This Month in Corruption: Short Rebates, Costly Supplies, Pricey Medicaid Services, etc.

Tuesday, October 31, 2017

Medicaid Shortchanged on Epi-Pen Rebates. Attorney General Maura Healey announced on Oct. 3 that Mylan, the pharmaceutical company, will pay $20.3 million to the Massachusetts Medicaid program (MassHealth) to resolve allegations that it knowingly underpaid rebates owed to the program for EpiPens dispensed to program members/recipients.  The payment is part of a “global settlement” with all of the 49 other states, the federal government, and the District of Columbia.  “Mylan knowingly misrepresented this drug to MassHealth in order to underpay on rebates and make a profit at the expense of our state,” said Healey.  “This settlement brings critical funds back to our MassHealth program.  Companies that receive payments from taxpayer-funded programs must be held accountable when they abuse this system.”

Massport Overcharged for Supplies.  Interline Brands, a New Jersey company, will pay a settlement of nearly $2 million to resolve allegations it overcharged the Massachusetts Port Authority hundreds of thousands of dollars for cleaning supplies, Attorney General Maura Healey announced on Oct. 10.  The investigation into Interline’s pricing methods began with a complaint from someone who walked into the office of the state’s Inspector General Glenn Cunha one day.  Under the terms of the settlement, Massport will receive $958,000 in damages, and other entities that were over-billed will receive more than $22,000.  Cunha’s office will receive $60,000 to defray the costs of the investigation, and the balance – roughly $960,000 – will go to the state’s general fund.
Arrest Made in Medicaid Overbilling. The owner of a home health agency, Hellen Kiago, 47, of Sturbridge, was arrested on the morning of Oct. 11 by Massachusetts State Police officers assigned to the office of Attorney General Maura Healey for allegedly stealing approximately $2.7 million from the state’s Medicaid program (MassHealth) by routinely overbilling and falsely billing for services that were not authorized, according to Healey’s office.  Kiago was identified by the authorities as the sole owner of Lifestream Healthcare Alliance, which has offices in Worcester and Dracut.  Kiago pleaded innocent at her subsequent arraignment.  Healey’s office began an investigation into Lifestream after receiving complaints from several former employees “alleging misconduct and fraudulent billing practices.”

Police Officer Indicted on Larceny, Money Laundering Charges. On Oct. 12, a Suffolk County grand jury indicted Joseph Nee, 44, a Boston police officer assigned to the department’s Evidence Management Unit in Hyde Park, on charges of larceny over $250 and money laundering (one count each).  Nee is accused of stealing money from the evidence room and attempting to launder it at the Plainridge Park Casino.  Authorities allege that Nee stole approximately $2,000 from the file of a closed bank robbery case.  The stolen money was identified by the traces of red dye left from an anti-theft dye pack that discharged during the robber, according to the Office of Attorney General Maura Healey.
Sheriff Employee Snared in Cash Smuggling Case. Jamie Melo, 45, of North Dartmouth, a captain with the Bristol County Sheriff’s Office, was indicted on Oct. 25 by a federal grand jury for allegedly helping Carlos Rafael, the owner of one of the largest commercial fishing businesses in the U.S., smuggle the profits from an illegal overfishing scheme to Portugal.  Melo was charged with one count each of bulk cash smuggling, structuring, and conspiracy, according to the Office of Acting U.S. Attorney for Massachusetts William D. Weinreb.    

Five Go Down in False ID Scheme. Five individuals charged in connection with a scheme to produce false identification documents through the Massachusetts Registry of Motor Vehicles (RMV) have agreed to plead guilty in federal court, according to an Oct. 2 announcement from Acting U.S. Attorney for Massachusetts William D. Weinreb.  The defendants in the case have been identified as: Evelyn Medina, 56; Annette Gracia, 37; Kimberly Jordan, 33; David Brimage, 46; and Bivian Yohanny Brea, 41.  All of the defendants reside in Boston, with the exception of Jordan, who is from Randolph.  Each has agreed to plead guilty to one count of producing without lawful authority an identification document or a false identification document, Weinreb announced.  At the time of their arrests, Medina, Gracia, Jordan and Brimage were all employed as clerks at the Haymarket RMV office in Boston.  The scheme involved the production, for cash, of Massachusetts driver’s licenses and identification cards for illegal aliens.
Falsifying Records? IRS Employee Says ‘Guilty.’ Erik Santiago-Then, 36, of Lawrence, pleaded guilty in federal court in Boston on Oct. 10 to ten counts of falsifying records in a federal investigation, the Office of Acting U.S. Attorney for Massachusetts William D. Weinreb reported.  Santiago-Then was working as a paid cooperator for the Internal Revenue Service’s Criminal Investigation (IRS-CI) unit when the falsifications occurred.  He is due to be sentenced on Jan. 3, 2018.  Here’s how Weinreb’s office described the crime:

“As part of his work uncovering evidence against the perpetrators of a stolen identity refund fraud scheme, Santiago-Then was given IRS-CI funds and authorized to set up a controlled meeting for the purpose of purchasing fraudulently-obtained tax refund checks.  However, Santiago-Then set up a sham meeting with a cohort during which time he obtained a list of personal identifying information, rather than tax refund checks.  Following the controlled meeting, and unbeknownst to IRS-CI, Santiago-Then split the IRS-CI funds with his cohort.  Santiago-Then subsequently engineered several recorded phone calls during which his cohort posed as someone else and purportedly gave Santiago-Then the run-around concerning the purported mix-up regarding the tax refund checks.”

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