A trio of alleged and admitted Medicaid frauds

Tools

Three Medicaid fraud cases made headlines recently, raising eyebrows due to benefits perpetrators gained or off-the-chart utilization patterns.

New Jersey officials announced 13 arrests as part of "Operation Rayscam," a law enforcement bust of an alleged Medicaid crime ring, The Star-Ledger reported. The leader, Rehan "Ray" Zuberi, stands accused of filing 30,000 fraudulent claims for unnecessary diagnostic testing. He also allegedly paid doctors more than $300,000 in kickbacks for referring patients.

"It's disgusting," Acting State Attorney General John J. Hoffman told The Star-Ledger. "This enterprise allegedly bilked millions of dollars from Medicaid, a program designed to help New Jersey's most vulnerable population."

The case began with an anonymous tip 18 months ago, according to Hoffman. The investigation led to search warrants on 14 locations, including 10 of Zuberi's offices and his billing company.

Zuberi is another example of a previously-excluded provider who allegedly robbed Medicaid again. Program dollars picked up the tab for his lavish lifestyle in a 9,000-square-foot mansion where Zuberi stored $100,000 in cash. He also paid for a Lamborghini with a $400,000 cashier's check, the article noted.

Also living large on the government's nickel was an owner of a counseling service who faces seven years behind bars. Garry A. Hankerson, Jr. pleaded guilty to racketeering and conspiracy to defraud the state after billing $622,000 for more services than he rendered, the Atlanta Journal-Constitution reported. Hankerson used Medicaid money to travel to Jamaica, Puerto Rico and Las Vegas and buy a luxury home and cars, the article noted.

Finally, authorities charged another dentist with insurance fraud, The Stamford Advocate reported. Georgy Betser, D.D.S., claimed to have seen 87 Medicaid patients in nursing homes on one day, according to his arrest affidavit. On another day, Betser filed for 261 procedures rendered to 71 beneficiaries in four cities. Audits revealed that services he claimed weren't documented. One patient for whom Betser billed was in hospice care, had difficulty breathing and died that same day, the article noted.

For more:
- here's the Star-Ledger article
- see the Atlanta Journal-Constitution article
- read the Stamford Advocate article

Related Articles:
The cautionary tale of Florence Bikundi, an excluded provider
Dental fraud and abuse rob Medicaid
Assistant US Attorney Ted Radway on fighting Medicaid fraud
Dentists call for audit standards
States boost efforts to fight Medicaid fraud

Filed Under