Are Regulators Cracking Down on Elder Abuse Medicare Fraud?

California State health insurance regulators are cracking down on insurance brokers who prey on elderly consumers confused by new federal health insurance rules.

On Tuesday, the Department of Managed Health Care took steps to bar a Folsom insurance agent from selling Medicare Advantage plans after she allegedly defrauded at least 12 capital-area seniors, who then incurred thousands of dollars in unexpected medical bills.

The agent, identified by state officials as Nadia King, allegedly canceled the existing Medicare coverage of her clients and enrolled them in Medicare Advantage plans run by private insurers.

King could not be reached for comment. She has until the end of the month to appeal the decision to revoke her privilege to sell Medicare Advantage products.

She is one of two dozen agents across the state getting legal scrutiny because of what officials said was deceptive marketing aimed at seniors.

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Are Regulators Cracking Down on Elder Abuse Medicare Fraud?

Caregiver Arrested for Theft

Erma Jean Williams, 58, is accused of taking vacations, remodeling her home and buying a car - all at the expense of Marian McGlone, the 90-year-old woman she was caring for.

"This lady took advantage of two really good people. My dad and step-mom. They were really good people," said step-son Robert McGlone.

Investigators say over a period of two years, Williams took control of McGlone's estate.

The NBC2 Investigators obtained video taken at an attorney's office. It documents the second to last time Williams tried to get Marian to change her will, just two weeks before she died.

The brothers say the video proves their mother was being taken advantage of.

"It shows she didn't know why she was there, how she got there, she didn't even remember our father's name," said Ronald McGlone.

Due to worries that McGlone wasn't competent, the will wasn't changed that day. But the sheriff's report shows four days later, Williams brought McGlone back to the office.

At that time the will was changed, leaving half of McGlone's trust to Williams.

McGlone died two weeks later.

Investigators say in the end, Williams stole more than $200,000 from the family.

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Caregiver Arrested for Stealing Money From Elderly Woman

'Socially Inept' PA Judge Gets Two Months Suspension

A district judge described by his attorney as "socially inept and challenged with women" was suspended without pay Tuesday for two months for behavior that included calling female lawyers repeatedly and making uninvited visits to their homes or offices.

The Court of Judicial Discipline also placed North East District Judge Gerard Alonge on probation until his current term expires at the end of next year and directed him to continue getting mental health treatment.

The 51-year-old Alonge apologized in court for behavior that the court described as "bizarre and weird" and "conduct akin to 'stalking.'"

"Never did I act or speak with malice, nor did I ever seek to cause distress to the women," Alonge said during a court hearing that included videotaped testimony by lawyers who praised his work as a judge.

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"Socially Inept" PA Judge Gets 2 Months Suspension

Complaint Dismissed in Contested Guardianship Action

For more than two years, I have been representing an elderly man in a contested guardianship action. My client’s son claimed that my client was incapacitated, and instituted a guardianship action in the Superior Court of New Jersey, Union County in November of 2007. I opposed that guardianship action on behalf of my client, maintaining that my client was competent and that the son was pursuing the action because he wanted control over his father’s assets.

After more than two years of litigation, and eight days of trial that spanned from March to December of 2009, Union County Superior Court Judge John F. Malone, P.J.Ch., issued his opinion on May 11, 2010, ruling in favor of my client and dismissing the son’s guardianship complaint.

Judge Malone found that my client’s son had failed to meet his burden of demonstrating that my client was incapacitated; instead, Judge Malone declared that my client was “logical, coherent and has good clarity of thought. [He] functions cognitively; he is lucid, alert, he can understand, communicate and remember information.”

Full Article and Source: Complaint Dismissed in Contested Guardianship Lawsuit, Dismissing Complaint Filed By Adult Child

94 Charged in Medicare Scams Totaling $251 mil

Elderly Russian immigrants lined up to take kickbacks from the backroom of a Brooklyn clinic. Claims flooded in from Miami for HIV treatments that never occurred. One professional patient was named in nearly 4,000 false Medicare claims.

Authorities said busts carried out this week in Miami, New York City, Detroit, Houston and Baton Rouge, La., were the largest Medicare fraud takedown in history - part of a massive overhaul in the way federal officials are preventing and prosecuting the crimes.

In all, 94 people - including several doctors and nurses - were charged Friday in scams totaling $251 million. Federal authorities, while touting the operation, cautioned the cases represent only a fraction of the estimated $60 billion to $90 billion in Medicare fraud absorbed by taxpayers each year.

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94 Charged in Medicare Scams Totaling $251 mil

For Elderly KY Couple, Help at Home Was a Nightmare

In failing health but determined to stay in their Jeffersontown home, Hans and Martha Rau turned several years ago to a personal service business for help with daily needs, including bathing, dressing and housekeeping.

But over a period of 12 months, the couple said, their paid helpers twice defrauded and exploited them.

Tens of thousands of dollars in cash, jewelry and valuables were stolen, including gold bands the couple exchanged before their 1948 wedding, according to the Raus' report to police.

And the workers -- who by law are not authorized to dispense medication -- sometimes mixed the couples' painkillers, overmedicating Martha Rau.

"It was terrible," said Hans Rau, 83, a former teacher who has severe arthritis and Parkinson's disease.

"A lot of things that were stolen were treasures to me,'' said Martha Rau, 81, who has arthritis and dementia.

While the 2009 General Assembly passed a law requiring personal service businesses to be certified with the Cabinet for Health and Family Services, it provides little oversight and few avenues for sanctions.

"It's pretty lame," said the Raus' son, Tom Rau of Jacksonville, Fla. "It needs more oversight."

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For Elderly Couple, Help at Home Was a Nightmare

Guardianship of Elderly Texans Examined

Between the years 2000 and 2040, the number of Texans aged 65 and over is expected to increase from two million to seven million, representing 16 percent of the total Texas population.

In addition to Texas' aging population, the 2006 American Community Survey conducted by the US Census found that approximately 15 percent of Texans had one or more disabilities. That number will increase as the population ages, placing even more demands on the Department of Aging and Disability Services (DADS) and Adult Protective Services (APS).

The Senate Committee on Jurisprudence, which I chair, recently heard testimony concerning the state's guardianship program implemented by DADS and APS. The hearing was in response to Lt. Governor David Dewhurst's interim charge, which asked the committee to study the efficiency and effectiveness of the guardianship program.

The program has been in the headlines lately as the result of various allegations by Texans, including claims of abuse or neglect within state-run facilities; improper revocation of guardianship status; mistaken determination of incapacity; abuse within the court system; and the mishandling of a ward's estate.

One widely publicized case documented an elderly couple allegedly forced into state custody after an APS investigation led to a judge's determination that they were incapacitated. As a result, the couple lost control of their home, their finances and, ultimately, their lives. This particular case illustrated an increasingly common claim made against the state guardianship program, that it lacks protection for the ward and the ward's estate.

Under the current state guardianship program, APS is charged with investigating allegations of abuse, neglect and exploitation to determine if a public guardian is necessary. Should APS determine that a guardian is appropriate for the situation, APS may refer the case to the DADS guardianship program.

After the referral, APS assists DADS with the process by providing details of the ward's assessment and serving as a resource during probate proceedings.

In the course of providing protective services to elderly and/or disabled Texans, APS may file emergency orders for protective services. These legal actions are presented to statutory probate courts or other courts with probate jurisdiction.

Since any abuse or injustice within the state guardianship program is unacceptable, this issue requires further examination by the Texas Legislature to ensure that elderly and disabled Texans are adequately protected.

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Guardianship of Elderly Texans Examined

Scrutiny Returns to Retirement Centers

Advocates Want More Oversight of Communities for Aged; the 'Refundable' Fees That Vanished

A fast-growing sector of senior housing is coming under increased scrutiny in Washington.

On Wednesday, a Senate committee will hold a hearing to discuss mounting concerns about continuing-care retirement communities, or CCRCs, which often charge large upfront fees to seniors in exchange for the promise of lifetime care. The hearing comes on the same day the Government Accountability Office releases a report urging state regulators of the CCRCs to be vigilant in their oversight of the communities.

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Scrutiny Turns to Retirement Centers

'The Killing of John Figg-Hoblyn'

You will probably not read this story in a local Santa Barbara newspaper. For in truth, it takes courage for a paper to even report an on-going atrocity when it involves local people and local businesses—and this story is truly the proverbial ‘tip of the iceberg’. This manner of Elder Abuse stretches far beyond Santa Barbara County and is a growing national concern. I strongly suggest everyone who reads this, should view the website of the National Association to Stop Guardian Abuse (NASGA) listed below.

This story begins in March, 2008 when I first began visiting John and Peggy Figg-Hoblyn. They were living a rather carefree life, in an old RV donated to them by a friend. Unlike most people I know, they had no debts and lived fairly comfortably on the $1600.00 a month they received in combined Social Security checks. They enjoyed each day to the fullest, doing the activities that John enjoyed most: hiking as much as ten miles a day, including long walks around Lake Cassitas; frequent visits from friends; reading the bible aloud in a strong, clear voice; attending the church of their choice every Sunday and remaining remarkably healthy and vigorous on what one doctor and a world renowned nutritionist, Patricia Bragg, called, an ideal organic diet.

There are hundreds of people in the Ojai Valley who marveled at the sight of this 82 year old man and his 73 year old sister/companion of 45 years as they were observed hiking for miles at a time, with full back packs. When John suffered a Urinary Tract infection and was admitted to the Ojai Community Hospital, the attending doctor and one of the lab technicians were amazed at the strength of John’s heart and his overall great physical condition. In his report, the doctor mentions talking to John. I mention this because John is sometimes slow to speak and one might think he is unable to communicate. Nothing is farther from the truth and especially if he gets angry or hears something he doesn’t agree with. John laughs readily at anything humorous. At age 82, John had never had a flu shot, never taken a psycho-tropic drug. With the help of his sister and friends, John was on a daily exercise regimen in addition to his rigorous walking regimen.

John Figg-Hoblyn has been incarcerated, with all loss of normal freedoms since August 11, 2008. There is no daily exercise regime, in fact he is encouraged to sit in a wheel chair instead of walking. His diet is not the one recommended by his doctor. Peggy is not allowed to take pictures of John. He is not free to go where he wants, do what he wants—not even go to church. Since August 11, 2008, he has had a daily diet of psycho-tropic drugs to keep his mind dull and his energy level reduced. John’s life has been ruined. He has the same privileges of any inmate on death row—where John actually sits right now. He is angry, frustrated and more and more going silent and limp.

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NASGA: John Figg-Hoblyn