In December 2007, Etienne Allonce and his wife, Helene Michel, were indicted on charges of health care fraud. Allonce and Michel were owners of Medical Solutions Management, Inc. (MSM), a durable medical equipment (DME) company operating out of Hicksville, NY. Tri-State Surgical Supply (Tri-State) is a DME company that has a contract with numerous nursing homes in Long Island, Queens, and Brooklyn, to provide Medicare and Medicaid covered DME supplies to residents.
According to the indictment, MSM employees allegedly posed as sub-contractors for Tri-State in order to gain access to several nursing homes. Once they entered the nursing homes under false pretenses, MSM employees allegedly accessed medical charts (containing private information protected by The Health Insurance Portability and Accountability Act of 1996 or HIPAA) for residents who required specialized wound care. MSM then allegedly billed Medicare Part B and/or and Medicaid for wound care supplies that were never ordered or provided.
It is also believed that MSM employees stole original documents containing HIPAA information from medical charts in facilities, in order to "manufacture" fraudulent MSM charts in an effort to legitimize their medical billings.
After Michel and Allonce were indicted on health care fraud charges for their participation in the aforementioned scheme, Allonce fled the United States to avoid prosecution and is believed to be residing in Haiti.
In April 2013, Michel was convicted on charges of health care fraud and wrongful disclosure of individually identifiable health information. She was sentenced to 12 years of incarceration and ordered to pay more than $4.4 million in restitution.
Allonce abandoned the young daughter he had with Michel, leaving the girl without any parents while her mother remains incarcerated.
From approximately February 2004 until February 2010, Poul Thorsen executed a scheme to steal grant money awarded by the Centers for Disease Control and Prevention (CDC). CDC had awarded grant money to Denmark for research involving infant disabilities, autism, genetic disorders, and fetal alcohol syndrome. CDC awarded the grant to fund studies of the relationship between autism and the exposure to vaccines, the relationship between cerebral palsy and infection during pregnancy, and the relationship between developmental outcomes and fetal alcohol exposure.
Thorsen worked as a visiting scientist at CDC, Division of Birth Defects and Developmental Disabilities, before the grant was awarded.
The initial grant was awarded to the Danish Medical Research Council. In approximately 2007, a second grant was awarded to the Danish Agency for Science, Technology, and Innovation. Both agencies are governmental agencies in Denmark. The research was done by the Aarhaus University and Odense University Hospital in Denmark.
Thorsen allegedly diverted over $1 million of the CDC grant money to his own personal bank account. Thorsen submitted fraudulent invoices on CDC letterhead to medical facilities assisting in the research for reimbursement of work allegedly covered by the grants. The invoices were addressed to Aarhaus University and Sahlgrenska University Hospital. The fact that the invoices were on CDC letterhead made it appear that CDC was requesting the money from Aarhaus University and Sahlgrenska University Hospital although the bank account listed on the invoices belonged to Thorsen.
In April 2011, Thorsen was indicted on 22 counts of Wire Fraud and Money Laundering.
According to bank account records, Thorsen purchased a home in Atlanta, a Harley Davidson motorcycle, an Audi automobile, and a Honda SUV with funds that he received from the CDC grants.
Thorsen is currently in Denmark and is awaiting extradition to the United States.
In January 2012, Yousef Kurdy was indicted on charges of health care fraud, aggravated identity theft, receipt of kickbacks for patient referrals, income tax evasion, aiding and abetting, and criminal forfeiture. Investigators believe that Kurdy fraudulently billed Medicare and Medi-Cal over $150,000.
Kurdy is a medical doctor who owned and operated two clinics in the San Diego, California area, collectively called Broadway Medical Center. According to the indictment, he submitted and caused to be submitted claims to Medicare and Medi-Cal for medical office visits that never occurred. In fact, investigators believe that Kurdy billed for office visits on dates that he was out of town, was attending continuing medical education classes, the patients were out of town, or the patients were deceased. Kurdy also upcoded office visits (submitted claims in an inappropriately high payment category) and submitted false claims with diagnoses of medical conditions from which the beneficiaries did not suffer.
Investigators also found that Kurdy solicited and received kickbacks and bribes in return for referring patients with false prescriptions to a pharmacy. These prescriptions generated over $1 million in billings to Medicare and Medi-Cal.
In January 2012, an arrest warrant was issued for Kurdy, who indicated that he would self-surrender, but failed to show up for his initial court appearance. Consequently, he is considered a fugitive at large. Investigators believe that he may be residing in Syria.
In September 2007, Omar Decendario and his co-conspirators were indicted on charges of health care fraud, conspiracy to commit health care fraud, and false statements. According to the indictment, Decendario was involved in a scheme to defraud Medicare of more than $20 million.
Decendario was a licensed vocational nurse employed at both Sunrise Nursing Registry and Provident Home Health Care Services, Inc., both located in Los Angeles, California.
Decendario allegedly paid nurses, physical therapists, and occupational therapists to sign home health care service forms, falsely indicating that they made skilled nursing visits at the patients' homes when, in fact, they did not make the visits.
In addition, Decendario and his co-conspirators allegedly created false daily route sheets, skilled nursing notes, and other forms to make it appear as if patients were receiving skilled nursing visits. These forms allegedly were then used to bill Medicare for home health services that were never rendered or were not medically necessary.
Decendario fled the United States and is residing in the Philippines. U.S. officials are working with that country to extradite Decendario to the United States to face charges stemming from the indictment.