West Virginia

July 23, 2010

Martinsburg Physician Indicted for Health Care Fraud (U.S. Attorney for the Northern District of West Virginia)

Martinsburg, West Virginia - A 54 year old Martinsburg physician was named in an Indictment returned by a Federal Grand Jury sitting in Martinsburg, West Virginia.

United States Attorney Betsy C. Jividen announced that Danine A. Rydland,  MD, was named in a 38-count Indictment charging her with health care fraud.  From June 1, 2004, to September 5, 2008, Rydland owned and operated a medical practice located in Falling Waters, Berkeley County, West Virginia; where she was assisted in the day-to-day operation of her medical practice, including the preparation of claims for reimbursement and submission of same to Medicare, West Virginia Medicaid, the Public Employee Insurance Agency, Unicare, and other third party payers.

Counts One through Fourteen of the Indictment allege that Rydland devised a scheme to defraud health care benefit programs, namely, Medicare, Medicaid, PEIA, and Unicare, and to obtain money owned by and under the custody of said health care benefit programs by means of false and fraudulent pretenses from June 2004 and continuing to September 2008.  It was part of the scheme that Rydland fraudulently obtained approximately $22,000 from Medicare; $59,000 from Medicaid; $3,400 from Unicare; and $2,800 from PEIA as a result of claims for prolonged services that were not rendered and for which there was no documentation of the amount of time spent in face-to-face contact with the patients.

Counts Fifteen through Twenty-Six of the Indictment allege that Rydland devised a scheme to defraud health care benefit programs, namely, Medicare, Medicaid, PEIA, and Unicare, and to obtain money owned by and under the custody of said health care benefit programs by means of false and fraudulent pretenses from June 2004 and continuing to September 2008.  It was part of the scheme that Rydland fraudulently obtained approximately $22,000 from Medicare; $22,000 from Medicaid; $5,000 from Unicare; and $7,500 from PEIA as a result of claims which misrepresented a higher level of office visit or for which no such service was rendered at all.

Counts Twenty-Seven through Thirty-eight of the Indictment allege that Rydland devised a scheme to defraud health care benefit programs, namely, Medicare, Medicaid, PEIA, and Unicare, and to obtain money owned by and under the custody of said health care benefit programs by means of false and fraudulent pretenses from June 2004 and continuing to September 2008.  It was part of the scheme that Rydland willfully accepted payment from Medicare, Medicaid, Unicare, and PEIA for established patient office visit services that were not rendered.

If convicted, Rydland faces a maximum penalty of 10 years imprisonment and a fine of $250,000 on each count of the Indictment.

The case will be prosecuted by Assistant United States Attorneys Erin K. Reisenweber and Alan G. McGonigal.  The case was investigated by the United States Department of Health and Human Services - Office of Inspector General and West Virginia Medicaid Fraud Control Unit.

It should be noted that the charges contained in the Indictment are merely accusations and not evidence of guilt, and that each defendant is presumed innocent until and unless proven guilty.

May 18, 2010

Woman Sentenced for Health Care Fraud (U.S. Attorney for the District of West Virginia)

Vanessa Cattanea, 36, of Charleston, West Virginia, was sentenced yesterday to 20 months in federal prison for multiple counts of health care fraud, the United States Attorney’s Office announced on May 18, 2010.  Chief U.S. District Judge B. Lynn Winmill also ordered Cattanea to serve three years of supervised release following her prison term, and required her to pay $1,054,260 in restitution to Medicaid. Co-defendant, Ronald Bret Hamilton, 49, of Pocatello, passed away in March 2010.

Cattanea and Hamilton were convicted in December 2009 by a federal jury in Pocatello, Idaho, on multiple counts of health care fraud. The jury found Hamilton guilty on 55 of 72 counts and Cattanea guilty on 76 of 84 counts.

During the nine-day trial, the jury heard evidence that Hamilton was the owner and Cattanea the treatment director for Teton Family Services, a company that offered partial care, a mental health service, for children. Teton operated clinics in Pocatello, Blackfoot and American Falls. The evidence showed that Hamilton and Cattanea knowingly and fraudulently billed Medicaid for services provided away from the clinic, which Medicaid does not cover, including trips to Yellowstone National Park, Bear Lake, and Salt Lake City, and for services provided by unlicensed staff.

“The costs of health care in this country are huge. Everyone is concerned and angry when public efforts to provide needed health care is defrauded and profiteered by unscrupulous people,” said U.S. Attorney Tom Moss.

This case was jointly investigated by the U.S. Department of Health and Human Services, Office of Inspector General, and Idaho Department of Health and Welfare.

August 28, 2009

Moorefield Physician Arrested for Illegally Dispensing Hydromorphone & Diazepam Resulting in Death (U.S. Attorney for the Northern District of West Virginia)

ELKINS, W.V. — A Moorefield, West Virginia, physician was arrested on August 26, 2009, on charges contained in a Criminal Complaint.

United States Attorney Sharon L. Potter announced that DR. Rajan Bakhshish Masih was arrested on charges that he allegedly distributed and dispensed 120 tablets of Hydromorphone and 50 doses of Diazepam to an individual on February 20, 2009, resulting in the death of that individual from the use of the substances. The Criminal Complaint further alleges that DR. Bakhshish did not distribute the substances for legitimate medical purposes in the usual course of his professional medical practices.

DR. Bakhshish had an initial appearance yesterday before Magistrate Judge John S. Kaull and is currently in federal custody. A preliminary hearing and detention hearing have been scheduled for September 1, 2009, at 10:00 a.m. in Elkins.

The charge in the Criminal Complaint carries a statutory mandatory minimum penalty of 20 years imprisonment and a maximum penalty of life imprisonment and a fine of $1,000,000.

The case will be prosecuted by Assistant United States Attorney Stephen D. Warner. The case was investigated by the Drug Enforcement Administration, Hagerstown, Maryland, Task Force; the West Virginia State Police; the Department of Health and Human Services-Office of Inspector General; the West Virginia Insurance Commission; the Grant County Sheriff’s Department; and the City of Moorefield Police Department.

It should be noted that the charges contained in the Criminal Complaint are merely accusations and not evidence of guilt, and that each defendant is presumed innocent until and unless proven guilty.

More information on the United States Attorney's Office for the Northern District of West Virginia at: http://www.usdoj.gov/usao/wvn/index.html

August 5, 2009

Former Pharmacy Employee Sentenced as Part of the United States Attorney’s Office’s Operation Pill Broker (U.S. Attorney for the Northern District of West Virginia)

WHEELING, W.V. — A 53 year old Wheeling, West Virginia, resident was sentenced on July 27, 2009, in United States District Court in Wheeling by Judge Frederick P. Stamp, Jr.

United States Attorney Sharon L. Potter announced that MARY ANN MCCARDLE was sentenced to three years probation with the first six months to be served under home detention. MCCARDLE entered a plea of guilty on April 8, 2009, to one count of possession with intent to distribute hydrocodone. In the Fall of 2008, the pharmacist of the Medicine Shoppe Pharmacy located on National Road in Wheeling, discovered a shortage of hydrocodone pills (Vicoprofen). From in-store security cameras, MCCARDLE, a pharmacy tech, was captured on an October 14, 2008, video with stealing hydrocodone pills and putting them in her pocket. When confronted by agents on October 24, 2008, 88 vicroprofen pills were recovered from MCCARDLE’s residence. As a result of the felony plea, both under federal regulations and pharmacy board rules, MCCARDLE loses her certification as a pharmacy tech. MCCARDLE has relinquished her license.

The case was prosecuted by Assistant United States Attorney John C. Parr. The case was investigated by the West Virginia State Police-Bureau of Criminal Investigations and the Drug Enforcement

Administration.

A copy of this press release may be found on the website of the United States Attorney's Office for the Northern District of West Virginia at: http://www.usdoj.gov/usao/wvn/press/press09/august/mccardle.html

June 16, 2009

Three Wheeling Residents Arrested In Conjunction with “Operation Pill Broker” (U.S. Attorney for the Northern District of West Virginia)

Wheeling, West Virginia — Three Wheeling, West Virginia, residents were arrested on charges contained in an Indictment returned by the Federal Grand Jury sitting in Wheeling, West Virginia, on June 2, 2009.

United States Attorney Sharon L. Potter announced that:

Frank L. Burdett, age 40; Willard Humes, age 62; and Alice Schoolcraft, age 56, were named in a seven-count Indictment which reflects law enforcement’s focus on prosecuting individuals who illegally sell prescription drugs, as set forth in the Northern District’s initiative “Operation Pill Broker.”

Burdett, Humes, and Schoolcraft were each named in Count One of the Indictment alleging that they conspired to distribute oxycodone from December of 2008 to May 4, 2009, in Wheeling.

Burdett and Humes were both named in Counts Two and Three of the Indictment alleging that they conspired to engage in interstate travel in aid of racketeering enterprise beginning from December of 2008 to April 28, 2009, from Wheeling, West Virginia, to Martins Ferry, Ohio; and aided and abetted in the distribution of oxycodone on January 9, 2009, in Wheeling.

Burdett was named in Count Four of the Indictment alleging that he attempted to possess oxycodone with the intent to distribute on May 4, 2009, in Wheeling; and was named in Count Five of the Indictment alleging that he distributed a counterfeit substance purported to oxycodone on May 4, 2009, in Wheeling.

Schoolcraft was named in Count Six of the Indictment alleging that she attempted to possess oxycodone with the intent to distribute on May 4, 2009, in Wheeling; and was named in Count Seven of the Indictment alleging that she distributed a counterfeit substance purported to oxycodone on May 4, 2009, in Wheeling.

The Indictment also includes a forfeiture allegation wherein the United States intends to seek the forfeiture of $950.00 in United States Currency seized from BURDETT and HUMES in Wheeling on May 4, 2009; and a money judgment in the amount of at least $10,000.

The defendants will have their arraignments on Friday, June 19, 2009, in Wheeling before Magistrate Judge James E. Seibert.

If convicted, the defendants face a maximum penalty of 20 years imprisonment and a fine of $1,000,000 on Count One of the Indictment and on each of Counts Three through Seven of the Indictment; a maximum penalty of five years imprisonment and a fine of $250,000 on Count Two of the Indictment.

The case will be prosecuted by Assistant United States Attorney John C. Parr.  The case was investigated by the West Virginia State Police and the Drug Enforcement Administration.

 It should be noted that the charges contained in the Indictment are merely accusations and not evidence of guilt, and that each defendant is presumed innocent until and unless proven guilty.

A copy of this press release may be found on the website of the United States Attorney's Office for the Northern District of West Virginia at: http://www.usdoj.gov/usao/wvn/press/press09/june/OperationPillBroker.html