Jury awards $16.5 million in State College suit

By Matt Carroll
Centredaily.com

A jury awarded $16.5 million Thursday to a woman who said she was drugged with carbon dioxide and manipulated to believe she was raped by family members at the hands of a former State College psychologist.

Her attorney, Bernard Cantorna, asked the jury to hold Julian Metter, 59, accountable for planting a “horror story” in the woman’s mind while she was drugged with carbon dioxide.

The jurors responded after five hours of deliberation, unanimously ordering Metter to pay what Cantorna said is the largest jury verdict in Centre County history.

“They clearly wanted to send a message that Dr. Metter is a danger to the public and anyone he might attempt to treat,” Cantorna said. “They wanted to make sure anybody and everybody could find this case and make sure he can never do this to anyone again.”

Metter, who had been in practice for 20 years, lost his license to practice psychology in June 2009 when he pleaded guilty to fraudulently billing Medicare, according to the National Council Against Health Fraud.

He was sentenced in February 2011 to serve five months in prison followed by two years probation. Cantorna said Metter is free to continue treating people, just not as a psychologist, after his probation.

When contacted Thursday night, Metter said he was saddened and disappointed by the jury’s decision. He said he will appeal the verdict.

“It was very surprising,” Metter said. “Everyone with me who knows (the woman) and the situation really felt we brought forward a very accurate picture.”

Cantorna said his client was made to believe she was raped at the hands of her family and abused in cultlike rituals by prominent members of the community.

Metter was accused in the civil lawsuit of creating those images and suggesting them as reality while the woman was drugged and in her most vulnerable state.

“He took a woman who never had any history of this and made her relive the most horrific things one could imagine,” Cantorna said Thursday during closing arguments in the six-day civil trial. “He made her live it.”

The lawsuit alleged the woman suffered lasting emotional anguish as a result. It also stated she suffered a brain injury due to repeated exposures to a mixture of carbon dioxide and oxygen.

The entire story is here.

Here is the civil complaint.

Here is a copy of the Consent Agreement and Order from the PA State Board of Psychology.

Here is Metter on Autism, with his center's "treatments" that fall outside the scope of a psychologist's practice.

Physician Guilty of Medicare Fraud Put Patients at Risk

By Robert Lowes

Medscape Medical News

Published January 18, 2012

A stiff prison sentence handed down to a physician in Los Angeles, California, last week for his role in a massive Medicare scam highlights how a seeming burlesque of medicine posed a danger to patients.

Alexander Popov, MD, was sentenced to 8 years and 1 month in prison in a federal court in Sacramento, California, after a jury last year found him guilty of conspiring to — and committing — healthcare fraud. An indictment issued in 2010 stated that Dr. Popov and 4 other physicians allowed a man named Vardges Egiazarian, who owned 3 clinics in the California cities of Carmichael, Richmond, and Sacramento, to submit Medicare claims in their names. Dr. Popov took on the role of co-owner and practitioner at the Sacramento clinic but never saw a patient there, according to federal prosecutors.

Over the course of 2 and a half years, Dr. Popov and the other physicians submitted more than $5 million worth of bogus claims to Medicare for nonexistent or unnecessary services, of which they received $1.7 million. The physicians' share of the take was 20% of what was paid out under their Medicare provider number.

In a sentencing memo filed in the case, federal prosecutors credit Dr. Popov and the other conspirators with doing "everything necessary to establish and operate a health clinic, with the exception of actual healthcare." As part of their hustle, they paid "cappers" to recruit and transport patients to the clinics, and the patients themselves received $100 each for showing up — a kind of reverse copay.

The patients, who were predominantly elderly immigrants who did not speak English, received little if any medical care during their visits. Clinic employees nevertheless recorded in their charts that they had received a comprehensive exam and a broad array of diagnostic tests. Staff would plug in off-the-shelf test results or would run tests on themselves and use those numbers. Dr. Popov, who lived in Los Angeles, saw none of these patients in person, but signed the charts anyway, according to prosecutors.

The entire story can be found here.

Lawsuit Accuses Company Of Fraudulently Cycling Patients Through Nursing Homes, Hospice Care

By Jordan Rau

Kaiser Health News Staff Writer

Originally published January 4, 2012

A national hospice company improperly cycled patients through nursing homes and hospice with a goal of making as much profit as possible from Medicare, according to a whistleblower lawsuit announced this week.

Federal attorneys also sued the hospice company, AseraCare, alleging it milked Medicare’s hospice benefit by pressuring its employees to enroll people into hospice who weren’t dying and resisted discharging them despite evidence they weren’t deteriorating. One hospice patient who should have been immobile from end-stage heart disease was healthy enough to go to his granddaughter’s graduation and a berry-picking excursion with a friend, the government charges.

For years, some critics of Medicare’s hospice benefit have said that the way the government pays providers gives them financial incentives to abuse the system. The suits against AseraCare, a Fort Smith, Ark.-based hospice company operating in 19 states, follow several other suits against big hospice companies but go further in their allegations that the company coordinated its use of nursing care and hospice care to maximize Medicare reimbursements.

The entire story is here.

12 Are Charged in Medicare Fraud Schemes Said to Cost $95 Million

By Kirk Semple
The New York Times
City Room
Originally published November 2, 2011

Federal agents swarmed several medical clinics and homes in New York City on Wednesday, arresting 10 people on charges of running Medicare fraud schemes that bilked the government out of $95 million, federal officials said.

Another defendant charged in one of the schemes surrendered later to the authorities and a 12th defendant was still at large on Wednesday afternoon, the officials said.

The defendants included three medical doctors, a doctor of osteopathy and a chiropractor, the United States Department of Justice said in a news release.

The cases are part of an aggressive campaign by the Justice Department and the Department of Health and Human Services to combat the escalating problem of health care fraud. In 2007, a special team was formed to combat fraud in Medicare, the federal program that helps provide health care for older people.

The entire story can be read here.

91 charged with Medicare fraud across U.S.

By Jerry Markon

The Washington Post

Published September 7, 2011

The Obama administration escalated its crackdown on health-care fraud Wednesday, announcing charges against 91 people in eight cities who are accused of bilking the Medicare system out of nearly $300 million and victimizing the elderly and disabled people who rely on the federal insurance program.

Among those charged in the coordinated series of arrests was a doctor in Detroit who allegedly billed Medicare for services provided to dead people and claimed that he performed psychotherapy treatments more than 24 hours a day. Other doctors, nurses and health-care company owners were charged in various schemes to get paid for services that were medically unnecessary or never provided, officials said.

“From Brooklyn to Miami to Los Angeles, the defendants allegedly treated the Medicare program like a personal piggy bank,’’ Lanny A. Breuer, assistant attorney general for the Justice Department’s criminal division, said at a news conference in Washington.

It was unclear whether lawyers had been appointed for the defendants, 70 of whom were charged in indictments unsealed this week. The other 21 were charged in recent weeks. More than 55 defendants had been arrested by Wednesday afternoon, in addition to others who turned themselves in to authorities.

The arrests, announced by Attorney General Eric H. Holder Jr. and Health and Human Services Secretary Kathleen Sebelius, marked the latest step in a campaign against fraud that the administration calls a key part of its health-care reform agenda. The health-care overhaul law, President Obama’s signature domestic initiative, is an issue in the presidential campaign, but few have questioned the need to crack down on fraud.

In May 2009, the administration launched the Health Care Fraud Prevention and Enforcement Action Team to seek out illicit billing practices. That team’s Medicare Fraud Strike Force carried out the raids in cities that also included Houston, Baton Rouge, Dallas and Chicago.

In Miami, 45 defendants — including a doctor and a nurse — are accused of participating in $159 million worth of schemes to submit false Medicare billings for home health care and other services. Holder said the victims included “some of the most vulnerable among us — including seniors suffering from dementia and Alzheimer’s disease.’’

Officials said the crackdown will continue. “The health-care system is part of our nation’s infrastructure, and we must do everything in our power to protect the integrity of Medicare,” said FBI Executive Assistant Director Shawn Henry.

The entire story can be read here.