News From Around the Web
> A Houston speech therapist pleaded guilty to multiple counts of healthcare fraud for her role in a scheme that billed TRICARE and Blue Cross Blue Shield of Texas for more than $3.7 million. Rebecca Lee Rabon, who owned and operated a speech therapy clinic for children, worked with a co-conspirator to submit claims for services she didn't provide. Rabon also submitted fraudulent claims under three unsuspecting employees, and even forged a letter to Blue Cross Blue Shield with a false address for one employee. Statement
> A New York pharmacist was indicted for healthcare fraud and false claims, among other charges, for his role in a $5 million fraud scheme. Andrew Barrett, who operated pharmacies in the Bronx, Rockland and Queens, fraudulently billed Medicare and Medicaid for medications he never dispensed at his Queens pharmacy, and used most of the money he was paid to buy drugs for the other two pharmacies. Prosecutors also allege Barrett used $2.5 million for personal spending, but claimed it as business expenses. Statement
> A Detroit physician pleaded guilty to accepting kickbacks to refer Medicare beneficiaries for home health services in a scheme that cost Medicare $3.6 million. Kutub Masiwala pleaded guilty to referring patients to Advance Home Health Care Services Inc. in exchange for cash payments. The owner of Advance pleaded guilty to his role in the scheme in July 2014. Statement
Health IT News
> Last week Premera announced a data breach that affected approximately 11 million consumers. In light of that breach, FierceHealthIT spoke with Attorney Ken Dort about why health insurers are such an enticing target. He says that medical records are more valuable than financial information on the black market and provide key information for fraud scams. Article
Health Payer News
> In a related article, Lisa Gallagher of HIMSS tells FierceHealthPayer that the healthcare industry needs more sophisticated security risk management solutions and periodic risk assessments. In light of the Anthem and Premera attacks, payers should also be more proactive in alerting potentially vulnerable members. Article
And finally… Whopper: A new fragrance by Burger King. Article