Michigan mental health CEO gets prison time for diverting Medicaid funding to his fortune teller; Nebraska pharmacist sentenced to nine years in state's largest fraud scam

News From Around the Web

> The former CEO of a Michigan community mental health authority was sentenced to a minimum of 32 months in prison after pleading guilty to charges that he embezzled Medicaid funding to send to his fortune-teller. Erving Brinker sent $510,000, disguised under contracts for healthcare consulting services, to a Key West psychic palm reader. In addition to his prison sentence, Brinker will pay over $1 million in restitution and civil penalties, and forgo his $2 million state pension. Announcement

> A Nebraska pharmacist was sentenced to more than nine years in prison for orchestrating the state's largest healthcare fraud scheme worth $14.4 million. Scott Tran, who owned Tran Pharmacy in Lincoln, submitted false claims to Medicare for drugs that were never ordered, including inhalers for cystic fibrosis patients. Despite his willingness to explain the scheme to authorities, the judge still gave him the maximum sentence, the JournalStar reports. Article

> The owner of an Ohio ambulance service pleaded guilty to a $1.4 million fraud scam. Over the course of seven years, Terry Johnson, owner and operator of Community Angels Ambulance Service, billed federal and state health programs for ambulance rides that were never provided, according to an article on the Cincinatti Enquirer. Article

Health Payer News

> UnitedHealth lost $720 million on Affordable Care Act compliant plans last year, according to fourth quarter earnings reported by the company. UnitedHealth executives also reiterated their plans to consider pulling out of ACA exchanges, and indicated that they will make an announcement concerning 2017 participation by midyear. Article

> After UnitedHealth and Aetna dropped out of America's Health Insurance Plans (AHIP), CEO Marilyn Tavenner said the organization's primary goal is to convince the two payers to rejoin. However, some of the largest AHIP members have also expressed dissatisfaction with the organization's direction, which focuses more on nonprofit and small insurers. Article

And finally… This guy is one-for-one at Powerball. Time to retire. Article

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