Tagged: fraud

Hospitals could face penalties for missing electronic health record deadline

More than half of U.S. hospitals were on the hook to meet a new set of “meaningful use” of electronic health records criteria — known as the stage 2 criteria — by the end of the fiscal year that ended in July. The new study’s data, which was gathered in late 2013, suggests that many may have missed the milestone. At the time, only 5.8 percent of those hospitals were on track to adopt all 16 of the stage 2 meaningful use goals.

Hospitals that bill the Medicare program and didn’t meet the criteria in fiscal year 2014 will be subject to financial penalties in fiscal year 2015…

The criteria, set forth by the Centers for Medicare and Medicaid, include relatively easy items such as using electronic health records to enter orders for medication as well as lab and radiology tests, to chart patients’ vital signs and to record patient demographics. More difficult activities include sharing electronic health record data with patients online, sharing electronic data with other providers who care for the same patients and submitting electronic data to vaccine registries…

The criteria are the second tier of compliance with the 2009 Health Information Technology for Economic and Clinical Health Act, also known as HITECH. The act requires hospitals to move from paper to electronic recordkeeping. At first, only a basic set of criteria is required, but once a hospital starts down the path, it must meet higher benchmarks at scheduled dates. The more than half of hospitals that were scheduled to meet the stage 2 meaningful use criteria in 2014 were the first wave to begin adopting digital medical records.

The study determined that the number of hospitals adopting electronic health records continues to rise steeply. Nearly 60 percent of hospitals now have at least a basic system. And 90 percent of those were on track to achieve many of the 16 core criteria.

The study suggests that, where hospitals are not able to meet criteria, they aren’t always to blame. Vendors must upgrade their products to make necessary functions available to meet the criteria. These challenges, however, appear to be concentrated in specific types of hospitals.

“Policymakers may want to consider new targeted strategies to ensure that all hospitals move toward meaningful use of electronic health records,” Adler-Milstein said. “We found that rural and small hospitals lag behind, suggesting a need to expand federal efforts to help these institutions select, purchase, implement and successfully use electronic health records in ways that earn them incentive payments and enable them to engage in new care delivery and payment models.”

Overdue. Way overdue. One of the best things we can thank Obama for – at two levels.

I really enjoy being able to access my medical records, diagnoses and communications – and love seeing them available between my physicians. Two of the four physicians on my Medicare chart are there: my GP and my eye doctor. Mostly just annual checkups; but, I’m glad they can see other’s work. The other two have just as perfunctory a relationship – and I’m confident they’ll soon be on board.

The best reason in the world to get hospitals into the mix makes me feel great – as a cynical geek. Because computational analysis is turning up crooked hospitals, administrators and healthcare conglomerates all over the country. And I love it.

When a hospital’s billing practices distort general rules of practice – it shows up. When a hospital is requesting ten times the national/regional average of one kind of profit center test – it shows up. Etc.

Like I said. Overdue.

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Dark pool greed drove Barclays’ policy

Barclays Plc was so bent on lifting its private trading venue to the upper ranks of Wall Street dark pools that it lied to customers and masked the role of high-frequency traders, according to New York’s attorney general.

Barclays falsified marketing materials to hide how much high-frequency traders were buying and selling, according to a complaint filed by Eric Schneiderman. Barclays runs one of Wall Street’s largest dark pools, a private trading venue where investors can trade stocks mostly anonymously.

Schneiderman has taken a leading role in seeking to reform how equities trade in the $23 trillion U.S. stock market, examining whether exchanges and dark pools give unfair perks to high-frequency traders. His suit against Barclays says clients such as institutional investors were the losers, led to believe they were safe from predators on a trading venue where aggressive trading strategies were in fact encouraged…

SEC Chairman Mary Jo White on June 5 voiced concern about the level of trading on venues where bids and offers are kept private, masking the true depth of demand for shares. Yesterday, the SEC said it would test a program to limit the amount of trading — now roughly 40 percent of volume — handled off public exchanges such as the New York Stock Exchange and Nasdaq Stock Market.

Schneiderman’s action will fortify a suspicion among critics of dark pools and high-frequency firms, which proliferated in the past decade with advances in computer power and efforts to spur competition among U.S. trading venues. Namely, that in the rush to attract traders to their markets and boost profits, the venues have catered to computerized market makers to the detriment of individuals…

In the complaint, filed in New York state Supreme Court in Manhattan, Schneiderman said Barclays told customers that it was protecting them from “aggressive, predatory or toxic” high-frequency traders, while secretly courting them.

Perhaps executives of the really big banks of the world truly believe there are only degrees of deceit – and therefore nothing criminal can occur. They lie to themselves as readily as they lie to their customers.

The question is one of fraud. The charge is grounded in the fraud they committed.

RTFA for a lot more detail and background.

Thanks, Mike

New York Congressman hit with 20-count indictment

grim Grimm

A two-year investigation into U.S. Rep. Michael Grimm’s campaign finances resulted in his indictment on Monday — on federal charges of cheating the government out of taxes on his restaurant.

Grimm was slammed with a 20-count indictment charging he fraudulently underreported the wages he paid his workers at Healthalicious on the Upper East Side and concealed the eatery’s actual income…

Grimm, 44, is also charged with obstruction and perjury for allegedly lying about his involvement in the business in a sworn deposition…

The feds said Grimm ran the day-to-day operations of the restaurant between 2007 and 2010, and “engaged in schemes to fraudulently under-report the wages he paid his workers — many of whom did not have legal status in the United States — and fraudulently under-report the true amount of money the restaurant earned to both federal and New York State tax and insurance authorities.”

He pulled off part of the scam by paying a “large portion” of employees’ pay in cash, “thereby lowering the restaurant’s payroll tax costs,” the feds said.

In all, prosecutors said, he hid more than $1 million in Healthalicious sales and wages…

FBI Assistant Director George Venizelos noted that…“As a former FBI agent, Rep. Grimm should understand the motto: fidelity, bravery and integrity. Yet he broke our credo at nearly every turn. Rep Grimm lived by a new motto: fraud, perjury and obstruction,” Venizekos said…

Last week, Grimm’s lawyer said the investigation into his Republican client was politically motivated and predicted he would be vindicated of whatever the charges were…

Grimm made headlines in January after threatening a New York 1 reported who’d asked him about the investigation.

In the exchange, which was caught on camera, Grimm said, “Let me be clear to you. If you ever do that to me again, I’ll throw you off this fucking balcony.”

A real class act – Congressman Grimm. As an ex-Marine, an ex-FBI agent, you’d think the concept of standing up for law and order might have made an impression on him. Though his behavior towards the press – and not so incidentally ordinary working people in his employ – makes it seem that exploitation is more in his line.

Prison, indictment, no problem in Illinois primary

In the Illinois primary elections, today, candidates on Chicago’s Democratic ballot will include someone who served a prison term for bribery, another who is due to go on trial on bribery charges this spring and a third charged with bank fraud.

“It’s a terrible indictment” of the local political culture, said Dick Simpson, a former Chicago alderman who teaches at University of Illinois at Chicago. “There is still a patronage-based political army on the West Side of Chicago.”

Political experts say all three candidates are either guaranteed victory or heavily favored to win.

The candidates include Isaac “Ike” Carothers, a former Chicago alderman who was sentenced to 28 months for bribery and tax fraud, and is now running for commissioner of the Cook County Board. He was released from prison in late 2011.

Derrick Smith, a state representative, was expelled by the Illinois House in 2012 after he was charged with taking a $7,000 bribe, but then won his seat back and is now running for re-election. His trial date has been set for the spring.

A third candidate, state Representative La Shawn K. Ford, has been charged with bank fraud for alleged actions before he was elected a legislator in 2006. He is running unopposed in his primary…

Chicago, the state’s largest city, ranked first in the nation in public corruption over the past three decades and has had 1,531 public corruption convictions since 1976, according to a 2012 analysis of U.S. Department of Justice statistics…

Ahead of Tuesday’s vote, both Chicago Mayor Rahm Emanuel and Cook County Board President Toni Preckwinkle have urged voters not to back the younger Carothers. They have endorsed another candidate, attorney Blake Sercye.

But both Smith and Ford have the backing of powerful state House Speaker Michael Madigan.

It’s been a long time since I lived in Chicago…but I recall standing offers from alley mechanics to get me any car I wanted. Cheap. Stolen, of course. I could pick out model, color, options. It would come with license and title.

FDIC sues banks over Libor manipulation and fraud

Bank of America, Citigroup and Credit Suisse Group AG were among 16 of the world’s biggest banks sued by the U.S. Federal Deposit Insurance Corp. for allegedly manipulating the London interbank offered rate from 2007 to 2011.

The FDIC, acting as receiver for 38 failed banks…claimed that institutions sitting on the U.S. dollar Libor panel “fraudulently and collusively suppressed” the rate. Also named in the suit, filed yesterday in Manhattan federal court, is the British Bankers Association, an industry group that oversaw Libor.

Regulators around the world have been probing whether firms colluded to manipulate interest-rate benchmarks including Libor, which affects more than $300 trillion of securities worldwide. Financial institutions have paid about $6 billion so far to resolve criminal and civil claims in the U.S. and Europe that they manipulated benchmark interest rates.

The cost for global investment banks could climb to $46 billion, analysts at KBW, a unit of Stifel Financial Corp., said in a report last year…

The failed banks “reasonably expected that accurate representations of competitive market forces, and not fraudulent conduct or collusion,” would determine the benchmark, the FDIC said in its complaint…

Investigators claim the banks altered submissions used to set the benchmark to profit from bets on interest-rate derivatives or to make the lenders’ finances appear healthier…

The FDIC alleges the banks committed fraud and violated U.S. antitrust laws in fixing the U.S. dollar Libor benchmark. It’s seeking unspecified damages on behalf of the failed banks, including punitive damages and triple damages for price-fixing.

The FDIC still echos the standards of Sheila Bair. It’s been a little while since she left; but, she set critical standards. Required reading for anyone interested in earning a living in finance and still maintaining the odd principle or two her book: Bull by the Horns: Fighting to Save Main Street from Wall Street and Wall Street from Itself.

Within the FDIC and the American banking community she always stands for small banks, community banks vs Wall Street’s version of Gargantua. She sat down and negotiated with the biggest bank presidents as equals and she tried like hell to be more equal than they – even with Congress ready and willing to give away the farm, the treasury and every taxpayer’s contribution to some of the worst examples of American capitalism.

She left the FDIC to work for a spell for the Pew Charitable Trusts; but, banking is what she knows best and she chose to leave the United States to work for a Spanish bank with a cleaner reputation than most of our own. She still asks out loud why no big American bank has ever offered a directorship to a bank reformer like Simon Johnson – or, I’d say, Sheila Bair.

And when she gives a talk to the staff of a bank she used to oversee as regulator – her fee goes to charity. A practice I don’t expect to witness every day from any of our former Congress-critters.

Generals made money on the side from the Iraq war!

More than 1,200 people are under investigation for a US military recruitment fraud during the Iraq war, officials say.

Two generals and dozens of colonels are implicated in the alleged scheme, in which referral fees were illegally collected for recruiting soldiers.

The fraud is said to have already cost the US government at least $29m (£17.7m) and may top $100m in total…

The National Guard programme – established in 2005 and later expanded to the Army and Army Reserve – paid soldiers, civilians and retirees $2,000 to $7,500 to recruit friends and family…

According to investigators, numerous schemes were used to defraud under the programme, which saw the Army pay out more than $300m for 130,000 recruits during the Iraq war.

High school principals and guidance counsellors were said to have accepted money for recruiting students who they knew were already planning to join the US military.

Other recruiters illegally accepted bonuses after forcing subordinates to register as recruiting assistants, before substituting their own bank account information.

More than 700 recruiters and 200 military officers are under investigation, and several former recruiters and soldiers have been indicted on federal charges.

“Clearly, we’re talking about one of the largest criminal investigations in the history of the Army,” financial oversight subcommittee chair Senator Claire McCaskill told USA Today.

“This is discouraging and depressing,” she added. “[It] is just a mess from top to bottom.”

It is kind of silly to expect more honesty from our military than we ever got from Congress or the Bush White House. Lying for profit was an established part of daily business – whether we look at Dick Cheney and Halliburton Industries or National Guard officers and the “recruits” they sent to Iraq. Only the size of the fraud is different.

And we actually arrest generals.

The likely future of Voter ID laws


 
“Voting laws are designed to assure a free and fair election; the Voter ID Law does not further this goal”

It’s way too early to forecast the fate of the Voting Rights Amendment Act of 2014, the federal legislation introduced Thursday in response to the United States Supreme Court’s decision last June in Shelby County v. Holder which struck down the heart of the Voting Rights Act. This sensible new measure has bipartisan support. But already there are grumblings on the right that the bill either isn’t necessary or that it too boldly protects the rights of minority citizens to be free from…discriminatory voting practices…

But it’s not too early to know that state voter identification laws will have an exalted place of protection in the Congressional response to Shelby County no matter what the final legislation looks like. In an effort to garner bipartisan support, that is to say in an effort to appease Republican lawmakers, the bill’s sponsors specifically exempted state voter ID laws from the litany of discriminatory voting policies and practices that would count under the new “coverage formula” contemplated by Section 4 of the proposed law. It’s like proposing a law to ban football and then exempting the Super Bowl.

The VRAA tells us that it will be left to state and federal judges around the nation to render their own judgment about the constitutionality of voter ID laws. And right on cue, the day after the federal measure was introduced on Capitol Hill, a judge in Pennsylvania did just that. Following a lengthy trial last summer, and six months of agonizing delay, Commonwealth Court Judge Bernard L. McGinley on Friday struck down Pennsylvania’s new voter ID law as violative of the constitutional rights of state voters…

The ruling is significant on its own terms, of course; it’s a major victory for voting rights advocates and a setback for vote suppressors in the state and everywhere else. As a matter of politics the import is clear. Pennsylvania is an eternal swing state—although it has swung blue most recently in national contests—and it is still considered a must-win for Democratic candidates for president. By blocking a law that would have erected practical impediments to mostly poor, young, old, and minority voters, Friday’s ruling makes it more likely that those likely Democratic voters will have their votes counted in 2014, at least…

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Prison term for woman who hustled fraudulent student loans to pay for plastic surgery

A Pennsylvania woman was sentenced to 15 months in prison after fraudulently soliciting $600,000 in student loans mainly used to pay for cosmetic surgeries.

Meredith Shuster, 36, of Cranberry, Pa., a suburb north of Pittsburgh, used her parents’ identities to solicit the loans. She then used about half the money on a series of cosmetic surgeries to alter her appearance, prosecutors said. The other half went toward myriad personal expenses…

Shuster’s lawyer argued she suffers from a condition called “body dysmorphic disorder” that caused her to feel compelled to constantly change her appearance.

Federal prosecutors said because nearly half the money went toward other expenses, the diagnosis wasn’t relevant and Shuster deserved to serve prison time.

U.S. District Judge Mark Hornak ordered the prison term, $632,613 be paid to the federal government in restitution and a 5-year probationary period upon Shuster’s release.

Gotcha!

State senator aided workers’ comp fraud worth millions — FBI

State Sen. Ronald Calderon accepted bribes from a Southern California hospital executive who ran an alleged workers’ compensation scheme that brought the executive tens of millions of dollars, according to a sealed FBI affidavit obtained by Al Jazeera’s Investigative Unit.

In exchange for payments to family members, Calderon, a Democrat who represents a suburban district here, protected the interests in Sacramento of Michael Drobot, who ran a busy spinal surgery clinic in Long Beach, Calif., the affidavit says. The document says Calderon ensured that changes to state law would not injure Drobot’s lucrative business of providing spinal fusion surgery, which joins two or more vertebrae.

The California State Compensation Insurance Fund, a quasi-governmental organization that makes payments on workers’ compensation claims, filed racketeering charges against Drobot and his medical companies earlier this year. The complaint alleges that he received $161 million through inflated surgery room and spinal implant reimbursement fees in what the state calls “multiple fraudulent schemes.” The allegations are contained in a lawsuit filed in U.S. District Court, Santa Ana, Calif.

Until now, Calderon’s alleged behind-the-scenes role in the workers’ compensation payment controversy has never been revealed…

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Berlusconi barred from office for two years over fraud conviction


You actually had the balls to say – Mission Accomplished!

A court in Milan has banned Silvio Berlusconi, Italy’s former prime minister, from holding public office for two years, following his conviction for tax fraud…However, the ban must be approved by parliament before taking effect.

Earlier this month, a cross-party panel of the Italian Senate recommended his expulsion from the chamber.

If he is expelled from parliament, Berlusconi will lose his immunity from prosecution in a string of criminal cases.

Berlusconi had threatened to topple the coalition government over the issue but backed down during a confidence vote…

He will also spend a year under house arrest, or doing community service – his preferred option, according to a request he formally submitted last week.

The votes on his expulsion and ban on holding office are expected to take place within the next few weeks.

He was sentenced to four years in prison, automatically reduced to one under a 2006 pardon act. He was also banned from holding public office for five years.

That sentence was upheld in August.

As erratic as the course of justice may be in Italian politics, by comparison, this case is one more example of the ineffectual and cowardly attitude towards politicians in the United States. Liars and frauds like George W. Bush and Dick Cheney committed inexcusable crimes against humanity – and left taxpayers with a bill for trillions of dollars.

The financial cost is conveniently forgotten by Republicans. The ethical failure is ignored by both of the TweedleDeeDum parties we are allowed. Add to this Obama’s legalization of government snooping into the lives of ordinary citizens and you need no explanation as to why America’s international reputation for corruption continues to grow.