Saturday, December 27, 2014

Wayne Residents Among Six Home Health Agency Employees Charged with Scamming Medicaid



Press release:
Six current and former home health agency employees have been charged by the Office of the Insurance Fraud Prosecutor for scamming Medicaid, Acting Attorney General John J. Hoffman said.

Recently, Anatoli Rountsev, 52, of Totowa, pleaded guilty to charges that he caused bills to be submitted to the Medicaid program for services that were never provided.

Rountsev pleaded guilty Dec. 19 to one count of second-degree health care claims fraud. As part of the plea agreement, the State recommended that he serve three years in state prison and pay restitution in the amount of $12,598. His sentencing is scheduled for March 27, 2015.

Rountsev admitted that between January 2008 and June 2009, he caused 463 false claims to be submitted to Medicaid for services that he did not provide. Rountsev failed to provide home health aide services for Medicaid beneficiaries on hundreds of claims since he was actually at another, unrelated job, and therefore unable to have performed any of the services, Hoffman said. The investigation determined that, as a result, Medicaid paid out $12,598.

Rountsev was a certified homemaker home health aide at Confident Care Corporation, a company that is headquartered in Hackensack and has ten satellite offices throughout New Jersey, as well as offices in Florida.

He is one of six current or former employees of Confident Care to be charged by OIFP for scamming Medicaid in a similar fashion. The others include:
  • Vladimir Faerman, 66, of Hawthorne, charged in October with 175 counts of second-degree health care claims fraud, second-degree theft by deception and third-degree Medicaid fraud. Faerman allegedly caused fraudulent claims totaling $87,616.23 to be submitted to the Medicaid program for work he never actually completed.

  • Elhan Gurban, 52, of Fort Lee, charged in July with 45 counts of second-degree health care claims fraud and one count each of third-degree Medicaid fraud and third-degree theft by deception. Gurban allegedly caused 1,413 false claims to be submitted to Medicaid, which paid out $64,125.

  • Roman Abashkin, 32, of Wayne, charged in July with 24 counts of second-degree health care claims fraud and one count each of third-degree Medicaid fraud and third-degree theft by deception. Abashkin allegedly caused 212 fraudulent claims to be submitted to Medicaid, which paid out $6,664.

  • Semen Rybalov, 68, of Wayne, charged in July with 15 counts of second-degree health care claims fraud and one count each of third-degree Medicaid fraud and third-degree theft by deception. Rybalov allegedly caused 45 false claims to be submitted to Medicaid, which paid out $2,180.

  • Naum Lavnevich, 56, of Oakland charged in June with 154 counts of second-degree health care claims fraud, one count of third-degree Medicaid fraud and one count of third-degree theft by deception. Lavenich allegedly caused 178 false claims to be submitted to Medicaid, which paid out $5,614.
Acting Insurance Fraud Prosecutor Chillemi noted that some important cases have started with anonymous tips. People who are concerned about insurance cheating and have information about a fraud can report it anonymously by calling the toll‑free hotline at 1‑877‑55‑FRAUD, or visiting the Web site at www.NJInsurancefraud.org. State regulations permit a reward to be paid to an eligible person who provides information that leads to an arrest, prosecution and conviction for insurance fraud.

Full Article & Source:
Wayne Residents Among Six Home Health Agency Employees Charged with Scamming Medicaid

1 comment:

Tina said...

We need to beef up our Medicaid fraud units because too many people who need Medicaid are denied while the scammers operate.