Have you ever been so embarrassed by something that any mention seems to depress you? I am in this position right now; the Department of Veterans Affairs (VA) – Office of Inspector General (VA-OIG) has released more investigation reports and analyses of the VA. Analyses that should be cause for the most profound concern by congressional representatives, and instead, they act like nothing is wrong, nothing to see here, go away. Well, I am too embarrassed to “go away,” and I demand action to clean house and curb this atrocious behavior!
“Courage involves pain and is justly praised, for it is harder to face what is painful than to abstain from what is pleasant.” – Aristotle
Too often, I am left asking where the Federal Government Employees are and what their responsibility is in fraudulent schemes. For example, we begin with a $50 Million scheme that had to have been suspicious to employees at Medicare, TRICARE, CHAMPVA, and many other health benefit programs.
- Nicholas Defonte and Christopher Cirri, both of Toms River, New Jersey, and Pat Truglia of Parkland, Florida, pleaded guilty to conspiracy to commit healthcare fraud. Each defendant played a role in defrauding healthcare benefits by offering, paying, soliciting, and receiving kickbacks and bribes in exchange for completed doctors’ orders for durable medical equipment, specifically orthotic braces. The defendants then fraudulently billed Medicare, TRICARE, the Civilian Health and Medical Program of the Department of Veterans Affairs (CHAMPVA), and other healthcare benefit programs. Cirri, Defonte, and their conspirators owned and operated multiple call centers where they obtained prescriptions for compound medications and other medical products reimbursable by federal and private healthcare benefit programs. The defendants caused losses to Medicare, TRICARE, and CHAMPVA of approximately $50 million.
Next, we see another case where Federal employees should have been aware, vocal, and the problems fixed before the scheme turned three years old.
- Matthew Camera of Erie, Pennsylvania, pleaded guilty to violating federal drug laws. From January 2017 to June 2020, while employed as the pharmacy chief at the VA medical center in Erie, he unlawfully obtained multiple dosage units of hydrocodone and oxycodone from pill bottles awaiting delivery to VA patients. Sentencing is scheduled for March 22, 2022.
- Michael Nolan of Tampa, Florida, and Richard Epstein, of Aurora, Colorado, were sentenced in a conspiracy to defraud two federal health benefit programs, Medicare and the Civilian Health and Medical Program of the Department of Veterans Affairs (CHAMPVA). From October 2016 through April 2019, Epstein and Nolan ran a telemarketing company in Tampa called REMN Management LLC that targeted the elderly to generate thousands of medically unnecessary physicians’ orders for durable medical equipment and cancer genetic testing. Epstein and Nolan also created and operated Comprehensive Telcare LLC, a telemedicine company through which they illegally bribed physicians to sign the orders regardless of medical necessity. They then illegally sold the signed physicians’ orders to client-conspirators to support false and fraudulent claims submitted to Medicare and CHAMPVA. The conspiracy resulted in the submission of at least $134 million in fraudulent claims and approximately $29 million in payments. Nolan was sentenced to six years and six months in federal prison, followed by three years supervised release and was ordered to pay $2.1 million. Epstein was sentenced to five years and three months in federal prison, followed by three years supervised release and was ordered to pay $3 million. The court ordered Nolan, Epstein, and other conspirators to pay over $29 million in restitution.
- Twenty people, including the two founders of Hertel & Brown Physical & Aquatic Therapy and 18 of its employees, were indicted in Erie County, Pennsylvania, of conspiracy to commit wire and healthcare fraud and healthcare fraud. According to the indictment, the defendants engaged in a multifaceted conspiracy from January 2007 to October 2021 that involved a range of fraudulent activities. These included allegedly using unlicensed technicians to provide therapy and then billing for the treatment as though licensed therapists had performed it, regularly billing for treatment using the name and credentials of physical therapists who were on vacation, recording, and billing for time that exceeded the actual treatment time, among several other allegations.
- Robin Calef of Brockton, Massachusetts, pleaded guilty to one count of theft of public funds. Calef shared a bank account with her sister, a veteran receiving monthly benefits from the VA. Her sister passed away in 2006, and Calef failed to report her death to the VA. Through September 2017, Calef stole approximately $102,289 in VA funds from the shared bank account. Sentencing is scheduled for March 1, 2022.
- Lisa Hoffman, a former pharmacy procurement technician at the East Orange VA Medical Center in New Jersey, pleaded guilty to theft of government property. From October 2015 to November 2019, Hoffman was responsible for ordering medication, including large quantities of HIV medication, for the center’s outpatient pharmacy. She stole approximately $10 million worth of HIV medication and sold it to Wagner Checonolasco of Lyndhurst, New Jersey. Hoffman is scheduled to be sentenced on March 9, 2022. Checonolasco previously pleaded guilty and is expected to be sentenced on December 15, 2021.
- Thirteen defendants, including three compounding pharmacy owners, three physicians, two pharmacists, and three patient recruiters, pleaded guilty to a years-long, multistate scheme to defraud the Department of Labor’s Office of Workers’ Compensation Programs (OWCP) and TRICARE. The defendants submitted false and fraudulent claims to the OWCP and TRICARE for prescriptions for compounded and other drugs prescribed to injured federal workers and armed forces members. The defendants paid kickbacks to patient recruiters and physicians to persuade them to prescribe the drugs. Medications were selected based on the reimbursement amount and not on the patients’ needs. The drugs were then mailed to patients, even though they often never requested, wanted, or needed them. The defendants were indicted in June 2018 and are scheduled to be sentenced in February 2022.
- Andrew Ziacik of New Kensington, Pennsylvania, was sentenced to one day of imprisonment followed by three years of supervised release and was ordered to pay $4,000. Between 2013 and 2017, Ziacik was an appointed federal fiduciary for his older brother, a service-disabled veteran. Ziacik was responsible for receiving his brother’s VA income and paying his brother’s debts. However, Ziacik admitted that he violated the terms of his fiduciary agreement by using the VA funds to purchase a Harley Davidson motorcycle, a diamond ring, and a GMC Sierra truck. As part of his sentence, Ziacik will pay restitution to his brother of $75,000.
When it comes to incompetence, neglect of duties, and abuse of veterans, the final entry in today’s chronicles of shame reflects blatant criminality, and repercussions and remunerations are only a small part of serving justice. Never forget the following fact, “overpayments should have been considered an administrative error and the debt waived since veterans are not responsible for repaying overpayments that are found to be the result of administrative errors” [emphasis mine]. The VA-OIG investigation reflects the following:
- April 2021, the VA Office of Inspector General (VA-OIG) discovered the VBA had incorrectly created a debt of about $210,000 for a veteran.
- Because of the size of the debt and VA’s plan to withhold the veteran’s entire monthly compensation benefits (over $1,100), and given the veteran’s history of treatment for mental illness, a prior suicide attempt, and suicidal ideation, the VA-OIG review team promptly contacted VBA for corrective action.
- When contacted by the veteran at four different VA offices, staff assured the veteran all was good, the overpayment was not his to pay, and it would be worked out administratively.
These are the investigation facts; to get this administrative error corrected, the problem had to percolate to the VA-OIG instead of any number of the checks and balances, quality assurance measures, and other in-house processes to catch the VBA from damaging a veteran. The VBA failed! How many hundreds of employees were responsible for this disaster and leadership failure? When will those employees be held accountable? The case presented is but one of thousands of cases every year where the VBA makes a mistake. The veteran, their family, and the taxpayer are abused, robbed, cheated, and responsibility shirked and avoided by the employees.
Imagine for a moment, you wake up, got to the mailbox. You find the VBA will take your monthly benefit, the money you need to live on because they made an error, but you have to pay for their mistakes unless a power greater than the local agency exerts sufficient force to correct the problem. Assurances from the VBA are pie-crust promises, easily made, easily broken, and crumby! The final statement in this charade from the VA-OIG is priceless.
“VBA should consider steps to avoid this type of error in the future.”
Seriously, the VBA’s internal processes failed and would have continued failing if the VA-OIG had not stepped in and demanded immediate action on the veteran’s behalf! How many other veterans are not so lucky; too many! America, the shame of the VA is beyond the pale, and a complete reckoning and corrective action should be the action of Congress as the President refuses to clean house in the Executive Branch, the Legislative Branch MUST step up and do their constitutional duties! The legislative and the executive branches must answer to us, the taxpayers and citizens, for the continual debacles displayed by recalcitrant and intransigent federal employees. In front of real judges, real people must answer and be held accountable for the crimes of neglect of duty demonstrated!
© Copyright 2021 – M. Dave Salisbury
The author holds no claims for the art used herein, the pictures were obtained in the public domain, and the intellectual property belongs to those who created the images. Quoted materials remain the property of the original author.