Category Archives: Identity Theft

Stolen name, stolen benefits: New details on alleged cult, FBI raid on mansion

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Stolen name, stolen benefits

MARTINEZ, Ga. (WRDW/WAGT) – The FBI and Columbia County deputies raided a West Lake mansion Wednesday, arresting the leader of the House of Prayer — a group critics call a cult that scams veterans out of benefits.

Columbia County deputies assisted with the raid at 3816 Honors Way, but it’s a Federal Bureau of Investigation case involving allegations of financial or identity theft and fraud.

The founder of the House of Prayer was taken into custody and booked into jail, but we’re not even sure who the mysterious man really is.

He goes by Rony Denis, but federal authorities say he stole that identity in 1983, so they don’t know his true name.  Source

Common Health Care Fraud Types

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CMS gives great details on the many health care fraud types Fraud, waste, and abuse pose major risks for the Medicaid program. “Fraud means an intentional deception or misrepresentation made by a person with the knowledge that the deception could result in some unauthorized benefit to himself or some other person.” “Abuse means provider practices that are inconsistent with sound fiscal, business, or medical practices, and result in an unnecessary cost to the Medicaid program, or in reimbursement for services that are not medically necessary or that fail to meet professionally recognized standards for health care.” [1] Providers who engage … Read More

Federal Exclusion Statute –

Medical Fraud Exposed  

Bad news for those in Federal health care Federal health care – Convicted?  You’re Out if Office of Inspector General finds convictions. OIG is legally required to exclude from participation in all Federal health care programs individuals and entities convicted of the following types of criminal offenses: (1) Medicare or Medicaid fraud, as well as any other offenses related to the delivery of items or services under Medicare or Medicaid; (2) patient abuse or neglect; (3) felony convictions for other health-care-related fraud, theft, or other financial misconduct; and (4) felony convictions for unlawful manufacture, distribution, prescription, or dispensing of controlled … Read More

Health care fraud indictment charges man and his company

Medical Fraud Exposed

Southern District of Georgia continues to lead nationwide effort against fraudulent ‘telehealth’ scams AUGUSTA, GA: A man and his “marketing company” have been named in a five-count federal indictment for a scheme that paid workers to solicit elderly residents for information used to fraudulently bill government medical programs. Patrick Siado, of Texas, and his company, Optimus Prime Marketing, LLC, are charged with one count of Conspiracy and four counts of Health Care Fraud, said Bobby L. Christine, U.S. Attorney for the Southern District of Georgia. The Conspiracy charge carries a penalty of up to five years in prison, while each … Read More

Georgia nurse practitioner convicted of health care fraud

Medical Fraud Exposed

A Rockdale County nurse practitioner has been convicted in a multimillion‑dollar telemedicine fraud scheme that exploited elderly Medicare beneficiaries. Prosecutors say Sherley L. Beaufils approved thousands of fake orthotic brace orders without examining patients, generating more than $3 million in fraudulent claims before being found guilty on multiple federal charges.

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Your Rights Under HIPAA

Medical Fraud Exposed

Know Your Rights Empower Yourself with Knowledge Understanding your rights is the first step to protecting yourself from medical fraud. Knowledge is power, and being informed can help you make educated decisions about your healthcare. Most of us believe that our medical and other health information is private and should be protected, and we want to know who has this information. The Privacy Rule, a Federal law, gives you rights over your health information and sets rules and limits on who can look at and receive your health information. The Privacy Rule applies to all forms of individuals’ protected health … Read More

Health Care Fraud – FBI

Medical Fraud Exposed

Health care fraud can be committed by medical providers, patients, and others who intentionally deceive the health care system to receive illegal benefits or payments. Health care fraud is not a victimless crime. It affects everyone—individuals and businesses alike—and causes tens of billions of dollars in losses each year. It can raise health insurance premiums, expose you to unnecessary medical procedures, and increase taxes. The FBI is the primary agency for investigating health care fraud for both federal and private insurance programs.  See More

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