Medicare Fraud 101

South Florida Company Bilks Medicare Out of $170 Million

R&I Billing was charged with fraudulently billing Medicare $170 million for infusions of HIV drugs. The scheme worked as follows: “From roughly October 2002 through April 2006, HIV clinics in South Florida serviced by R&I Billing allegedly provided bills to Medicare that indicated patients were being injected with excessive amounts of HIV medications…Based on claims filed byR&I Billing, Medicare paid more than $100 million for these fraudulent services” according to a joint statement issued by the Department of Justice and Health and Human Services.

Medicare spending in 2006 totaled $40 billion for the care of 43 million elderly and disabled Americans. Infusion therapy provides medicines intravenously outside of a hospital or nursing home for many such beneficiaries. There are approximately 1,200 providers of infusion therapy in the United States.

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1. Jay Drai Says:
   August 30th, 2007 at 1:14 am

   ENERGY FRAUD CHARGES VS MULTIUT OWEND BY NACHSHON DRAIMAN

   IN THE CIRCUIT COURT OF COOK COUNTY, ILLINOIS
   COUNTY DEPARTMENT - CHANCERY DIVISION
   FILED
   JACK GORE on behalf of himself and all ) NOV 28, 2002
   other persons or entitles similarly situated, |
   •
   vs. No. 01 CH 19688

   DOROTHY 8ROWN CLERK OF CIRCUIT COURT

   MULTIUT CORP, an Illinois corporation, } Judge Stephen A, Schiller
   Defendant ) Courtroom 2402

   RESPONSE TO §2-619.1 MOTION TO DISMISS J/
   Plaintiff JACK GORE (“Gore”). by his attorneys LARRY D DRURY LTD., hereby responds to the Motion to Dismiss 2nd Amended Complaint, pursuant to 735 ILCS 5/2-615 and 619, brought as a combined 2-619.1 motion by defendant MULTIUT CORP. (“Multiut”).
   Introduction
   Multiut is trying to time-bar this case by transforming express a written agency-service contract drafted by Multiut into a contract for sale of goods, and by disputing Gore’s allegations as to concealment and discovery of the wrong – but without submitting any Rule 191 affidavit or documentation. This is a class action arising out
   of a written contract drafted by Multiut, attached here and to the 2nd Amended Complaint as Exhibit A and B collectively referred to herein as the “contract” or “agreement “ unless otherwise indicated by context): (1)
   (A) A service contract to act as Gore’s “purchasing representatives” in obtaining natural gas from “off system” suppliers. This contract, entered into on or about December 1990, was titled “Agreement,” Exh. A 1, 3-6, 10. And,
   {B} A series of supplemental agency contracts to act as Gore’s agent, in so doing with respect to various Properties. These were entered into contemporaneously with the service contract and thereafter, and titled “Natural Gas Purchasing and Agency Agreement.” Exh.-B. (2)
   (1) Similarly Multiut refers to them collectively as “the agreement” in its brief (Mem. p. 2, fn. 1). Although the documents are on separately filed pages, they are mutually inclusive and one could not be entered into without the other; e.g. the service contract refers to and incorporates the agency contracts, wherein Multiut refers to itself as Gore’s ‘exclusive natural gas purchasing agent’. See Exh. A, third introductory paragraph and 16-17; Exh. B 1,

   (2) Exh. 8 one of the series, is dated 1998, Exh. C is Gore’s §2-806 affidavit as to the others. Gore has stated he does not have a copy of each, they are inaccessible to him i.e. no longer in his possession, whether missplaced or otherwise, and cannot be located or returned. 2nd Amd.. Compl. {4; Exh, C, in the 1st Amd. Complaint, Count 4 for breach of oral contract was voluntarily dismissed without prejudice after Gore’s deposition of May 8,- 2002, when the service contract and the 1998 agency contract were produced by Multiut and adequately established, Exhs, A-B are the same Exhs. 1-2 attached to the Gore transcript, excerpts of which are attached herein as Exh. D, Similarly the missing agency agreements are likely in Multiut’s possession and will be produced in discovery.
   The contract was drafted by Multiut, it unequivocally defines Multiut’s role in the transactions, and shows that this case is not governed by the UCC. What is at issue here is not the “good” that Multiut obtained for Gore, but the service Multiut provided as his purchasing agent. Gore is suing upon the service and agency contract – not the natural gas - and has alleged that Multiut breached its duties in two respects;
   {1} By falsely and intentionally charging and retaining for its own use funds that were to be applied to a City of Chicago 8% gross receipts tax (“Tax”), which it had promised would be placed in escrow and forwarded to the City. Between December 1990 and January 1995 (after the City of Chicago changed the Tax), Multiut collected approximately $14,000 from Gore and at least $1 million to $1.5 million from the Class, for this Tax that was not actually imposed upon Multiut. 2nd Amd. Compl. 7-9, ‘3! Multiut not only failed to inform Plaintiff and
   the Class that the money collected was not so applied or escrowed, but also failed to escrow, account for, and refund the funds with interest.
   (2) By overcharging for the service of providing natural gas. Multiut was to charge for natural gas actually supplied to Gore and the Class on a set per therm cost basis, plus an amount equal to 1/2 of their respective per therm cost savings per month, instead, Multiut overcharged and billed Gore at least $100.000 and the class millions of dollars and refuses to provide an accounting and refund with interest. Id. 10-11.
   Gore has further alleged that Multiut prevented him from discovering the wrongs by intentionally concealing them until at least December 2000, when he discovered the truth and could not reasonably have done so earlier. (Gore testified at his deposition on May 8, 2002 that he first discovered the discrepancies in his bills, the overcharges, the taxes, and failure to escrow the taxes, in December 2000. See Exh, D, pp. 25-28,) Thereafter he was unable to obtain any refund and based thereon, terminated Multiut’s services on or about June 2001, However, the wrongful acts are continuing to date, in that Multiut continues to ‘refuse to provide an accounting and refund with interest to Gore and the Class, all to their detriment and damage. They seek imposition of constructive trust (id. 22), an accounting and damages in not less than the foregoing amounts plus interest (id, 9-13, 23).
   Gore filed the original Class Action Complaint on Nov. 20, 2001, and in lieu of responding to a motion to dismiss, filed the 1st Amended Class Action Complaint Feb. 14, 2002, setting forth 4 counts for (1) breach of
   3-: The City did not and will not collect the 8% Tax, presumably because of U.S. constitutional restrictions as to the interstate commerce clause and exceptions for interstate pipelines and out-of-state suppliers. As a result in 1994 the City changed the tax from an 8% gross receipts tax to a flat rate tax of 1.4 to 1.5 cents per therm. 2nd Amd. Comp. P 8. in Multiut’s response to First Request to Admit {attached hereto as Exh. F), it has admitted the following statements about this Tax; (8) that Multiut collected approximately $14,000 in Tax from Gore between 1991-1994; and (9) that Multiut spent its customers Tax payments on business expenses.. Yehuda Draiman testified to the same effect in his deposition 1-10-02 See transcript excerpts attached hereto as Exh. E, at pp, 36-37,40, 68, and Exh, 6 thereto.

   Activity Date: 8/15/2007 Participant: GORE JACK
   CASE SET ON STATUS CALL
   Court Date: 8/29/2007
   Court Time: 0930
   Court Room: 2402
   Judge: BRONSTEIN, PHILIP L.

2. Jay Draiman Says:
   May 18th, 2008 at 3:31 pm

   Nachshon Draiman, Chicago – nursing home administrator license (044001323) revoked and fined
   Illinois Department of Financial and
   Professional Regulation NEWS
   IDFPR
   Disciplinary Actions for January 2008 SPRINGFIELD
   The Illinois Department of Financial and Professional Regulation (IDFPR)
   announced today that the Directors of the Division of Professional Regulation, Daniel E. Bluthardt, and Insurance, Michael T. McRaith, signed the following disciplinary orders in January. Orders for the Division of Banking were authorized by Director Jorge Solis.

   NURSING HOME ADMINISTRATOR

   Nachshon Draiman, Chicago – nursing home administrator license (044001323)
   revoked and fined $2,000 for misrepresenting information in his application concerning postgraduate education degree, to obtain nursing home administrator licensure from the Department.

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