Federal authorities charged 107 doctors, nurses and social workers in seven cities, including Houston, with Medicare fraud Wednesday in a nationwide crackdown on unrelated scams that allegedly billed the taxpayer-funded program of $452 million — the highest dollar amount in a single set of Medicare busts in U.S. history.

It was the latest in a string of major arrests in the past two years as authorities have targeted fraud that’s believed to cost the government between $60 billion and $90 billion each year.

Hundreds of federal agents fanned out around – the country Wednesday, raiding businesses, seizing documents and charging 107 suspects in Miami, Los Angeles, Detroit, Chicago, Tampa, and Baton Rouge, as well as Houston. The government suspended payment to 52 providers as part of the investigations.

In Houston, nine people were indicted Wednesday for more than $16 million  in fraudulent Medicare claims. Among them were four Houston private ambulance companies accused of $7 million in phony trips to an outpatient psychiatric clinic and the owners of two Houston home health care operations accused of $9 million in fraudulent Medicare claims.

Among the others arrested Wednesday were the owners of two community mental health centers in Baton Rouge, charged with billing $225 million in scams. Hoor Naz Jafri and Roslyn Dogan allegedly recruited vulnerable patients, including elderly people, drug addicts and mentally ill people. Their patient charts were doctored to show services that were billed to Medicare but often never given, according to an indictment.

More than 50 people were arrested in Miami in unrelated scams totaling $136 million involving community mental health centers and home health care agencies.

Dozens charged in record fraud sting is a post from: Accident & Injury Law in Texas

The owner of a Texas medical service provider was among seven people indicted in an extensive health care fraud scheme that allegedly bilked Medicare and Medicaid of nearly $375 million, authorities announced Tuesday.

The federal indictment accused Jacques Roy, a doctor who owned Medistat Group Associates in DeSoto in North Texas, of leading a scheme that billed Medicare for home health services that were not medically necessary or were not done.
Also indicted were Roy’s office manager as well as the owners of three home health agencies. A federal indictment unsealed Tuesday accuses the agencies of using Roy to rack up millions of dollars in false claims.

The indictment alleged that from January 2006 through November 2011, Roy or others certified 11,000 Medicare beneficiaries for more than 500 home health services — more patients than any other medical practice in the U.S.

Investigators for the U.S. Health and Human Services department noticed irregularities with Roy’s practice about one year ago, officials said.

Roy had “recruiters” finding people to bill for home health services, said U.S. Attorney Sarah Saldana, the top federal prosecutor in Dallas. Some of those alleged patients, when approached by investigators, were found working on their cars and clearly not in need of home health care, she said.

Medicare patients qualify for home health care if they are confined to their homes and need care there, according to a federal indictment.

Saldana said Roy used the home health agencies as “his soldiers on the ground to go door to door to recruit Medicare beneficiaries.”

Roy, 54, is charged with health care fraud and conspiracy to commit health care fraud. He and the other defendants have been taken into custody.

The Centers for Medicare and Medicaid Services also announced the suspension of an additional 78 home health agencies associated with Roy. The agencies were collecting about $2.3 million a month, said Peter Budetti, CMS’ deputy administrator for program integrity.

Until recently, HHS could not effectively track data to identify the kind of fraud now linked to Roy, who was billing beneficiaries “off the charts” for more than five years, officials said. The department’s inspector general, Dan Levinson, told reporters the department’s technology “has not come online as quickly as we’d like to see.”

7 indicted in Texas health care scheme is a post from: Accident & Injury Law in Texas

A 20-year-old man was charged with felony intoxication manslaughter in the
death of one of his passengers after a crash Saturday night in northwestern Travis County.  According to an arrest affidavit filed Monday, Jose Olvera-Tovar lost control of a Ford Explorer late Saturday on General Williamson Drive near RM 620. The Explorer struck several concrete blocks, was launched into the air and struck a utility pole, according to the affidavit.

Passenger Jose Guillen-Ortiz, 29, died in the wreck. Olvera-Tovar and another passenger were treated for minor injuries at University Medical Center Brackenridge and released before Olvera-Tovar was arrested.

Driver charged in man’s death is a post from: Accident & Injury Law in Texas

A state appeals court upheld the conviction of Martin DiCarlo, a 47-year-old Williamson County man sentanced to life in prison in 2008 after his seventh drunken driving conviction.

On Friday, the 3rd Court of Appeals in Austin rejected DiCarlo’s arguments that prosecutors improperly questioned potential jurors and ruled that a recorded jailhouse phone conversation between DiCarlo and his brother was properly introduced into evidence.  In the call, the brother berates DiCarlo for previous drunken driving episodes, and DiCarlo responds, “We all make mistakes.”

The court ruled that the conversation impeached DiCarlo’s claims that he was having a diabetic episode, and that the brother’s coarse language did not make the jury more likely to convict.

The opinion noted other factors that were more likely to sway jurors: “In a seperate, recorded conversation with his ex-wife discussing why he was in jail, (DiCarlo) stated, ‘It’s my fault for drinking and driving.’ The arresting officer reported observing signs consistent with intoxication while appellant was driving and while he was performing field sobriety tests.  Most compelling is appellant’s blood-alcohol concentration measured by the breath test on which both readings – .139 and .144 – were well higher than the acceptiable .08 level for legal driving.”

Life sentance for 7th DWI Upheld is a post from: Accident & Injury Law in Texas

Local singer, Melanie Wilkinson, was killed in a collision on Monday at the 2200 block of East 51st Street, just east of Waterbrook.  Ms. Wilkinson had performed for Ann Richards, Lady Bird Johnson and Barbara Jordan and was scheduled to sing in Washington with a choral group at the National Cathedral in the next few days.

She was leaving her job as an overnight 911 call-taker at Austin’s Combined Transportation, Emergency and Communications Center when the wreck happened.

Austin police spokesman Cpl. Scott Perry said a man was driving a Checy Tahoe east on 51st Street about 11:45 a.m. when he crossed the center line and hit Wilkinson’s Toyota Corolla, heading west.  The Tahoe flipped over the Corolla, hit a telephone pole and then rolled off the Corolla.

The Tahoe driver, Dewayne Maupin, 32, was arrested on existing warrants of delivery of a controlled substance and theft by check.

Local Singer Killed in Car Wreck is a post from: Accident & Injury Law in Texas

Wesley Ray Marek, arrested August 11th, 2006, after a Round Rock officer stopped him over a possible traffic violation on Sam Bass Road, was sentenced in Williamson County recently to 25 years in prison after his 10th conviction on driving while intoxicated charges.

The officer found that Marek was wanted in Brown County, almost 100 miles west of Waco, on a probation violation and was driving with a suspended license.

Because he had been convicted of three or more driving while intoxicated charges, the most recent charge was a third-degree felony.  In addition, because he had been sentenced to prison at least two previous times, the charge was enhanced to a first-degree felony, punishable by 25 to 99 years or life in prison.

Williamson County Man gets 25 years for 10th DWI is a post from: Accident & Injury Law in Texas

Austin police released an annual ranking of bars where motorists who were stopped on suspicion of drunken driving reported having their most recent drinks.

Several bars in downtown topped the list including Rain, Oilcan Harry’s, and The Ranch.  Police are using the list to help target enforcement efforts.

The rankings are based on information drivers gave officers after they were arrested.

Police in Austin Tracking Where Drunk Drivers Drank is a post from: Accident & Injury Law in Texas

A Taylor man, Anthony Lynn Falco, was sentenced to 60 years in prison Wednesday for his 10th driving while intoxicated conviction.

Mr. Falco was pulled over in June and told police that he had been drinking beer at a Round Rock bar, failed field sobriety tests but refused to give a breath sample. After a blood search warrant was obtained, the sample showed he had more than two times the legal limit of alcohol in his blood.

Mr. Falco pleaded guilty to felony DWI in January and waived his right to a jury trial. District Judge Burt Carnes then sentenced him to 60 years in prison making him eligible for parole in 15 years.

According to Williamson County District Attorney John Bradley, Mr. Falco had nine previous DWI convictions starting in 1979. He served time for the last three.

Mr. Bradley said that convicted DWI offenders like Falco should have to give a breath or blood sample and urged state legislators to pass such a law.

Taylor Man Gets 60-year Sentance for DWI Number 10 is a post from: Accident & Injury Law in Texas

Oscar Barbosa, 51, of Williamson County was sentenced to 33 years in prison after pleading guilty to his sixth driving-while-intoxicated conviction on Monday.

He had been arrested in September because he was weaving on U.S. 183 in Liberty Hill, according to Williamson County District Attorney John Bradley.  A breath test found that Mr. Barbosa had more than two times the legal limit of alcohol for driving in his system.

Williamson County Man Sentenced for Sixth DWI is a post from: Accident & Injury Law in Texas