“There is no kind of dishonesty into which otherwise good people more easily and frequently fall than that of defrauding the government.” – Benjamin Franklin
Some people apparently go into medicine for a chance to defraud the nation’s health care system.
On Monday, the Justice Department unveiled the results from its 2025 National Health Care Fraud Takedown. Here, federal and state agencies charged 324 people, including 96 licensed medical professionals, for allegedly filing $14.6 billion in bogus claims to Medicare, Medicaid and private insurers.
The Justice Department billed it as its “largest health care fraud takedown in history,” yet it is hardly a rounding error against the backdrop of about $5 trillion in annual health care expenditures nationwide.
This means there may not be as much fraud as advertised, or that a lot of fraudsters are really good and authorities can’t catch them.
Consider also that one big bust was accountable for about two-thirds of the $14.6 billion in fraud uncovered.
A transnational crime syndicate, based in mostly Russia, got nailed buying up durable medical equipment companies in the U.S., stealing the identities of one million Americans, and falsely billing Medicare for $10.6 billion for catheters and such. (It was a nice haul considering that the overall catheter market receives less than $2 billion in annual revenue.)
This one outsized scam overshadowed all others. The list of case descriptions from the Justice Department mostly reads like a manual of stupid crook tricks. Among those charged:
Farrukh Jarar Ali of Pakistan allegedly ran a $650 million scam involving at least 41 substance abuse treatment clinics in Arizona. Ali is the owner of ProMD Solutions, which allegedly recruited patients from homeless camps and Native American reservations. It then filed fraudulent claims for services that were never rendered. Ali personally profited $24.5 million while drunks still roam the desert.
Dr. Shivangi Amin, 39, a licensed physician in Los Angeles, allegedly took kickbacks for referring Medicare beneficiaries to hospice care facilities. Amin didn’t evaluate these patients or review their medical records and Medicare got stuck with more than $2 million in bogus bills. But wait … technically, we’re all dying, right doctor?
Ricardo Ramos, a 49-year-old chiropractor in Tampa, Fla., allegedly recruited ne’er-do-wells to stage traffic accidents, file false police reports and seek treatment at the clinic where he worked. From there, Ramos filed fake insurance claims. After paying off co-conspirators, he allegedly bagged more than $169,000 from the scheme. Why chase ambulances?
Susan Braddock, 63, of Fort Worth, Texas, ran a telemedicine company that allegedly billed Medicare for consultations that never happened or were medically unnecessary. Her scheme allegedly resulted in more than $26 million in dubious Medicare claims. And get this: She named her company, “Big Easy Bad Dog.” Gosh, detective? What was your first clue?
Veronica E. Whitt, 56, of St. Louis allegedly used someone’s Medicaid identification information to submit false claims for personal care services that were never provided. Medicaid paid over $16,000 based on her false claims. She named her company, “Christ Did It All In-Home Services.” Now Christ may have died for the sins of all mankind, but it’s a safe bet that he’s not taking this rap.
Yoga To The People
Gregory Gumucio, 64, of Colorado Springs, Colo., grew his chain of yoga studios to 20 locations and took in more than $20 million in revenue from 2010 to 2020.
He tapped markets in San Francisco, Berkeley and Oakland, Calif.; Tempe, Ariz.; Orlando, Fla.; and cities in Colorado, Washington, Spain and Israel.
He lived the extravagant life that preaching a phony spiritual practice can provide, including a country club membership, frequent foreign travel, pricey hotels, fancy meals, fine clothing and NFL season tickets.
It was a remarkable stretch for a yoga master who turned out to be a real poser. He reportedly used at least six aliases, three Social Security numbers and claimed three places of birth.
In 2020, VICE News interviewed more than 30 people who knew or worked with Gumucio since the mid-1990s who “depict him as a predator with a penchant for controlling and sexually manipulating bright and often vulnerable young women.”
But it wasn’t his decades of being a creep that did him in. Turns out, Gumucio couldn’t even pretend to pay his taxes. On Monday, he was sentenced to four years in prison for tax evasion.
Now he’s finally getting a dose of enlightenment.
Enjoy your stay. And Namaste.
Please welcome Wade Cook to The Hall of Shame
Today, we posthumously induct Wade Cook into the Business Blunders Hall of Shame, where we chronicle the follies of the past in hopes of avoiding the same follies in the future.
Cook was a financial guru who was far more gifted at self-promotion and filing bankruptcy than teaching people how to make money.
He self-published his first get-rich-quick book, “Real Estate Money Machine,” while working as a taxi driver in 1981. By 1987, he filed personal bankruptcy.
This could have been the end, but Cook updated his book in 1996 and kept right on cooking.
You might be asking, “Who wants to hear get-rich-quick lessons from a bankrupt taxi driver?”
That’s where the wonders of marketing come into play. Cook knew how to round up suckers through aggressive media campaigns and paid radio programs. He lectured at hundreds of seminars. He authored numerous books, including “Wall Street Money Machine,” “Wealth 101,” “Brilliant Deductions” and “Business Buy the Bible.”
He frequently made religious references in his rants and writings and presented himself as an upstanding member of the Church of Jesus Christ of Latter-day Saints. Yeah, in addition to being a Wall Street Wizard, he was veritable theologian and a real ethicist.
His company, Wade Cook Financial Corp., was charging up to $5,695 for seminars, claiming participants would make potential monthly returns of 20% on their investments. This gross exaggeration put him at odds with the Federal Trade Commission in 2000, but a settlement with the regulator didn’t stop Cook.
At its peak, his company employed 550 people and generated annual revenues of $118 million. But in 2002, it filed for Chapter 11 bankruptcy and ultimately liquidated.
In December 2005, Cook and his wife, Laura, were indicted for evading federal income tax on $9.5 million in royalties from 1998 to 2000, filing false tax returns, and obstructing investigations by creating fictitious documents.
In August 2007, Cook was sentenced to 88 months in prison and ordered to pay $3.75 million in restitution. Laura Cook received an 18-month sentence.
After his release from prison, Cook continued promoting his financial teachings through books and online platforms, despite his complete loss of credibility. In the end, there was only one thing that could stop his incessant money-machine malarkey. He died of cancer in 2021.
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Hey Al! Good work as always! Tell us why we should like or even sign up for health advantage plans. My impression is that they provide a few cheap extra benefits but charge the government
(us taxpayers) a lot of money. They certainly spend a lot on advertising and junk mail! Thanks!
And the Senator from FL (a/k/a The Walking Cadaver)...