The American Chiropractor Volume 36, Issue 6 | Page 68

Newport, KY Chiropractor convicted of health
care fraud conspiracy
NEWPORT, KY -The owner of a chiropractic clinic in Newport, Ky. has been convicted of a fraud scheme involving tens
of thousands of dollars.
A federal jurv in Covington convicted 48-vear-old Andrea
Almond. of Cincinnati. for conspiracy to commit health care
fraud late Friday afternoon. The jury returned the verdict after
four days of trial and six hours of deliberation.
According to evidence established at trial, from September 2008
through April 2010, Almond conspired with a co-defendant to
bill the Kentucky Medicaid Program for chiropractic services
rendered at the Newport Chiropractic Center.
Court documents state that Almond never actually practiced
at the Newport Chiropractic Center. The billed services were
instead provided bv other doctors. who had never been approved
or emolled in Kentuckv Medicaid Program.
Officials say Almond billed the Kentucky Medicaid Program
using her National Provider Identification number, knowing
that the Kentucky Medicaid Program would not have paid for
any claims for treatment rendered by unapproved providers.
Officials say Almond and her co-conspirator fraudulently
submitted approximately 1,943 claims to the Kentucky Medicaid Program, which totaled $483 ,797. Documents state they
received $95,098 in payment.
Co-conspirator Elaine Legg has already pled guilty in the case.
In a separate case, Dr. Nanci Allen, a former part owner in the
Erlanger Chiropractic Clinic, pled guilty to a similar scheme
to defraud the Kentucky Medicaid Program. These individuals
are also awaiting sentencing.
Almond will appear for sentencing on September 4, 2014. She
faces a maximum of 10 years in prison.
Source: http://wwwjox19.com/

Los Angeles Physician Assistant Pleads Guilty
in Two Medicare Fraud Cases
Erasmus Kotey. 77. of Montebello. Calif.. pleaded guilty before U.S. District Judge Margaret M. Morrow in the Central
District of California to one count of health care fraud and one

count of conspiracv to commit health care fraud. Sentencing
is scheduled for Sept. 8, 2014.
According to court documents, Kotey was a physician assistant who worked at medical clinics in and around Los Angeles County. From approximately November 2007 through
February 2008, Kotey engaged in a scheme to commit health
care fraud through his work at a clinic located at 866 North
Vermont Avenue in Los Angeles. In addition, from approximately April 2008 through December 2008, Kotey engaged in
a conspiracy to commit health care fraud through his work at
a clinic located at 943 South Atlantic Boulevard, Suite 218, in
Monterey Park, Calif.
At both clinics. Kotey signed prescriptions and other medical
documents for medically unnecessary power wheelchairs and
other durable medical equipment (DME). Kotey and his coconspirators then sold the prescriptions to DME supply companies, knowing that the prescriptions were fraudulent. Based
on these fraudulent prescriptions. the DME supply companies
then submitted false and fraudulent claims to Medicare.
Combined, the two indictments allege that fraudulent prescriptions from Kotey were responsible for approximately $7 million
in false and fraudulent claims to Medicare, and Medicare paid
approximately $3 million on those claims.
The cases were investigated by the FBI, HHS-OIG and the IRS
and brought as part of the Medicare Fraud Strike Force, under
the supervision of the Criminal Division's Fraud Section and
the U. S. Attorney 's Office forthe Central District of California.
The cases are being prosecuted by Trial Attorney Fred Medick
of the Fraud Section and Assistant U. S. Attorneys Kristen Williams and Cathy Ostiller of the Central District of California.
Since its inception in March 2007, the Medicare Fraud Strike
Force, now operating in nine cities across the country, has
charged more than 1,700 defendants who have collectively
billed the Medicare program for more than $5.5 billion. In
addition, HHS 's Centers for Medicare and Medicaid Services,
working in conjunction with HHS-OIG, are taking steps to
increase accountability and decrease the presence offraudulent
providers.

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