Articles Tagged with fraud

 
A New Jersey man is facing fraud charges after a federal grand jury agreed he took advantage of senior citizens. The man is accused of operating a nonprofit with the intention of defrauding people with unnecessary tests. According to Tapinto.net, Seth Rehfuss, 43, of Somerset NJ, used a nonprofit agency called Good Samaritans of America to commit “health care fraud and conspiracy to wrongfully access individually identifiable health information and to pay illegal remunerations to health care professionals.” The fraud lasted from July 2014 through December 2015, while he managed to deceive low-income seniors. The victims were told Good Samaritans of America was a nonprofit that helps seniors understand the federal benefit programs. But, the article says, the organization was a fraud. He actually used the nonprofit to scare victims into genetic testing. The indictment says Rehfuss used fear-based tactics by suggesting the seniors could be at risk for heart attacks, strokes, or cancer and even suicide if they did not have the genetic testing. He told them he was offering “personalized medicine.”

The article says that Rehfuss took DNA swabs from senior citizens in their homes and community rooms during fear-based presentations designed to get their personal information. He apparently tried to recruit healthcare providers on Craigslist. Once they signed a contract the healthcare providers received requisition forms that often included a patient’s personal information, Medicare information, medication lists, and diagnosis codes. The healthcare providers that choose to cooperate were paid to sign-off on requisition forms authorizing testing for patients “they never examined”.

The fraudulent scheme racked up over $1 million in Medicare costs at two laboratories. He also shared his commissions with a co-conspirator, Sheila Kahl. Together authorities say they were planning to expand to Georgia, Delaware, Virginia, Maryland, Pennsylvania, South Carolina, Michigan, Mississippi, Florida, Tennessee, and Arizona. The healthcare fraud conspiracy means he could be put away for a decade and pay a $250,000 fine, or twice the gross gain or loss from the offense. The conspiracy charge carries a possible 5-year sentence and a $250,000 fine, or twice the gross gain or loss from the offense. His co-conspirator, Sheila Kahl pleaded guilty and is awaiting sentencing.

1-1-300x198Upcoding In The ER Could Be Stealing U.S. Tax Dollars

It’s an old and shady practice that has been in the forefront of Medicare and Medicaid fraud for years. Upcoding can hit taxpayers hard and drive emergency room bills to the thousands.

What is Upcoding?

briberyFCPA is Being Encouraged to Fight Foreign Bribery

The US Justice Department is apparently bulking up its anti-foreign bribery program.  According to HETQ, the US plans to expand benefits for companies who report on any acts of foreign bribery their employees may have committed.  Deputy Attorney General Rod Rosenstein announced the new policy at the 34th International Conference on the FCPA in Maryland.

The FCPA

Kobe SteelKobe Steel Admits to Falsifying Data in Another Blow to Japanese Businesses

Kobe, in Japan, is most well-known internationally for its luxury beef industry.  But now the name of the port city may be marred in scandal.  The Economist reports that Kobe Steel has admitted to falsifying data regarding its aluminum, copper and steel products.  Kobe Steel is one of the oldest industrial firms in all of Japan and 3 days after the bombshell admission its stock had fallen by $1.6 billion.

The False Data

A very common corporate scheme to save taxes and avoid having to pay benefits is when companies classify employees as independent contractors and issue a 1099. This is tax fraud clear and simple and has opened up a potential for whistleblowers with specific information about their company misclassifying full time employees as independent contractors to reveal that tax fraud and receive a large reward for doing so. The tax liability must exceed $2 million dollars and the proof available must be substantial and easy to follow. In addition, the matter must be reported in the right way and not revealed to the media or others. Executives, inside accountants or senior managers should also be aware that the government is now investigating these issues and it is better to report the matter than be the subject of a criminal investigation.

HOW TO KNOW THE DIFFERENCE BETWEEN AN EMPLOYEE AND INDEPENDENT CONTRACTOR

If a person is on an employer’s payroll and receives a steady paycheck, the person is likely an employee. If a person supplies their own tools, equipment and material and the worker controls their own hours they are generally considered independent contractors. The employer’s tax liability is determined by the worker’s employment status. With employees, employers must pay state and federal unemployment tax, social security tax and workers compensation tax. When a person is an independent contractor, the hiring company is not required to make any such payments.