SPRINGHILL CARE GROUP: July 2012

Tuesday, July 31, 2012

N. Korean refugees investigated for insurance fraud - blogger - kaboodle - zimbio

http://www.zimbio.com/Springhill+Care+Group/articles/B1UrrzEIAAD/N+Korean+refugees+investigated+insurance+fraud?add=True

SEOUL (AFP) - South Korean police said on Tuesday they were investigating 27 North Korean refugees for swindling private insurance firms out of hundreds of thousands of dollars in bogus medical claims.Police said the refugees faked illness in collusion with hospitals to claim a total of 1.04 billion won (S$1.16 million) from insurance firms between 2007 and 2010.While listed as hospitalised, they frequented saunas, restaurants and even nightclubs. The scam also involved a 71-year-old doctor and five hospital employees who conspired with the refugees to claim a separate 104 million won from the state health insurance agency, police said.Police are also investigating two brokers on suspicion of helping the refugees send some of the proceeds to relatives in the North.

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Kickbacks, Honest Services, and Health Care Fraud after Skilling - kaboodle - zimbio

http://www.zimbio.com/Springhill+Care+Group/articles/EyQKO-xtTR8/Kickbacks+Honest+Services+Health+Care+Fraud?add=True

Joan H. Krause

University of North Carolina (UNC) at Chapel Hill - School of Law

August 8, 2012

Annals of Health Law, Vol. 21, No. 1, 2012
UNC Legal Studies Research Paper No. 2018589

Abstract:
This essay considers how the 2010 Supreme Court decision in Skilling v. United States, which limited the situations in which mail and wire fraud cases may be premised on violations of the “intangible right to honest services,” has the potential to alter the future of health care fraud litigation. While Skilling is widely perceived to have closed the door to several types of common mail and wire fraud prosecutions, this may not turn out to be the case in health care. In health care, the renewed focus on kickbacks as evidence of an honest services breach instead may dovetail nicely with both the Obama Administration’s emphasis on criminal health care fraud enforcement and the jurisprudence of the Medicare & Medicaid Anti-Kickback Statute. This kind of leverage may prove very difficult for prosecutors to resist, and most certainly will require changes in the way the health law bar approaches common Anti-Kickback concerns.

Number of Pages in PDF File: 10

Keywords: health care fraud, Medicare, white collar crime

Accepted Paper Series

Date posted: March 8, 2012

Suggested Citation
Krause, Joan H., Kickbacks, Honest Services, and Health Care Fraud after Skilling (August 8, 2012). Annals of Health Law, Vol. 21, No. 1, 2012; UNC Legal Studies Research Paper No. 2018589. Available at SSRN: http://ssrn.com/abstract=2018589
Contact Information
Joan H. Krause (Contact Author)
University of North Carolina (UNC) at Chapel Hill - School of Law ( email )
Van Hecke-Wettach Hall, 160 Ridge Road
CB #3380
Chapel Hill, NC 27599-3380
United States
919-962-4126 (Phone)
919-962-1277 (Fax)

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Sunday, July 22, 2012

Hollywood, Miramar and Sunrise

http://www.afamilymemberhomecare.com/news/hollywood-miramar-and-sunrise-florida-home-health-aide-private-duty-agency-family-member-homeca

HHS Secretary and Attorney General host seventh Regional Health Care Fraud Prevention Summit in Chicago (April 4, 2012)--At a Chicago summit highlighting a new high-tech war against health care fraud, Health and Human Services (HHS) Secretary Kathleen Sebelius and Attorney General Eric Holder today discussed how the Affordable Care Act and the Obama administration’s Health Care Fraud Prevention and Enforcement Action Team (HEAT) are helping fight Medicare fraud. The Chicago summit is the seventh regional health care fraud prevention summit hosted by the Department of Justice and HHS.

The regional summits bring together a wide array of public and private partners, and are part of the HEAT partnership between HHS and the Department of Justice to prevent and combat health care fraud. The Obama administration’s HEAT efforts have resulted in record-breaking health care fraud recoveries. In fiscal year 2011, for the second year in a row, the departments’ anti-fraud activities resulted in more than $4 billion in recoveries, an all-time high.

“We have a simple message to criminals thinking about committing Medicare fraud: don’t even try,” said Secretary Sebelius. “Thanks to health reform and our administration’s work, we have new tools and resources to catch criminals and stop Medicare fraud before it happens.”

“This Administration continues to move aggressively in protecting patients and consumers and bringing health care fraud criminals to justice,” said Attorney General Holder. “Through HEAT, we have achieved unprecedented, record-breaking successes in combating health care fraud and as a result of the Affordable Care Act, we have additional critical resources, tools and authorities to continue this great success.”

New tools provided by the Affordable Care Act are strengthening the Obama administration’s efforts to fight health care fraud. As a result of Affordable Care Act provisions:

Criminals face tougher sentences for health care fraud, 20-50 percent longer for crimes that involve more than $1 million in losses;
Contractors that police Medicare for waste, fraud, and abuse will expand their work to Medicaid, Medicare Advantage, and Medicare Part D programs;
Government entities, including states, the Centers for Medicare & Medicaid Services (CMS), and law enforcement partners at the Office of the Inspector General (OIG) and DOJ, have greater abilities to work together and share information so that CMS can prevent money from going to bad actors by using its authority to suspend payments to providers and suppliers engaged in suspected fraudulent activity.

Increased collaboration has yielded significant results through the HEAT partnership. Since the creation of HEAT in 2009, the Medicare Fraud Strike Force operations have expanded from two to nine locations throughout the United States, including Chicago. Strike Force operations expanded to Chicago in February 2011 and since that time, charges have been filed against more than 35 defendants in the Northern District of Illinois for offenses related to health care fraud. Overall, in fiscal year 2011, strike force operations in nine locations charged a total of more than 320 defendants for allegedly billing more than $1 billion in false claims.

In February, as a result of HEAT and strike force actions, a Dallas-area physician and the office manager of his medical practice, along with five owners of home health agencies, were arrested on charges related to their alleged participation in a nearly $375 million health care scheme involving fraudulent claims for home health services. In conjunction with this action, CMS imposed payment suspensions against 78 home health agencies in the Dallas area.

Medicare Fraud in Florida

http://www.homehealthcareagencies.com/blog/general/medicare-fraud-florida/

It was President Franklin Delano Roosevelt who once said ‘With great power comes great responsibility.’ Unfortunately, there are many people in our society that neglect their responsibility and abuse their power. Those who commit fraud against people who are disabled are especially heinous.

Recently, the state of Florida has had to deal with an overwhelming amount of Medicare fraud. The estimated cost of the most recently interrupted scheme of illegal billings is around $200 million dollars, and it was perpetrated by at least ten different offenders. So far, they have all either pled guilty or been convicted of crimes ranging from money laundering to conspiracy to commit health care fraud. There were several different companies involved in the scheme, which involved falsifying records and intentional misreporting of facts to Medicare.

Essentially what these criminals were doing was incorrectly reporting that some patients qualified for home health care when, in fact, they did not. Once these falsified certifications were sent to Medicare, the defendants would then bill Medicare for services that were not only unnecessary, but we usually not even provided.

The scheme went even further into the health care industry when perpetrators began contacting legitimate medical facilities and providers and offered them compensation for help in falsifying documents. These providers, which even included some doctors, would receive kick-backs for giving personal information to the defendants.

So far, ten people have been convicted of Medicare fraud as a result of this scheme in the last year. Those convicted of money laundering crimes have been sentenced or will be given sentences of at least three years in prison. Those convicted of more serious crimes will receive stiffer sentences. All of those sentenced and facing sentencing will be responsible for repaying the money that they essentially stole from the state. Any personnel working as care givers will also have their state certifications revoked and will no longer be allowed to practice once they have served their sentences.

Florida has vowed to arrest and punish all of those responsible for defrauding the state of its tax dollars. With every state in the union in a financial crunch, those dollars are needed now more than ever. Florida has made press statements recently that it has recovered over $125 million in fraudulent Medicare claims in the last year, and is making promises to recover as much as it possibly can in the next.

Wednesday, July 18, 2012

Springhill Caregroup (SpringhillCareG) on Twitter – Springhill Care Group

http://blogs.rediff.com/ambrociabanks/2012/07/15/springhill-caregroup-springhillcareg-on-twitter/

https://twitter.com/springhillcareg

Springhill Group look to cater to the special requirements of each person citizen and any changing circumstances that occur throughout their time living in our care. This gives families the comfort that their loved one has the support and care.
We fully understand a need to a place that residents will be proud to call their home is what they require most. All are built in attractive locations, nestled amongst existing communities, so our residents can easily retain their ties with their families.
Springhill Care offers retirees the finest in clinical care, while receiving the positive aspects of living in our cozy and comfortable community.
Email us now at info@springhillcaregroup.net

Tuesday, July 17, 2012

FUNNY OR DIE - Tagged Springhill Care Group on Tumblr

http://www.funnyordie.com/articles/b22460f873/tagged-springhill-care-group-on-tumblr

The decision of US to let the blind human rights activist Chen Guangcheng return into China’s fold following his escape from authorities is straining ties between the two countries as diplomatic dialogues opened in Beijing.

The 40-year old Chen who is now considered a dissident became an international human rights inspiration to many Chinese after earning the ire of the local government for exposing forced abortions in line with the country’s one-child policy. The self-taught lawyer took to the US embassy after his escape, apparently to ask for help but was eventually ushered into the Beijing Hospital.

According to a senior official’s statement to Springhill Care Group, Chen has indeed went into the embassy that day and has requested for medical treatment for his injured foot. American medical personnel have then conducted medical tests and made appropriate treatment during the time he was there.

Immediately after the incident, the Chinese government has expressed its disapproval about the entire affair, demanding an apology from the US for taking Chen in.

“What the U.S. side should do now is neither to continue misleading the public and making every excuse to shift responsibility and conceal its wrongdoing, nor to interfere in the domestic affairs of China,” said Chinese Foreign Ministry spokesman Liu Weimin.

This incident came just when the US Secretary of State Hilary Clinton is visiting Beijing in a meeting with Chinese officials on security and trade talks. And although no one mentioned Chen’s name, it is evident in their statements that the incident is on the spotlight as the 2 nations struggle to maintain common ground.

Clinton said in her opening statement, “The United States believes that no state can legitimately deny the universal rights that belong to every human being – or punish those who exercise them. A China that protects the rights of all its citizens will be a stronger, more prosperous partner for the United States.”

Dai Bingguo issued a rebuttal on behalf of China, saying, “I wish to point out in particular the fundamental way to manage state-to-state relations is to abide by the basic norms of international relations, namely to respect China’s sovereignty, core interests and choice of social system.”

Meanwhile, Chinese President Hu Jintao made his point known in his opening speech during the 4th round of US-China Strategic and Economic Dialogues. He remarked that US and China should know how to respect each other despite their disagreements and also appealed to its counterpart to break the conventional belief that superpowers are bound to engage in conflicts.

Springhill CareGroup: UN Sanctions 3 North Korean Firms

http://springcaregroup.blogspot.co.uk/2012/07/un-sanctions-3-north-korean-firms.html

United Nation’s Security Council has decided to freeze the assets of 3 North Korean companies and consequently ban them from global trade because of their involvement in exporting, procuring and financing nuclear-related weapons.

UN’s sanctions committee has named the 3 blacklisted firms as Korea Heungjin Trading Company, Amroggang Development Banking Corporation and Green Pine Conglomerate.

Amroggang is a financing company involved in ballistic missile sales and is related to Tanchon Commercial Bank, which was blacklisted in 2009 for its participation in selling of arms. Green Pine is the firm which took over most of the activities of the Korea Mining Development Trading Corporation, North Korea’s primary arms dealer that was blacklisted in 2009. It manufactures military maritime crafts, missile systems, torpedoes and also provides technical assistance to defense firms. Meanwhile, Korea Heungjin Trading Company was utilized to manufacture equipment with missile design applications and had been used for trading by the Korea Mining Development Trading Corporation.

The Security Council committee has also approved more technology and items that would be banned for transfer from and to North Korea, adding to its list that contains North Korea’s nuclear-related resources.

Originally, South Korea, Japan, US and the European Union proposed to Security Council’s committee a list of 40 North Korean firms they wanted to sanction but China blocked the deal, resulting in only the approval of 3 companies. China usually opposes economic sanctions and is an ally of North Korea, though it had previously approved sanctions against the latter in its 2009 nuclear test.

Before the final decision of the committee, Springhill Group Home discovered that the companies included in the sanction list included 5 individuals and 8 more firms. The UN sanction committee works on a consensus basis, meaning that any individual member of the council is capable of blocking an agreement.

Diplomats have tried to minimize the incident where Beijing vetoed most of the entities on the proposed list. They have asserted that the “committee’s strong and united response shows that the Security Council is determined that there be consequences for this provocation and any future North Korean violation”. Apparently, they believe that such measures will increase North Korea’s isolation and make it harder for it to move forward with its illicit programs.

The United Nations has sanctioned the 3 North Korean firms in light of the nation’s failed April 13 rocket launch where it claims to put a satellite into orbit amidst a general suspicion that it is actually a missile test, something that is exclusively reported by Springhill Group Home.

Springhill Care Group via Multiply - Min Ho Park's column on Newsvine – Springhill Care Group - by Ambrocia Banks Discussions – Last.fm

http://www.last.fm/group/Springhill+Care+Group+-+by+Ambrocia+Banks/forum/1264655/_/2065397

http://min-ho-park.newsvine.com/_news/2012/07/13/12729224-springhill-care-group-via-multiply

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Tags: care group, florida group, gold, group, group florida, groupreview, health medicine, home care, korea, medicarefraud, of, seoulsouth, south, south korea, southkorea, southkoreagroup, springhill, springhill care, springhill caregroup, springhill florida, springhill group, springhillfraud, springhillgroup, springhillreview, warningto [ Show All Tags ]Springhil Care Group

Wednesday, July 11, 2012

Newsvine – Group of Springhill South Korea: The Laziest Scams in Internet History

http://www.tablezine.com/2012/04/20/newsvine-group-of-springhill-south-korea-the-laziest-scams-in-internet-history/

NEWSVINE – GROUP OF SPRINGHILL SOUTH KOREA –- A certain “Sehwan Jung” in South Korea has been sending a number of desperate requests for funds over Twitter: “I am in urgent need of money. Can you lend me 500,000 dollars?I will make it up to you later.” A diabolical plot, indeed, though Mr. Jung’s scam is unlikely to work. For one, people can see everything someone sends on Twitter and quickly realize he’s sent the exact same message over and over. For another, he is tweeting almost exclusively to celebrities, including Channing Tatum, Rosario Dawson, Carly Simon, journalist Nicholas Kristof (who today sarcastically answered, “Sure!”), and the foreign minister of Bahrain, Sheikh Khalid bin Ahmed Al Khalifa.

“Now this one is a real winner,” says Dan Ring, a spokesperson for Boston-based data protection company Sophos. “Sehwan Jung’s list of celebrities is almost as entertaining and as random as his actual request, and it’s one of the more optimistic requests out there. I hope there’s no way someone will fall for this.”

The “Sehwan gambit” joins the following examples as one of the laziest scams in Internet history.

• “JOHN” fails to mention what he even wants to con you out of:

Subject: what are you sale

Greetings,My name is JOHN, i am highly interested in buying your{ what you want to sale } from you ,I will like you to give me the FINAL ASKING price and the lastes condition,also i will like you to scan the pics for me for proper verifycation.

• This scammer doesn’t even attempt to establish a personal connection before offering $18 million:

Beloved,

I am Elizabeth Etters, a Christian.I picked your email randomly for an inheritance of $18M. Please contact me for more details via [redacted].

• One malware attack came in the form of a bogus Christmas card—sent on March 19:

Date: 2010-03-19 09:27:15

“You have just received a Christmas greeting card! To see your custom card and who sent it, please check the attachment.”

• In this excerpt, one “Professor Farnsworth” selects you to survive a man-made black hole:

“… The truth is that this experiment that CERN are conducting is extremely dangerous, and could cause global disaster. This experiment has a 95% of causing a black hole, thus swallowing a large area of the planet. The scientists do not want you to know this as they know it will cause panic. However, I can help you.

I am arranging for a number of selected people to be evacuated to a safe location on an island in the South Pacific via aeroplane. You have been selected from random to take part in this evacuation, thus continuing the survival of the human race …”

• African prince scams are so tired. This reward is allegedly offered by England’s royal family:

250,000.00 Pounds has been awarded to you From the Queen Elizabeth’s Foundation ,send us your:-

Names___

Address___

Tel____

Country__

springhill group south korea, springhill group: Learn what a CFE can do for you

http://www.valueinvestingnews.com/springhill-group-south-korea-springhill-group-learn-what-cfe

In today’s economic climate, who will help you protect your company and your clients from the devastating impact of fraud?

Fraud can creep into your business in a number of ways.
You may find you need an objective expert to deter potential problems, investigate allegations or provide resolution.
A Certified Fraud Examiner (CFE) offers anti-fraud knowledge and skills you need to:

• Investigate allegations against one of your employees
• Recommend strong anti-fraud internal controls
• Conduct interviews related to sensitive issues
• Provide assistance with financial dispute resolution
• Resolve irregularities discovered during your company’s audit
• Provide expert testimony on financial and investigative matters

A Unique Set of Skills
Fraud Examiners have a unique set of skills that are not found in any other discipline; they combine knowledge of complex financial transactions with an understanding of law, criminology, investigation and how to resolve allegations of fraud.

CFEs work in a variety of disciplines including accounting, auditing, fraud investigation and security, as well as in different industry segments including government, healthcare, financial services, manufacturing and retail distribution.

CFEs are knowledgeable in four areas critical to the fight against fraud:

• Fraudulent Financial Transactions
• Criminology & Ethics
• Legal Elements of Fraud
• Fraud Investigation

Reduce Fraud Risks and Costs
Heightened fraud awareness, combined with new laws and regulations, has increased the already growing demand in the workforce for professionals who are highly skilled at deterring, detecting and investigating fraud.

CFEs have the ability to:

• Identify and reduce opportunities for fraud
• Implement effective anti-fraud controls
• Continuously improve anti-fraud measures based on new risks and technologies
• Educate employees to deter fraud and report wrongdoing
• Resolve allegations or suspicions of fraud
• Assist in the recovery of fraud losses

Experience and Integrity
The standards for CFE certification are set by the ACFE’s Board of Regents, who are elected by CFE members and drawn from the most experienced members of the profession. CFE candidates must hold a Bachelor’s degree from an accredited institution and posses two or more years of professional experience in a field related to fraud deterrence and detection.

The CFE Exam is a rigorous process, testing the knowledge of candidates in all areas of fraud examination. CFEs are required to acquire at least 20 credit hours of continuing professional education each year to ensure that they remain informed, empowered and educated.

Code of Ethics
As leaders who inspire public confidence in the integrity and objectivity of the profession, CFEs adhere to the Certified Fraud Examiners Code of Professional ethics.
The code includes:

• Commitment to professionalism
• Diligence in performance
• Avoidance of conflict of interest
• Testifying truthfully and without bias or prejudice
• Complete confidentiality
• Revelation of all material matters discovered during an examination
• Continued effort to increase the competence and effectiveness of professional services performed under his or her direction

The CFE credential is the globally preferred certification for anti-fraud professionals. CFEs are specialists in the detection, deterrence and investigation of fraud. Over 20,000 CFEs are actively fighting fraud worldwide.

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service delivered with a genuine sense of warmth, friendliness, individual pride and Company Spirit, in a manner exceeding expectations.

Monday, July 9, 2012

SOUTH GROUP SPRINGHILL KOREA: China, Korea linked to pill scam | Bangkok Post: news | Dropjack-livejournal

http://springhillcare.livejournal.com/8774.html

The move came after the Department of Special Investigation (DSI) obtained information that a Thai company had struck a deal to buy 10 billion pseudoephedrine-based cold tablets from a Chinese firm.

Previously, the DSI obtained information that the firm also signed a deal to buy 850 million tablets, or 40 tonnes of the medicine, from South Korea.

The DSI found that 87 million cold tablets were transported into Thailand from South Korea by plane on nine occasions since 2010.

They had false air cargo manifests to avoid attracting attention from the authorities.

The DSI suspected the medicines were smuggled in from South Korea.

The DSI is investigating two companies suspected of being involved in the smuggling of the pills from overseas.

The companies are UTAC Thai Co Ltd, a supplier of integrated circuits, and TVR Group Co Ltd, a car dealer and vehicle hire firm.

Some information relating to the drug purchases was uncovered at the companies during recent searches of their premises but the firms denied any involvement.

Mr Tarit said yesterday DSI officials also discovered a contract to buy 10 billion pseudoephedrine-based cold tablets from China during the search at UTAC Thai Co Ltd.

Under the contract, the first batch of 2 million tablets was to have been shipped to Thailand on July 31, 2009.

He said the DSI also found a photo showing a man collecting the pills from Suvarnabhumi airport cargo warehouse.

The cold tablets from China and South Korea have the same brand name of COLCOLCO, he said.

Mr Tarit said DSI officials also searched the company’s factory but there was nothing amiss.

However, it was found that the company had three South Korean executives and one Thai executive, Mr Tarit said.

He said the Korean Food and Drug Administration recently sent information regarding the nine shipments of pills which showed the contract to buy the cold tablets from South Korean was signed by UTAC Thai Co.

Mr Tarit said the DSI’s special case committee had decided to take up the inquiry into the pseudoephedrine smuggling case.

The committee had also agreed to investigate call centre scams involving criminal gangs duping people into transferring money to their accounts via ATMs.

Mr Tarit said he would head the inquiry into the smuggling of the cold tablets and lead an investigation team to travel to South Korea to seek more information about the contract.

Mr Tarit said shipping companies that were paid to import the pills would face prosecution for supporting the alleged smuggling of the medicine and for making false declarations, even if the tablets went through proper customs procedures before being shipped to Thailand.

Deputy Prime Minister Chalerm Yubamrung, who chairs the DSI’s special case committee, said he had sought help from senior authorities in China to support Thailand’s efforts to crack down on the smuggling of cold pills and they were willing to help.

Newsvine – Group of Springhill South Korea: The Laziest Scams in Internet History-livejournal

http://springhillcare.livejournal.com/9068.html