Drug Topics - March 10, 2008 - (Page 92) 92 DRUG TOPICS MARCH 10, 2008 www.drugtopics.com VIEWPOINT Kenneth Hines and Daniel Wardlaw (from l. to r.) The wrong prescription for growing your income here are a few things in life that we all know can negatively affect our future, such as cheating on your income taxes or kicking a sleeping grizzly bear. The consequences of both can be devastating. One would think that trying to defraud Medicaid, a federal crime, would fall into that same category. Yet, there are health providers out there who have no reservations about fleecing Medicaid. Medicaid was not designed as a source of income for conmen. When crooks try to bilk Medicaid, law enforcement will step in – every time. So please read these words of caution in the spirit in which they are intended – as a humble reminder against committing any kind of healthcare fraud. An ounce of prevention is still worth a pound of cure. T An example from the public record Quoting from a November 26, 2007, U.S. Attorney’s Office press release, “Alexander D. Milman, 47, of Kirkland, Washington, was sentenced today in U.S. District Court in Seattle to 63 months in prison, three years of supervised release and $1,694,241 in restitution for Conspiracy to Commit Health Care Fraud . . . Milman owned A-Z Pharmacy with locations in Bellevue, Kent, and Tacoma, (Washington) and was the secret owner of Lakeshore Pharmacy in Kirkland. The restitution amount is the amount paid by Medicaid for fraudulent bills submitted by Milman’s Pharmacies . . .” “. . . Milman and his wife, Valentina M. Milman, 40, recruited Medicaid patients to use their Pharmacy by offering gift certificates for pharmacy goods. The Milmans then created false records, including physician prescriptions and delivery receipts so that they could bill the government’s Medicaid program for drugs and medical supplies that were never delivered. The Milmans billed Medicaid for more than $1.7 million in medical supplies and prescription drugs that were never delivered to Medicaid patients. When the Medicaid program suspended the Milmans’ ability to bill Medicaid in November of 2004, the couple entered into a conspiracy with Oleg Ordinartsev, 38, and Vladimir Mitkovetski, 49, to hide their involvement with Lakeshore Pharmacy in Kirkland, Washington. Valentina Milman acted as the pharmacist at Lakeshore and Alexander Milman had an ownership interest in the pharmacy. The pharmacy submitted more than $200,000 in bills to Medicaid after the pharmacy had fraudulently obtained its Medicaid provider number.” “The three others involved in the scheme have already pleaded guilty. One of the co-conspirators, Oleg Ordinartsev, admitted in his plea agreement that he submitted false paperwork to Medicaid hiding Milman’s ownership role. Ordinartsev pleaded guilty to Conspiracy to Commit Health Care Fraud on July 6, 2007. Vladimir Mitkovetski admits in his plea agreement that he lied to government investigators, claiming he was the sole owner of Lakeshore Pharmacy and that he was simply purchasing equipment from Milman. Under Milman ’s direction, Mitkovetski created false paperwork to hide Milman’s ownership of Lakeshore Pharmacy. Mitkovetski pleaded guilty to making a false statement on June 19, 2007. Valentina Milman pleaded guilty to Conspiracy to Commit Health Care Fraud and Conspiracy to Launder Money on December 7, 2006.” IRS Criminal Investigation’s role IRS Criminal Investigation is probably best known for investigating income tax evasion. However, our rather unique ability in “following the money” can also be applied when investigating other types of white collar fraud, such as healthcare fraud. We generally investigate these crimes side by side with other federal, state, and local law enforcement agencies. Such was the case in the Milman investigation where our special agent worked with investigators from the U.S. Health & Human Services—Office of Inspector General and other agencies. During the 2005 through 2007 fiscal years, our agency initiated over 12,300 criminal investigations nationwide. In those same three fiscal years, over 200 people nationwide were sentenced for various crimes related to healthcare fraud, which IRS helped investigate. The average sentence for those 200+ individuals was approximately 35 months of incarceration, which is defined as federal prison, time spent in a halfway house, home detention, or some combination thereof. Restitution in the amount of the fraud is required as a matter of law. Healthcare fraud, in any form, hurts real people. So please don’t let yourself be tempted by making a fast buck through such means, because you just might be kicking your local IRS special agent into action. KENNETH HINES is the west. DANIEL WARDLAW IRS Special Agent in Charge of the Pacific-Northis an IRS Special Agent and Public Information Officer for the Pacific-Northwest. http://www.drugtopics.com
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