INVESTIGATIONS & AUDITS GROUP. Date: 07/07/2015. All Medicare Advantage and Part D Plan Sponsors. Mark Majestic Director
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1 DEPARTMENT OF HEALTH & HUMAN SERVICES Centers for Medicare & Medicaid Services 7500 Security Boulevard Baltimore, Maryland INVESTIGATIONS & AUDITS GROUP Date: 07/07/2015 To: From: All Medicare Advantage and Part D Plan Sponsors Mark Majestic Director Re: Medicare Fraud Strike Force 2015 On Thursday June 18, 2015, there was a nationwide takedown in multiple cities resulting in indictments against 66 Medicare providers. The providers include home health agencies, pharmacies, physicians, and durable medical equipment suppliers. The enforcement actions are the result of the Medicare Fraud Strike Force operations, which are part of the Health Care Fraud Prevention & Action Team (HEAT). HEAT is a joint initiative between the Department of Justice and HHS focused on combining efforts to detect, prevent and deter fraud and enforce anti-fraud laws around the country. We are alerting you to this information so that you can take appropriate measures regarding these providers and the Medicare Part C and Part D benefits you offer. These measures, in particular, should be focused on the appropriate detection and identification of fraud, waste and abuse as required under Medicare Part C and Part D programs. Enclosed is a list of all of the providers that were indicted as part of this investigation. If you identify egregious billings from these providers, please contact Health Integrity, CMS National Benefit Integrity Medicare Integrity Contractor (NBI MEDIC) or CMS. Any questions you may have on this subject should be directed to your CMS Account Manager and Martina Gilly of the National Benefit Integrity MEDIC at gillym@healthintegrity.org. The MEDIC may also be reached at SAFERX ( ). 1
2 List of Indicted Providers Provider/Pharmacy Pramela Ganji, MD (Christian HH) Medpsych Nursing Home Psych Services (NHPS) FL/Rodney Hesson NHPS FL/Rodney Hesson Alpha Pharmacy & Discount Rx Quality (deactivated) Vivi Pharmacy Bayou River Health Systems / Louella Givens NHPS FL/Rodney Hesson Angeles Home Health Agency, Inc Little Havana Store Inc. Sophia Lin, DC 1111 Medical Center Blvd, STE 304 North, Marrero, LA, Windlewood Dr, Katy, TX, E Columbus St, Dadeville, AL, Constellation Dr, Slidell, LA, SW 8th St, Miami, FL, SW 8th St STE 44, Miami, FL, NW 7th St STE , Miami, FL, th Street, Suite A, Mandeville, LA, Galaxie Dr, Suite A-1, Jackson, MS, SW 72nd St, Suite 108, Miami, FL, SW 1st St, Miami, FL, Old Town Rd, Port Jefferson Station, NY, BG MD11311R PH PH X
3 Nirmal Mazumdar NHPS FL/Rodney Hesson Dr. Eduardo Carrillo, MD Constance Umeh-Nnadi dba CNN Home Health Care, Inc. Sonic Pharmacy Nicole Pharmacy LLC Professional HHC Palm Village Family Clinic Mauran Ambulance, Inc. Renovation Health Care LLC Endless Medical Services d/b/a EZ Pharmacy Waseem Alam Blue Water HHC Fondren Rd STE 460, Houston, TX, Archie Wheat Rd, Poplarville, MS, Retama Street, Suite C, Elsa, TX, Corner Oaks Ln, Houston, TX, N Homestead Blvd, Homestead, FL, W 44th Pl, Hialeah, FL, N Canton Center Rd, Suite # 387, Canton, MI, Mile 7 Rd, Penitas, TX, st St, San Fernando, CA Commerce Way, Suite # 550, Miami Lakes, FL, SW 8th Street, Miami, FL, Woodward Ave, Bloomfield Hills, MI, E 14 Mile Rd, Suite B, Roseville, MI, F BC L PH ** BA WA
4 Astra Pharmacy Hatem Ataya MD PC Dr. Joseph R. Altamirano Omeed Memar Gerald Daneshvar Care Concepts of Louisiana Galaxy Pharmacy & Discount Renovation Health Care LLC Martell Pharmacy Garcia Pharmacy Laran Lerner At Home Network EDI Pharmacy Godwin Oriakhi dba Baptist Home Care Providers, Incorporated 237 NW 12th Ave STE D, Miami, FL, Baldwin Rd, Lapeer, MI, Santa Monica Blvd, Suite 202, Los Angeles, CA, E Washington St STE 200, Chicago, IL, Joseph Campau St, Hamtramck, MI, Houma Blvd, Suite 308, Metairie, LA, W Flagler St STE D, Miami, FL, SW 122nd Ave, Miami, FL, W Flagler St, Miami, FL, Beacom Blvd, Miami, FL, S Merriman Rd, Westland, MI, Middlebelt Rd, Livonia, MI, East 9th Street, Hialeah, FL, Harwin Dr, Suite 125, Houston, TX, BA G BM FD PH BL , FL LL PH
5 Royal Care Pharmacy Titan Management Services d/b/a Maxima Home Health, Bayou River d/b/a HouseCall Richelle Munoz, OT Celeste Brown Sanders Dorothy Pana, PT Precious Deshield dba Medpsych Home Health Care NW Pharmacy Inc Miller Home Care PCS MS/Gertrude Parker Choice Medical Home Ricardo Mendez, ARNP CBC Services LLC Christian Home Health Robert Rouzaud 7300 W Sunset Blvd STE L, Los Angeles, CA, Stumpf Blvd, Bldg 7 Suite 8, Terrytown, LA, E 4th St, Brooklyn, NY, Pearl St, Suite 308, Ypsilanti, MI, th Ave., #C, Flushing, NY, Bellaire Blvd, 145, Houston, TX, NW 7th St, Miami, FL, SW 72nd St STE 214, Miami, FL, Market St, Flowood, MS, Prairie St STE 200, Chatsworth, CA, Mile 7 Rd, Penitas, TX, Pearl St, Suite 308, Ypsilanti, MI, Jackson Ave, Suite A, New Orleans, LA, E 152nd St, Cleveland, OH, P MM FR
6 Waseem Alam MD PC PCS AL/Getrude Parker Hatem Ataya PCS FL/Gertrude Parker Biomax Pharmacy Dixie Pharmacy & Discount PCS LA/Gertrude Parker Godwin Ogbuokiri, MD (Christian HH) Metro Physical Therapy Bliss Healthcare Naranja Pharmacy San Nicolas Pharmacy Barry Lake Fischer Woodward Ave, Bloomfield Hills, MI, Perimeter Park S, STE 100N, Birmingham, AL, Court St, West Branch, MI, Grand Blvd, STE 206, Miramar Beach, FL, SW 42nd St STE # 212, Miami, FL, S Dixie Hwy, Palmetto Bay, FL, Doubloon Dr, Slidell, LA, Downman Rd, New Orleans, LA, Northland Dr E, Suite 208, Southfield, MI, S Grand Ave, Glendora, CA, S Dixie Hwy, Homestead, FL, W Flagler St, Suite 102, Miami, FL, Fairway Dr, Naperville, IL, BA , FA PH PH R PH PH BF
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