Latest news with #kickbacks
Japan Times
28-05-2025
- Business
- Japan Times
LDP's Shimomura denies he ordered kickbacks to resume in 2022
Hakubun Shimomura, former policy chief of the ruling Liberal Democratic Party, said Tuesday that he did not request kickback practices at an LDP faction be resumed after they were once suspended in April 2022. Speaking as a witness at a meeting of the Budget Committee of the House of Representatives, the lower chamber of parliament, Shimomura said the resumption was not decided at an executive meeting in August 2022. In a hearing in February, a former chief accountant of the now-defunct faction once led by former Prime Minister Shinzo Abe said that "a faction executive" asked for the restart of the kickback system in July 2022, and the resumption was decided at an executive meeting in August of the same year. The testimonies of the former chief accountant and Shimomura, whom the leading opposition Constitutional Democratic Party of Japan and others regard as "the faction executive" in question, conflicted with each other. According to Shimomura's explanation, a faction member called for kickbacks exceeding their quotas in their fundraising ticket sales after a fundraising party was held in May 2022. Shimomura said he had told Abe, then head of the faction, and the former chief accountant after June of that year that "such a call has come out." Shimomura also said that there was such a call in his talks over the phone with the former chief accountant in late July of the same year, after Abe's death. Shimomura said he "merely told them in a businesslike way" such opinions, emphasizing that "I didn't mean I requested the resumption." He told the day's committee meeting that the executive meeting held in August 2022 "discussed means to conduct kickbacks in forms other than cash refunds but did not reach a conclusion." His explanation matches testimony given by Hiroshige Seko, a Lower House lawmaker, who has left the LDP, that the executive meeting was about alternatives for the faction to buy up tickets at fundraising parties by its member lawmakers. Shimomura explained that the discrepancies between testimonies from him and the former chief accountant came from differences in perception. "A conclusion should have been made clear at the executive meeting," he said. "I need to reflect on how I phrase things if I made the former chief accountant misunderstand." Some opposition lawmakers said the facts have not been made clear yet and called for summoning former LDP General Council chief Ryu Shionoya and former Prime Minister Yoshiro Mori, a former leader of the faction, as witnesses.
Yahoo
10-05-2025
- Business
- Yahoo
CT dentists enter civil agreement totaling almost $650K to resolve ‘kickback' allegations
Multiple dentists in Norwalk have entered into a civil agreement with the state and federal governments to resolve allegations that they paid kickbacks to a patient recruiting company. The civil settlement agreements, announced Friday, resolve allegations of violations of the federal and state False Claims Acts against Advanced Dental Center PC and its owners Tal Yossefi and Elad Yossefi, according to the U.S. Attorney's Office for the District of Connecticut and the Connecticut Office of the Attorney General. As part of the agreement, Advanced Dental paid $495,721 to reimburse the Medicaid program. According to officials, Advanced Dental is enrolled in the Connecticut Medical Assistance Program (CMAP), which includes the Connecticut Medicaid program. Between July and December 2018, the dentistry is alleged to have paid a third-party patient recruiting company $120 for each Connecticut Medicaid patient the company referred to them whenever a patient received dental services above routine preventative care. Authorities said the practice is prohibited by the federal anti-kickback statute, the CMAP provider agreement and the Connecticut Dental Health Partnership provider manual. 'Paying kickbacks for patient recruitment is illegal,' Connecticut Attorney General William Tong said in a statement. 'Dentists participating in Connecticut's public healthcare programs are responsible for knowing the law.' 'This is the fourth settlement arising from ongoing joint investigations, and we will continue to work closely with our state and federal partners to aggressively protect the integrity of our public healthcare programs,' Tong said. Officials with the U.S. Attorney's Office noted that Nazneen Jaffri, a dental provider formerly licensed in Connecticut who operated a practice in Norwalk, also agreed to reimburse the Medicaid program $150,000 for allegations stemming from January 2019 to April 2021. Officials said the reimbursement resolved allegations that she violated the False Claims Act by submitting or 'causing to be submitted' claims to CTMAP for dental services rendered to Connecticut Medicaid patients referred by a third-party patient recruiting company. 'In entering into their respective civil settlement agreements, the providers and their practices did not admit liability,' the U.S. Attorney's Office said in a statement.
Fox News
09-05-2025
- Fox News
Amtrak bilked out of $12M by at least 119 employees, doctors in fraud scheme; many still on the job: report
At least 119 Amtrak employees and doctors took the railroad company for a ride in a massive $12 million health fraud scheme, a watchdog found. Amtrak's Office of Inspector General (OIG) said employees based in Pennsylvania, Delaware, New Jersey, New York, Maryland, Connecticut and Washington, D.C., accepted cash kickbacks from three healthcare providers in exchange for the use of their insurance information and that of their dependents in a scheme from 2019 to 2022. "The sheer volume of employees who cavalierly participated in this scheme to steal Amtrak's funds suggests not only a serious lapse in basic ethics, but a troubling workforce culture, at least in the Northeast region, in which blatant criminal behavior was somehow normalized," said Amtrak Inspector General Kevin H. Winters. Fox News Digital has reached out to Amtrak. The healthcare providers used that employee information to file fraudulent and questionable medical claims for services that were never provided or not medically necessary, the OIG said. Overall, the taxpayer-funded railroad carrier's health plan was billed more than $16 million and was bilked out of $12 million. Of the 119 employees implicated, 28 retired or resigned as a result of the OIG's investigation, and 30 left the company for "other reasons." Another dozen employees have been criminally charged, and seven have pleaded guilty and are awaiting sentencing. Sixty-one are still on the job. In a statement to Fox News Digital, Amtrak said it has taken "significant steps" to address medical insurance fraud. "Like many employers, Amtrak calls on medical benefit providers and insurers to do more to identify suspicious activity and stop medical insurance fraud," the company said. "Amtrak strongly condemns this reprehensible act that occurred between 2019 and 2022 and is taking swift action with all active employees involved in the investigation. "While we continue to work closely with the OIG to identify and stamp out fraud, we also continue to work on other initiatives to address this issue," the statement added. "Amtrak has implemented various measures to enhance fraud prevention and empower employees to report suspected wrongdoing. These efforts include increasing oversight and strengthening efforts to eliminate fraudulent schemes." The OIG launched a probe when an agent noticed unusual billing patterns in reports by data analysts. Three New York healthcare providers with "questionable" billings who shared a high number of Amtrak employees as patients were identified by investigators. An undercover agent posing as an Amtrak employee met with Punson Figueroa, aka "Susie," an acupuncturist from Long Island City, New York, June 16, 2021. During the visit, Figueroa told the agent to sign his name 30 times for service without dating the signatures, the OIG said. Figueroa then submitted alleged fraudulent claims to Amtrak's healthcare plan, saying the agent had visited providers at least seven times in May 2021 for acupuncture and physical therapy. The agent visited Figueroa's office again on July 29, 2021, where she allegedly handed him an envelope containing $1,000. Figueroa continued to use the agent's insurance information to submit dozens of fraudulent claims to Amtrak's healthcare plan, investigators said. Figueroa pleaded guilty to defrauding Amtrak's healthcare plan, was sentenced to three years of supervised release and was ordered to pay restitution of $9.05 million. Two other healthcare providers and a medical biller have also pleaded guilty for their roles in the scheme. Michael DeNicola, a podiatrist from New York, pleaded guilty June 29, 2022, to conspiracy to commit health care fraud, distribution of a controlled substance and unlawful possession of a gun. He has not yet been sentenced. Regina Choi, a medical biller from Woodside, New York, who previously worked for Figueroa, pleaded guilty to conspiracy to commit health care fraud June 11, 2024, for submitting false and fraudulent claims to the Amtrak health care plan and paying cash kickbacks to Amtrak employees. Her sentence is also pending. In 2018 and 2019, OIG auditors issued separate reports that said Amtrak could strengthen measures to identify fraudulent medical claims sooner. Both reports noted billing patterns indicative of potential fraud among hundreds of providers, the OIG said.
