introduced comprehensive legislation to combat financial fraud against seniors. The bipartisan Elder Abuse Prevention and Prosecution Act (S. 3270) expands education, prevention and prosecution tools to reduce crimes against seniors. The bill would increase training for federal investigators and prosecutors and equips each judicial district with at least one prosecutor having expertise with elder abuse cases, and establish an elder justice coordinator within the Federal Trade Commission's Bureau of Consumer Protection, among other provisions. An estimated 6 million Americans over the age of 60 fall victim to abuse or exploitation each year, and many of those crimes go unreported. Financial crimes targeting seniors robs them of at least $2.9 billion annually.

Monday, January 11, 2016

Nursing Home Residents’ Rights


Editor's note: This Shark agrees with the rights below, but would reflect on an incident that took place at a nursing home where Alice R. Gore resided.  Alice's daughter and an elderly friend complained about Alice's bed sores and the fact that Alice's roommate was eating her lunch tray on top of her bed pan.  The manager did the only thing he could; he called the police on Alice's daughter and friend for "creating a disturbance".  So much for "residents rights". Lucius Verenus, Schoolmaster, ProbateSharks.com

Nursing Home Residents’ Rights
Federal and state nursing home regulations govern the rights of nursing home and assisted living residents. These regulations, designed to protect patients from abuse and neglect, address privacy, security and participation in care concerns. Among these regulations are the laws created by the Nursing Home Reform Act.
Congress passed the Nursing Home Reform Act in 1987 following a 1986 study finding that nursing home residents were frequently being abused and neglected. The purpose of the Nursing Home Reform Act is to make certain that all federally-funded nursing homes provide quality care and services aimed at maintaining the physical, mental and social well-being of each resident. This act makes the care of nursing home residents a matter of federal law and ensures that any violation of the standards set forth in the guidelines is considered a federal crime. The act also offers consequences and solutions to problems or violations, requires nursing homes to provide specific services, and establishes a residents’ Bill of Rights.
The Nursing Home Reform Act enacted the following rights for nursing home residents:
  1. The right to live without the fear of enduring physical restraint
  2. The right to live in a caring environment free from abuse, mistreatment and neglect
  3. The right to receive personal care that accommodates physical, medical, emotional and social needs
  4. The right to privacy
  5. The right to voice grievances without discrimination or reprisal
  6. The right to a social contact/interaction with fellow residents and family members
  7. The right to be treated with dignity
  8. The right to exercise self-determination
  9. The right to exercise freedom of speech and communicate freely
  10. The right to participate in the creation and review of one’s individualized care plan
  11. The right to be fully informed in advance of any changes to care plan or status of the nursing home

Wednesday, August 27, 2014

Protect seniors from abuse with a federal system

Protect seniors from abuse with a federal system

August 10
The Aug. 4 Metro article “In Va., a cautionary tale for seniors ” talked about elderly abuse and fraud, a scenario that is all too common. And it will continue to be, as long as there is no coordinated, federally funded system in place to prevent it.
Congress has established and funded national networks to protect children — and even animals — from abuse, but no similar system exists to protect vulnerable adults. It’s time for Congress to prioritize the health and safety of all Americans, regardless of age.
Nearly 5 million seniors are victims of abuse, neglect or exploitation each year. Direct medical costs associated with elder abuse exceed $5 billion annually, and older victims of financial abuse, such as Pearl Buckley, the woman in the story, lose an estimated $2.9 billion each year.
Vulnerable adults deserve the same protections our society affords their pets and grandchildren. We must call upon Congress to make this a reality by fully funding the bipartisan Elder Justice Act, which it passed in 2010 but has yet to fund.
The system failed Ms. Buckley. Don’t let it fail anyone else.
Martha Roherty, Washington
The writer is the executive director of the National Association of States United for Aging and Disabilities.

Monday, July 14, 2014

Lawyers still unraveling the case of the thieving conservator

Lawyers still unraveling the case of the thieving conservator

  • Article by: JAMES ELI SHIFFER , Star Tribune
  • Updated: July 12, 2014 - 4:00 PM

Five lawyers, their meters running, sat down in a Hennepin County courtroom last Thursday. The task at hand: Sorting through the mess left behind by the collapse of Alternate Decision Makers Inc., a company entrusted with the lives and money of dozens of vulnerable adults.
In June 2013, the company’s lawyer and staff confronted the founder and president, Stephen Grisham, with evidence that he had stolen from a veteran under his supervision. Grisham stepped down and gave up his caseload, becoming the latest in a shameful line of court-appointed guardians and conservators caught abusing their largely unregulated powers.
The year since then has been a swirl of investigations, audits and court hearings. More signs of wrongdoing by Grisham emerged. A necklace that belonged to the estate of a deceased Minneapolis woman was sold for $1,500. Another woman lost nearly $16,000 in Krugerrands, the famous gold coins from South Africa.
Federal charge
 
After an investigation by the Department of Veterans Affairs, Grisham was charged last month with a federal count of misappropriation by a fiduciary. He faces up to five years in prison. It’s a stunning fall for a man whom judges enlisted for years to manage the affairs of victims or potential victims of financial exploitation. When people become incapacitated by Alzheimer’s, mental illness, substance abuse or other conditions, judges frequently choose guardians to make decisions about health care and living arrangements and conservators to control their finances.
After other guardians and conservators went bad in recent years, the state court system has improved its oversight of these professionals. Yet it was Grisham’s own employees who discovered their boss’s misdeeds.
Grisham was not in the courtroom last week, and his lawyers said he would have no comment. But his name was on everyone’s lips Thursday. “Mr. Grisham takes these matters very seriously,” said his attorney, Michael O’Neill. O’Neill told the probate referee that Grisham acknowledged the additional “wrongdoing” involving the Krugerrands and the necklace.
The owner of the missing coins, Helen Durand, sat in the front row of the gallery, her head tilted back, a slight smile on her face. For an hour, she listened to expressions of concern about Grisham’s malfeasance. Yet most of the arguing was about who would pay legal fees, which is a very popular conversation topic in this courthouse, and every other one, for that matter.
Robert McLeod, a lawyer for Alternate Decision Makers, said the company is “effectively dead.” Yet he wants a bonding company to pay at least $90,000 in legal and accounting fees that were expended to detect an estimated $100,000 in missing assets.
Grisham’s confession last year set off a scramble by the company to change locks, safe combinations and passwords, to find other conservators and guardians who could take over Grisham’s cases and to hunt for clues to additional thefts by Grisham.
 
“We acted as if he stole from every file,” McLeod said. If the company had not investigated, “the concern was that he would have continued stealing.”
Probate referee
But the bonding company’s lawyer, Robert Kuderer, said the company should not be rewarded for cleaning up a problem of its own creation. He jabbed a sheaf of legal papers in McLeod’s direction.
“They stole. They’re bad actors, and they can’t divorce themselves from Grisham,” Kuderer said. “They are one and the same for the purposes of malfeasance.”
The probate referee, George Borer, commended McLeod for doing such a thorough investigation. He called the question a “tough one” and said he would issue a ruling later this summer.
After Thursday’s hearing, Durand walked out of the courtroom. For all the heated talk about who’s going to pay for what, she still has hope “that justice would be done.”
You can bet that the legal bills in the Grisham affair will add up to plenty of Krugerrands before that happens.

Contact James Eli Shiffer at james.shiffer@startribune.com or 612-673-4116. Read his blog at startribune.com/fulldisclosure.

Tuesday, July 8, 2014

Former conservator faces federal theft charge

Former conservator faces federal theft charge
Posted by: James Eli Shiffer Updated: July 2, 2014 - 12:54 PM
As a guardian and conservator, Stephen Grisham managed the finances and lives of hundreds of Minnesotans deemed incapacitated by a judge. Now Grisham is the latest of these court-appointed caretakers to face a criminal charge after the authorities say he embezzled from vulnerable adults under his supervision.
The company founded in 2000 by Grisham, Alternate Decision Makers Inc., handled at least 293 cases before he stepped down last summer in the face of the theft allegations. Grisham was charged with "misappropriation by a fiduciary" via "criminal information," which is filed in anticipation of a plea deal, The document indicates the embezzlement happened between January 2012 and December 2013, and that Grisham violated laws of the Department of Veterans Affairs governing his role as a fiduciary for "veterans, beneficiaries, and other individuals who were deemed incompetent or were incapable of handling their financial affairs." 
An attorney for Grisham declined to comment Wednesday. A plea hearing has not been scheduled. If convicted, Grisham faces up to five years in prison.
I spent several years investigating misconduct by guardians and conservators - the Star Tribune's coverage is archived here. Lawmakers have tightened scrutiny of these professionals, and as of last summer, they must register with the court system. You can search the registry here.

Friday, June 20, 2014

Former Bexar Co. judge indicted on bribery, extortion, fraud charges

Editor's note: Your ProbateShark believes that some Probate Court of Cook County judges should be wearing the orange outfits.  Lucius Verenus, Schoolmaster, ProbateSharks.com


Former Bexar Co. judge indicted on bribery, extortion, fraud charges

by Kens5.com
KENS 5
Posted on June 19, 2014 at 4:52 PM
Updated yesterday at 6:13 PM

 SAN ANTONIO -- A 15-count indictment filed against a former Bexar County judge alleges the judge engaged in a scheme to defraud citizens of their right to his honest services.

The court document was filed Wednesday afternoon. It charges 50-year-old Angus Kelly McGinty with one count of conspiracy to commit federal bribery, one count of bribery, one count of extortion and 12 counts of honest services wire fraud.

The indictment alleges McGinty solicited and accepted bribes from San Antonio lawyer Alberto Acevedo, Jr. over a nine-month period in 2013.

In the scheme, McGinty reportedly received gifts, services and payments from Acevedo that totaled more than $6,655, according to the indictment. In exchange, McGinty would return favorable rulings for Acevedo’s clients, including "lenient sentences and less restrictive conditions of release."
Sources outside the courthouse said McGinty swapped with Acevedo, giving the attorney bond reductions on his cases in exchange for auto repair work on the judge’s vehicles.

“The outcome of criminal cases should be determined by the evidence and the law, not by paid-for bias.  When citizens cannot have faith in the very people who are sworn to uphold the law, confidence in our judicial system is shaken," said U.S. Attorney Damon P. Martinez. "The Justice Department is committed to restoring that faith by rooting out corruption wherever it may be found.”

McGinty resigned on Feb. 14, 2014, a month before Acevedo plead guilty to bribery. In his plea, Acevedo admitted he engaged in corruption by influencing McGinty with things of value. He is currently out on bond and awaiting his sentencing hearing.

If convicted, McGinty faces a statutory maximum penalty of 20 years in federal prison and a $250,000 fine.

Wednesday, June 4, 2014

Kids for cash developer reports to prison

Kids for cash developer reports to prison



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Robert K. Mericle, convicted developer involved in the so-called Kids-for-Cash case, leaves the William J. Federal Building and U.S. Courthouse after being sentenced to a year in prison. Mr. Mericle previously pleaded guilty to a felony charge of withholding information on a crime. Michael J. Mullen / Staff Photographer
Kids-for-cash developer Robert K. Mericle may be a multimillionaire, but his spending power in the prison commissary will be the same as everyone else: a maximum $160 every two weeks.
Mr. Mericle on Monday morning reported to a prison camp on the grounds of Federal Correctional Institution at Schuylkill, interrupting his life of privilege to begin a one-year jail stint that subjects him to a strict list of rules.
If Mr. Mericle, Inmate No. 15135-067, intends to remain in control of his real estate empire, he’s allowed business associates as visitors but is forbidden from conducting business by telephone, according to a copy of the prison’s rules and regulations handbook.
A federal judge in April sentenced Mr. Mericle to one year in prison for concealing information from federal agents investigating two Luzerne County judges, Mark A. Ciavarella Jr. and Michael T. Conahan, in the infamous kids-for-cash scandal. The 51-year-old’s federal crime stems from his paying $2.1 million to the judges who were accused of conspiring to shutter a county-run juvenile detention center and sending scores of juveniles to two facilities built by Mr. Mericle’s construction firm.
Mr. Mericle will live around, work with and serve time with about 300 other inmates at the minimum security camp, which consists of two dormitory-style housing units, an administration building, and athletic fields surrounded by woods, rather than fencing or barbed wire. The prison camp is part of the campus of Federal Correctional Institution at Schuylkill, but is isolated from the secured, medium-security main prison next door that houses about 1,375 inmates.
The prison is 62 miles from Mr. Mericle’s home in Jackson Twp., making visits from friends and relatives much more convenient than if he had been sent far away.
Mr. Mericle pleaded guilty on Sept. 2, 2009, to failing to disclose to federal investigators and a grand jury that he knew the judges were defrauding the United States by lying about the money on their taxes. However, his sentencing was postponed for years because he was supposed to be the key witness in the corruption trial of former state Sen. Raphael Musto, who was declared not competent to stand trial early this year and then died in April a day before Mr. Mericle’s sentencing.
At Mericle’s sentencing, U.S. District Judge Edwin Kosik told Mericle he was guilty of “very serious criminal conduct” and needs to be punished accordingly.
Mr. Mericle will spend the entire year in federal custody because inmates sentenced to one year or less in the federal system are not eligible for good conduct time.
 
Contact the writer:
bkalinowski@citizensvoice.com, @cvbobkal on Twitter

Friday, March 28, 2014

Ex-conservator's control over couple fed 'evil desires'

Ex-conservator's control over couple fed 'evil desires'

SHARECOMMENTMORE
Citing "the horrific abuse of power and misuse of trust by a court-appointed conservator," a federal judge in Nashville has awarded nearly $700,000 to a mentally disabled Clay County couple victimized by sexual and financial abuse for more than six years.
In a 12-page order issued Tuesday, U.S. District Judge Kevin H. Sharp ordered Walter M. Strong of Celina to reimburse the couple for money he misappropriated and to pay damages to the wife for sexual battery charges.
Sharp cited testimony that Strong, 77, promised the woman candy or something from the store in return for sex.
"Defendant had complete control over plaintiffs' lives and their money and he used that control for his own needs and evil desires," Sharp wrote.
Strong already had pleaded guilty to theft and sexual battery charges and served nine months of a 385-day prison sentence before being released in October. He is on probation and has been ordered to pay restitution of $105,480 in the criminal case.
The case first came to light last year as the state General Assembly was considering a series of reforms in the state conservatorship laws. Those changes, including provisions to provide additional protections to wards, were approved and went into effect July 1.
As Sharp noted, Strong appeared as his own attorney and offered little or no defense to the charges, though he did dispute some of the claims of how he had used the couple's funds.
"Defendant utilized plaintiffs' funds as if they were his own," Sharp wrote, adding that Srong coerced the wife into performing sexual acts and required the husband "to provide labor and services without remuneration."
Court records in Clay County show that the couple were placed in a conservatorship in 2004 by a Clay County judge. Strong was removed as the conservator on July 5, 2011, after state officials, tipped by a neighbor to the abuse, filed an emergency petition with the court.
Kelly Tayes, who operates a conservatorship business, was then named to replace Strong.
Tayes testified in the civil suit she filed on the couple's behalf that the sexual abuse was "the most horrific" she had seen in 18 years of acting as a conservator.
How much money the couple will collect remains unclear. Sharp, in his ruling, noted Strong's limited resources: a pension from the state of Pennsylvania, five acres of land assessed at $38,000 and a pickup truck worth $37,000 but with a $12,000 outstanding lien.
Sharp wrote that the husband was forced to provide free labor for Strong. That work included tending a large garden and feeding the conservator's cattle. He noted violations of the federal law and the state Adult Protection Act. Sharp did reduce the award for the forced labor performed by the husband from a requested $64,800 to $25,000, stating that the record did not make clear exactly how many hours the husband had worked.
The couple's attorney, Craig Fickling Jr. of Cookeville, was awarded $10,000 in legal fees even though he had agreed to drop the claim.
$105,000 on meals
Sharp wrote that some of Strong's explanations for his actions would border on the laughable were they not so serious. For example, he noted that Strong spent $105,000 of the couple's money on restaurant tabs, plus additional payments from their assets for the purchases of a tractor, bedroom set and cattle feed.
He said Strong's claims that the couple benefited from those purchases defied credulity.
"The couple," he wrote, "lived in a filthy and dilapidated trailer that they were purchasing from the defendant."
Tayes said she was pleased with the ruling and plans to meet with the couple, now living in the Cookeville area, to read and explain it to them.
She said the wife has been "doing better" though she is still troubled by what has happened to her.
Contact Walter F. Roche Jr. at 615-259-8086.

Thursday, March 6, 2014

U.S. Supreme Court won't hear Ciavarella appeal

Editor's note: This Shark believes that the judges of the Probate Court of Cook County should take heed. Lucius Verenus, Schoolmaster, ProbateSharks.com

 

U.S. Supreme Court won't hear Ciavarella appeal



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Former Luzerne County Judge Mark Ciavarella is serving a lengthy prison term in connection with the kids-for-cash scandal. Also incarcerated is former judge Michael T. Conahan. Michael J. Mullen / TIMES-SHAMROCK

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The U.S. Supreme Court has declined to hear the appeal of former Luzerne County Judge Mark A. Ciavarella Jr., according to an order posted Monday morning on the high court’s website.

Ciavarella, jailed for 28 years on corruption charges, has now exhausted all his appeals options. The only thing he and his attorneys can do now is ask the Supreme Court to reconsider its decision, something his attorneys don't plan to do.
ARCHIVE: Stories, documents, videos from Ciavarella's trial

The ex-judge’s appeal was a long shot and denial was likely, Ciavarella’s attorneys previously said, since the Supreme Court only hears about 75 of the 10,000 cases each year it is asked to consider.
The court did not give a reason for denying the appeal. Ciavarella case was just listed under a heading of "CERTIORARI DENIED."
“Are we disappointed? Sure we are. But we understand the Supreme Court takes very few cases in the course of the year,” said attorney Al Flora Jr., who represented Ciavarella along with attorney William Ruzzo. “I know it’s very difficult to get cases before the court. We gave it our best effort, and that’s all that could be expected.”
 
Flora said he sent Ciavarella an email notifying him of the decision. Ciavarella remains jailed at Federal Correctional Institution at Pekin, a medium security facility in Pekin, Ill. 
 
U.S. Attorney Peter J. Smith, whose office prosecuted Ciavarella, said the U.S. Supreme Court's denial of the ex-judge’s appeal validated a solid prosecution.
 
“We’re very pleased with the Supreme Court decision not to hear his appeal. We thought his case was very well presented and the outcome was appropriate,” Smith said in a telephone call Monday afternoon.
 
“This was a terrible experience for Luzerne County and the community, but we think the outcome as far as the verdict, sentence and outcome of the appeal are appropriate under all the circumstances.”
 
While Ciavarella’s direct appeals are over, he can still mount post-conviction appeals with the U.S. District Court, which heard his trial in 2011, Flora said.
 
But he’d likely be doing so with new attorneys, Flora said.
 
“For all practical purposes, in terms of filling our obligation, our obligation is complete,” Flora said. “Billy Ruzzo and I did our best to advocate on his behalf. That’s why we stayed on this case from the beginning.’’ 
 
A jury convicted Ciavarella in February 2011 on 12 of 39 counts, including racketeering and conspiracy, on allegations he conspired with a former colleague to shutter a county-run juvenile detention center and funnel youths to for-profit detention centers while accepting cash payments.
Ciavarella, 63, and former judge Michael T. Conahan were accused of failing to report $2.1 million paid by Robert K. Mericle, whose construction company built the detention centers in Pittston Township and Butler County, and accused of taking $770,000 in kickbacks from attorney Robert Powell, who co-owned the facilities.

The rules of the Supreme Court detail what happens when it declines to hear an appeal or, as it's legally known, denies a writ of certiorari:

“Whenever the Court denies a petition for a writ of cer­tiorari, the Clerk will prepare, sign, and enter an order to that effect and will notify forthwith counsel of record and the court whose judgment was sought to be reviewed,” the rules say. “The order of denial will not be suspended pending disposition of a petition for rehearing except by order of the Court or a Justice.”

After Ciavarella was convicted at trial in federal court in Scranton, he appealed to the U.S. Third Circuit Court of Appeals. The appeals court declined to overturn the ex-judge’s conviction or sentence in May 2013. Attorneys for the disgraced judge appealed to the nation’s highest court in October.

In a 32-page document filed with the Supreme Court, Ciavarella’s attorneys had listed three reasons why the justices should hear Ciavarella’s case:

> U.S. District Court Judge Edwin M. Kosik, who rejected Ciavarella’s initial plea agreement that called for an 87-month prison sentence and later hammered him with 28 years after a trial, was biased toward Ciavarella as evidenced in letters he wrote to citizens and comments he made to a reporter.

> Ciavarella’s racketeering convictions all relate to a single January 2003 payment by Mericle, which fell outside of the five-year statute of limitation. The attorneys say U.S. District Court and the U.S. Third Circuit Court of Appeals, both of which rejected past appeals on the matter, erred in ruling Ciavarella waived this as an appellate issue because it wasn’t addressed at trial.

> Although a jury acquitted Ciavarella on a majority of the charges, Kosik considered all the alleged crimes for sentencing purposes by using the “preponderance of the evidence” threshold, which doubled the sentencing guidelines Kosik used to form Ciavarella’s punishment.

The Supreme Court’s decision, effectively cementing the fate of Ciavarella, comes at a time a movie about the judicial scandal “Kids for Cash” opens in theatres around the nation.
Ciavarella's projected release date is Dec. 30, 2035, according to the Federal Bureau of Prisons website.
“The consequences for the defendant in this case were severe, but his crimes were severe and the impact on Luzerne County was severe,” Smith said.
After Ciavarella was first charged in January 2009, federal prosecutors continued an ongoing public corruption probe that snared more than 30 people, most of them elected officials. Smith said he hopes all the prosecutions, including Ciavarella’s, made a difference in the community and helped deter corruption.
 
“We’re always going to hopefully be able to pursue any allegations of corruption. And that’s going to continue,” Smith said. “If there is any change for the better as a result of this case, that will be one good outcome.”
 
Smith said his office worked closely with the U.S. Solicitor General’s Office to file a response after Ciavarella’s attorney filed an application for an appeal with the Supreme Court.
 
“We're happy the government prevailed,” Smith said. “The trial team and investigators worked long and hard on this case.”
 
Since Ciavarella could file post-conviction appeals with lower courts regarding different issues, Smith was reluctant to say the case is over.
 
“It’s probably premature to say this is the end,” Smith said. “But we’re pleased with the outcome.”
 
bkalinowski@citizensvoice.com, 570-821-2055 @cvbobkal
 
CIAVARELLA TIMELINE
 
November 1995: Ciavarella first elected to the Luzerne County bench.
January 2002: Ciavarella named juvenile court judge by President Judge Michael T. Conahan.
Oct. 9, 2002: Conahan announces closing of county-owned juvenile detention center.
January 2003: First $1 million payment to Ciavarella and Conahan from Robert K. Mericle, builder of a private juvenile detention center, PA Child Care center, in Pittston Township.
Feb. 5, 2003: County begins placing juveniles in PA Child Care center.
January 2004: PA Child Care co-owner Robert J. Powell makes first of $770,000 in payments to judges.
July 2005: Second $1 million payment from Mericle after a second juvenile detention center is built in western Pennsylvania.
January 2006: Ciavarella elected president judge by his peers.
May 2008: Amid criticisms of his practices and investigation, Ciavarella removes self as juvenile court judge.
May 29, 2008: A Citizens Voice’ investigation reveals financial interest between judges and Powell in Mountain Top housing project.
Jan. 26, 2009: Ciavarella and Conahan charged, agree to plead guilty and serve 87 months.
March 12, 2009: Ciavarella resigns from the bench. Conahan had already retired.
July 31, 2009: Federal judge rejects the plea agreements.
Sept. 9, 2009: Grand jury indicts the former judges on 48 counts.
July 23, 2010: Conahan pleads guilty.
Feb. 18, 2011: A jury finds Ciavarella guilty of racketeering and other charges.
Aug. 11, 2011: Ciavarella sentenced to 28 years in federal prison.
Sept. 23, 2011: Conahan sentenced to 17½ years in federal prison.
May 24, 2013: Federal appeals court upholds Ciavarella’s conviction and sentence.
Oct. 28, 2013: Ciavarella files appeal with U.S. Supreme Court
March 3, 2014: U.S. Supreme Court declines to hear Ciavarella appeal

Wednesday, March 5, 2014

Biggest Medicare Fraud in History Busted, Say Feds

Biggest Medicare Fraud in History Busted, Say Feds

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Federal officials say they have taken down the largest Medicare fraud scheme investigators have ever discovered: a $375 million dollar home healthcare scam operating in the Dallas, Texas area.
The alleged "mastermind" of the fraud, Dr. Jacques Roy, is charged with certifying hundreds of fraudulent claims for Medicare reimbursement, and pocketing millions in payments for services not needed, or never delivered. Prosecutors say the 54-year-old Dr. Roy, who was arrested today and could be sentenced to life in prison, operated a "boiler room" to churn out thousands of phony Medicare claims and recruited homeless people as fake patients.
"Today, the Medicare Fraud Strike Force is taking aim at the largest alleged home health fraud scheme ever committed," said Assistant Attorney General Lanny Breuer. "According to the indictment, Dr. Roy and his co-conspirators, for years, ran a well-oiled fraudulent enterprise in the Dallas area, making millions by recruiting thousands of patients for unnecessary services, and billing Medicare for those services."
The government charges that Dr. Roy was planning to take the money and run. He allegedly hid much of his Medicare money in an offshore account in the Cayman Islands, and in documents filed in court today, the government charges that Dr. Roy was planning to change his identity and flee the country to avoid prosecution. In a motion opposing bail for Dr. Roy, prosecutors claim that he had created a false Canadian identity under the name Michel Poulin, had a copy of a book called "Hide Your A$$ET$ and Disappear," and a guide to yacht registration in the Caymans.
Dr. Roy's scam was clever, wide-ranging, and very, very profitable, according to prosecutors. He allegedly exploited the Medicare regulation that requires a doctor to "certify" that Medicare services are legitimate – that they are needed and are being delivered to the patient. Dr. Roy allegedly sold his certification as "a commodity" to nearly 500 home health care companies in Texas, certifying patients for Medicare services regardless of whether they needed them or received them. In return, the government charges, Dr. Roy would receive a portion of the fraudulent Medicare payment.
Between 2006 and 2011, according to the 13-count indictment unsealed today, Dr. Roy certified more Medicare beneficiaries for home health services and had more patients, than any other medical practice in the United States. He allegedly even had a "boiler room" where employees worked all day signing his name on Medicare claims. Roy's company, Medistat Group and Associates, received hundreds of claims per day, and Dr. Roy allegedly instructed employees in the company's "485 Department," named for the "Plan of Care" form, to sign his name by hand or affix his electronic signature. Since 2006, according to prosecutors, Medistat Group and Associates has "certified more than 11,000 unique patients from over 500 home healthcare agencies in the Dallas-Fort Worth area." Medistat and the home health care agencies billed Medicare for more than $350 million and Medicaid for more than $24 million for these patients.

Homeless 'Patients' Recruited in Alleged Medicare Fraud

Seventy-eight companies associated with Dr. Roy will have their Medicare eligibility suspended immediately as a result of this indictment, the Justice Department says, and six associates of Dr. Roy's alleged scheme were also charged as co-conspirators. Operating under the company names Apple of Your Eye, Ultimate Care and Charry Home Care, among others, the associates allegedly fed a steady stream of fraudulent clients to Dr. Roy to be certified as Medicare eligible. In some cases, the indictment charges, Medicare patients were recruited by offering cash and groceries in return for signing up for home health care. These fraudulent "patients" were then allegedly certified by Dr. Roy for services. Some of those recruits didn't even have a home to visit, according to sources close to the investigation: they were recruited from homeless shelters.
For example, the indictment charges that Charity Eleda of Charry Home Health services "visited The Bridge Homeless Shelter" in Dallas to recruit Medicare patients. She allegedly sat in a parked vehicle outside the shelter, and hired recruiters to send prospects to her car. She allegedly paid the recruiters $50 per new "patient." "Any treatment that Charity Eleda provided was either in her vehicle, in the courtyard of the Bridge, or on a park bench," said the indictment.
Dr. Roy's business manager, identified in the indictment as J.A., allegedly recorded phone calls with Dr. Roy in which he objected to working with the coconspirators to drum up phony business, and suggested that the company "invest in legitimate marketing" to attract business instead. According to the indictment, Dr. Roy responded, "I've done enough marketing to know it's b___sh__, and I don't want to do it."
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Federal sources say investigators have been looking into Dr. Roy's operation for years, and he was suspended from the Medicare program in 2011. But according to documents filed today, Dr. Roy found a way around the suspension by creating a new company, "Medcare HouseCalls," and working through his associated companies.
Last summer, investigators searched his home and found evidence that Dr. Roy had stashed some of money he alleged stole from Medicare in a secret account in the Cayman Islands. There was also evidence that Dr. Roy had created a false identity for himself -- he had a fake driver's license and a birth certificate in the name of Michel Poulin, and applications for Canadian citizenship. Investigators also found bank deposit slips from Cayman Island banks, a guide to yacht registration in the Caymans, a book titled "Hide Your A$$et$ and Disappear: A Step by Step Guide to Vanishing Without A Trace," and a copy of "The Offshore Money Manual."

Thursday, February 13, 2014

Hopes dim for lawyer's victims who lost more than $1 million

Hopes dim for lawyer's victims who lost more than $1 million

Feb. 10, 2014   |  
4 Comments
John Clemmons waits outside Metro booking to turn himself in last November. Clemmons pleaded guilty to stealing thousands from wards he had been assigned to protect. / John Partipilo / File / The Tennessean

What’s next?

John E. Clemmons is serving an 18-year sentence in state prison.

Bond insurance has provided partial reimbursement in three cases Clemmons handled. If a judge rules that Clemmons violated the terms of his insurance policy, no payments would be made to his victims.

He still faces the prospect of judgments in two other cases. involving Donald E. Griggs and William C. Link.
The insurance company that provided malpractice coverage to jailed Nashville attorney John E. Clemmons is asking a federal judge to declare they have no responsibility to help pay back his victims who lost more than $1 million.
If the judge agrees, the amount Clemmons’ victims would receive could be smaller than expected.
In a suit filed last week in U.S. District Court in Nashville, lawyers for the Hanover Insurance Company stated that Clemmons’ policy does not apply in cases where he broke the law. Clemmons pled guilty in Davidson and Rutherford counties to theft from his clients.
Clemmons is currently serving an 18-year prison sentence at the state prison at the Charles B. Bass Correctional Complex in Nashville.
In its complaint, the insurance company cited several provisions of the policy they say Clemmons violated, including “any intentional, dishonest, criminal, malicious or fraudulent act or omission.”
The suit cites pending legal actions against Clemmons in three Davidson County cases, his guilty pleas to theft charges and the suspension of his license to practice law.
“Clemmons admitted his misappropriation,” the suit states.
Though the move by the insurance company was not unexpected, one of the lawyers who now represents some of the victims says he is concerned that some may never be fully repaid. The malpractice policy could have provided an estimated $300,000.
“I’m worried about it,” said Paul Gontarek, who was appointed to take over some of the cases by Probate Judge David “Randy” Kennedy.
An even grimmer assessment came from Michael Hoskins, who represents the heirs of another former Clemmons client.
“The estate’s prospects for a full recovery are bleak because Clemmons apparently blew all the money financing his lavish and reckless lifestyle,” Hoskins said in an email response to questions.
Prosecutors in the Clemmons criminal cases have stated that Clemmons spent his clients’ money on gambling at casinos in a number of states.
Court records show that bond insurance that Clemmons was required to purchase has provided at least partial reimbursement in three of the cases including the one being handled by Hoskins.
The victim in Rutherford County, Russell Church, has been repaid all that he was owed, a little over $120,000, according to court officials. Church’s was the first case to become public.
Gontarek said his next step will be to get judgments against Clemmons in the cases of Donald E. Griggs and William C. Link.
“Then we’ll attempt to recover from him personally,” said Gontarek.
The victims also can collect from the Tennessee Lawyers Fund for Client Protection, but the maximum amount that can be claimed for any one attorney, regardless of how many victims there are, is $250,000.
Contact Walter F. Roche Jr at 615-259-8086