October 16, 2011
Kelli Kennedy, the Associated Press' top reporter on issues of health care fraud and abuse, released an article on October 16, 2011 titled "Medicare yanks licenses, gives them right back." The article-- which was printed in major newspapers including the Wall Street Journal and Chicago Tribune-- exposed glaring problems and loopholes in the nation's $520 billion Medicare program. The article explains that private contrators now have substantial responsibility for safeguarding the Medicare Trust Fund, and are paid millions annually to process Medicare claims, screen Medicare providers, and combat fraud. Due in part to poor coordination between these government contractors, Medicare fraud is estimated at $60 to $90 billion annually, and remains rampant in hot spots including South Florida, Los Angeles, Baton Rouge, La., Houston, Brooklyn, N.Y., and Detroit .
Kennedy explains the problem as follows:
Medicare hires Contractor A, which is in charge of fraud detection, to inspect a medical equipment company. Under the law, providers are required to have an office that is open and staffed during regular working hours — but some have empty storefronts and some have only a post office box.
Contractor A recommends revoking the company's Medicare license to Contractor B. But Contractor B ultimately decides whether to revoke and often does not have the same information that Contractor A has.
Kennedy called upon O'Quinn Stumphauzer partner Ryan Stumphauzer, the former Deputy Chief of Health Care Fraud at the Miami U.S. Attorny's office, to explain the problem:
Sometimes one subcontractor without firsthand knowledge of the case or the necessary medical expertise will overturn a suspension made by the contractor that had direct evidence of fraud, said Ryan Stumphauzer, a former Miami federal prosecutor who specializes in health care fraud.
So the company appeals, and an independent third party known as a hearing officer decides whether to reinstate the license. If the provider disagrees with that decision, the appeal can be kicked up to an administrative law judge.
. . . . . . . . . . . .
"Nobody from (the government) bothers to attend the appeal hearing, so the judge hears a one-sided story and the government is virtually guaranteed to lose," Stumphauzer said. "Every taxpayer should be outraged."
You can read the full story online in the Wall Street Journal, Chicago Tribune, Miami Herald, and others.
Ryan Stumphauzer is available to counsel business entities and individuals on health care fraud and abuse issues. Whether it is defending a client against a government enforement action, assisting a whistlelower in reporting ongoing fraud, or helping clients navigate onerous contractor audits, Ryan Stumphauzer has the skills to help.
View Other News
Ryan O'Quinn to Serve as Panelist for the ABA National Institute on White Collar Crime
March 4, 2015
O'Quinn Stumphauzer Selected by Chambers & Partners as Top Firm for White-Collar Crime & Government Investigations
December 31, 2014
Ryan Stumphauzer to Speak at the Annual Meeting of the American Academy of Physical Medicine & Rehabilitation
November 15, 2014
ABA Invites Ryan O'Quinn and Ryan Stumphauzer to Serve as Panelists for CLE Program Titled "Significant White Collar Prosecutions and Investigations: Perspectives from the Government and the Defense"
November 14, 2014
Ryan O'Quinn Consulted by Politifact as a Parallel Proceedings Expert
October 8, 2014
The FBI Taps Ryan Stumphauzer to Help Train Agents on Cross-Examination Techniques
May 20, 2014
Miami Herald Seeks Legal Commentary from Ryan Stumphauzer During Trial of Hialeah Mayor Julio Robaina
April 20, 2014
Ryan Stumphauzer to Serve As Panelist for ABA Health Law Webinar: "Ask the Government- A Practical Discussion of Healthcare Self-Disclosure Protocols"
January 29, 2014
Ryan Stumphauzer featured on CNBC's "American Greed: The Fugitive Series"
December 5, 2013
Cystic Fibrosis Foundation Honors Ryan Stumphauzer as a Recipient of the "40 under 40, Outstanding Lawyers of Miami-Dade County Award"
August 29, 2013
Southern District of Florida's Securities and Investment Fraud Initiative Ranks No. 1 in Stock Fraud Prosecutions
August 14, 2013
Ryan Stumphauzer Will Serve as the Keynote Speaker at the Annual Meeting of the American Association of Neuromuscular and Electrodiagnostic Physicians
June 26, 2013
Ryan Stumphauzer Offers Insight in Bloomberg Article Regarding the Criminal Investigation of Chicago Sacred Heart Hospital
June 14, 2013
Ryan Stumphauzer To Serve as Panelist for the "New Faces of Economic Crime" Symposium in Miami, FL
May 16, 2013
Ryan Stumphauzer to Speak at the ABA's Annual Conference on Emerging Issues in Healthcare Law
February 1, 2013
Ryan Stumphauzer Served as an Instructor at the FBI's National Training Academy in Quantico, Virginia
July 26, 2012
Ryan Stumphauzer Quoted in Atlanta Journal Constitution Article Discussing Medicare Fraud Trends and Enforcement Priorities
June 1, 2012
Ryan Stumphauzer Moderated the Civil & Criminal Health Care Fraud Panel at the Southern District of Florida's Bench & Bar Conference
April 27, 2012
Ryan Stumphauzer Interviewed on CBS News Regarding the Trayvon Martin Investigation
April 10, 2012
Miami Herald Quotes Ryan O'Quinn on Recent Fraud Indictment against Joel Steinger, Steven Steiner and Henry Fecker III
March 1, 2012
Ryan O'Quinn Quoted in Fortune Magazine Exposé on Barry Minkow - All American Con Man
January 5, 2012
Ryan Stumphauzer Featured in Reuters Special Investigative Report "Mediscam"
December 22, 2011
Ryan Stumphauzer Quoted in Washington Post Article Concerning Hospice Industry Kickbacks & Improper Financial Relationships
December 17, 2011
Ryan Stumphauzer to Serve As Panelist at 26th Annual National Institute on White Collar Crime
November 28, 2011
Cystic Fibrosis Foundation Honors Ryan O'Quinn as a Recipient of the "40 under 40, Outstanding Lawyers of Miami-Dade County Award"
November 5, 2011
Ryan Stumphauzer Quoted in National News Story Addressing Medicare Fraud and Contractor Negligence
October 16, 2011
Ryan Stumphauzer Quoted in Miami Herald Article Adressing Convicted Felons in the Medicare Program
August 15, 2011
Securities Fraud Case Against Barry Minkow filed by Ryan O'Quinn Receives National Coverage
July 21, 2011
Ryan Stumphauzer Serves as Instructor at FBI's National Training Academy in Quantico, Virginia
June 23, 2011
Ryan Stumphauzer Quoted in Palm Beach Post Article Concerning Attorney General Inquiry of Department of Juvenile Justice
May 25, 2011
Ryan Stumphauzer Quoted in Palm Beach Post Investigative Report Concerning DJJ Psychiatrists that Accept Payments from Drug Companies, Prescribe Antipsychotic Medications to Children in State Custody
May 24, 2011
Ryan O'Quinn Quoted in Miami Herald Article Covering Billion Fraud Case
May 18, 2011
Miami Herald Covers Attorneys of O'Quinn Stumphauzer as "Movers" in South Florida Business and Legal Community
May 5, 2011
Ryan Stumphauzer to Speak at ABA 21st Annual National Institute on Health Care Fraud
April 1, 2011
Ryan O'Quinn Featured in Wall Street Journal, New York Times, and Washington Post for Work on Barry Minkow Securities Fraud Case
March 30, 2011
Ryan Stumphauzer to Speak at Florida Healthcare Corporate Compliance Association's Annual Retreat
March 10, 2011
Ryan Stumphauzer Honored at the NHCAA's Annual Training Conference in Las Vegas, Nevada
November 17, 2010