Articles Posted in White Collar Crimes

In a recent Supreme Judicial Court of Massachusetts written opinion regarding a Massachusetts Medicare false claim and larceny case, the court upheld the trial court conviction of the defendant for four counts of violating the Medicaid false claims statute, and one count of larceny over $250 by false pretenses, holding that the trial court was correct in its decisions. The Supreme Judicial Court concluded that due to a variety of reasons, the five claims made by the defendant are not compelling, and subsequently, affirmed the trial court decision.

Facts of the Case

According to the court’s opinion, on April 8, 2014, the defendant signed a provider contract agreeing to “comply with all federal and state laws, regulations, and rules.” In 2015, the defendant overruled the assessment of a registered nurse regarding the care of two patients, directing that the two patients receive more hours than the registered nurse had determined was necessary for their care. These directions would become the basis for the larceny and Medicare false claim charges registered against the defendant.

Additionally, the defendant falsely instructed one of her employees to cover up illegal practices regarding overcharging, telling her to label them “clerical errors” and “inadvertent” even though they were intentional. Another employee involved in the defendant’s billing process raised the alarm, pointing out that home health aides working for the defendant did not have the required training certifications. When she brought this to the attention of the defendant, she was told to continue billing for the services regardless of certification level. Finally, facing an external audit, the defendant engaged in fraudulent practices, attempting to fool auditors by having files faxed to the office to convince outside observers that the files were received from external doctors when they were in fact sent by the defendant back to herself.

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Investigators from local, state, and federal authorities announced last week that they have made an arrest inconnection with an extensive criminal operation, which involved identity theft, high end electronics, and counterfeit money. The suspect was arrested last Thursday on the Boston Common after he allegedly attempted to purchase counterfeit money.

The alleged criminal enterprise involved a man operating out of a kiosk located within a jewelry store, named “Time Products,” which is located at Downtown Crossing on Washington Street.

Authorities believe that the suspect would procure credit card information from people, or use their identities to apply for new credit card accounts. He would then use that information to purchase iPads, high end cell phones, and other high end electronics.

Attorney General Martha Coakley stated, among other things, that “Runners were paid [to use] those accounts to obtain smart phones and other high-end electronics at discounted prices from stores across the Commonwealth.”

It is believed that the runners would use the acquired identities or credit cards to purchase the high end phones at a discount, by for example agreeing to a two year service contract. A local news station reported that the credit cards may have also been used to purchase gift cards, which were then used to purchase merchandise. The products were in turn then sold, either from the kiosk or on the street, at a lower than market price.

Police said that an undercover investigation, which is ongoing, ultimately led to the arrest of the suspect. The Boston PD commissioner said that more arrests are expected, in addition to the at least two other men who have been arrested on unspecified charges.
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