“A Thief Who Steals From A Thief Gets 100 Years Of Pardon”

Thieves smash stolen SUV into San Francisco museum for gold

Updated 4:36 am, Wednesday, January 28, 2015

SAN FRANCISCO (AP) — Wells Fargo Bank officials vowed to reopen a popular corporate museum in the heart of San Francisco’s financial district after thieves smashed a stolen SUV through its front door and made off with historic gold rush nuggets on display.

The museum is a popular destination for schoolchildren and tourists and includes two restored stagecoaches, a working telegraph and other California Gold Rush era memorabilia.

The thieves struck at about 2:30 a.m. Tuesday when they rammed a Chevrolet Suburban through the museum’s revolving door. They then emerged from the SUV, and one of them held a security guard at gunpoint while the others took up to 10 ounces of gold nuggets from a display case.

The three men escaped in a four-door sedan driven by an accomplice. The security guard was unharmed. The iconic stagecoaches weren’t damaged, bank spokesman Ruben Pulido said.

“Rest assured, the museum will reopen, so it can continue to serve the thousands of visitors and Bay Area residents who visit it each year,” Pulido said. Wells Fargo opened its first branch on the site in 1852, Pulido said.

The tactic mirrored three other smash-and-grab thefts involving vehicles in the San Francisco Bay Area since May. Police said they are investigating whether there’s a connection.

Last week thieves backed a U-Haul van through the front of a Patagonia store near San Francisco’s Fisherman’s Wharf, loaded it with high-end outdoor clothing and gear and sped off.

On Nov. 26, two men rammed a vehicle into an upscale designer boutique in Union Square and took handbags.

Across San Francisco Bay, thieves in May busted through the glass at an Apple Store in a bustling shopping district in Berkeley to steal electronics, leaving the car behind.

Police did not reveal the value of the stolen merchandise in any of the cases.

As many as 10 ounces of gold with an estimated value of roughly $10,000 was stolen from the Wells Fargo museum. Wells Fargo officials were still trying to determine exactly what was stolen before determining a more precise loss figure.

Dealers of precious metals say they will be on the lookout for nuggets with historical significance that suddenly appear on the market, rare coin dealer Don Kagin said.

Melting the gold could remove possible markings concerning when and where the nuggets were mined, said Fred Holabird, a mining geologist and an owner of a rare and unique collectibles business in Reno, Nevada.

“This is such bad news from my viewpoint,” he said, calling the potential loss of historical indicators a tragedy.

Holabird said the nuggets could be worth two to 10 times the value of gold now selling for about $1,300 an ounce on the open market.

Selling stolen precious metals is difficult but not impossible. Robbers who swiped $1.3 million in gold, quartz and other valuable metals on display at the California State Mining and Mineral Museum in 2012 were able to sell about $12,000 worth of gold to pawn shops and dealers, police said.

Some of the stolen items, including a bag of ground-up quartz, were recovered. Five men were convicted of the heist at the museum in the Sierra Nevada foothills.

People walking to work stopped to snap photos of the SUV wedged in the shattered revolving doors.


South San Francisco Dental Care Does An Incredible Job!

My friends I want to thank the incredible team at South San Francisco Dental Care for the wonderful job they did on my teeth. My treatment began with a root canal done by Dr. Victor Peritore. We all know that a root canal is the nightmare of any one going to the dentist. Some people claim that it is more painful than giving birth to a child. (Being a male I cannot confirm or deny this!) Dr. Peritore did an excellent examination and proceeded to do the actual root canal. We had a huge crisis during surgery. He was concerned that my tooth might have been cracked. If he had not been able to save the tooth, it would have had to be extracted. Putting in a replacement tooth would have been a very painful process costing thousands of dollars and not generally covered by dental insurance. Dr. Peritore worked for two hours and saved the tooth. I was then seen by Dr. Lucinda Hall. She did an excellent job of doing the build up on the crown above the root canal and filling six cavities. When I came home and the pain medicine wore off I did not suffer pain or discomfort. I have been with this dental practice for almost seven years. They have always given excellent treatment and treated me like a wonderful and a special person.

As Per The FT of London, Federal Prosecutors Use Real Time Big Data Mining To Cut Medicare Fraud

January 12, 2015 7:04 pm

US healthcare: Big data diagnoses fraud

Investigators use data mining tools to claw back billions stolen by crooked doctors and clinics

Late on an April evening in 2010, agents with the Federal Bureau of Investigation broke into a medical clinic in Bath Beach, Brooklyn, an area popular with Russian immigrants. Once inside, they installed a hidden camera in an air-conditioning vent in the ceiling directly above a desk.

Over the next six weeks, the camera recorded a blonde-haired woman stuffing envelopes with $100 bills, which she handed to elderly patients. In exchange, patients handed over their Medicare identification number, which Bay Medical used to bill for services that the patients would often never receive. If there were any doubts about the legality of the scheme, Bay Medical kept a Soviet-era poster pinned to the wall showing a woman with her finger pressed against her lips and a simple message in Russian: “Don’t Gossip.”

Bay Medical fleeced Medicare, the US taxpayer-funded healthcare programme for the elderly and disabled, for $50m in illegal payments, US authorities later proved. Its employees used the proceeds of the fraud to splurge on plastic surgery, luxury cars and vacations.

Sixteen people were arrested, including two doctors and Irina Shelikhova, the mastermind. All but three were convicted or pleaded guilty to charges related to healthcare fraud. Ms Shelikhova, a Ukrainian immigrant, was sentenced to 15 years in prison and ordered to pay $86m in losses and fines.

The Bay Medical case may sound like an example of old-school detective work, and in many ways it was. But before agents could plant their hidden camera, US investigators harnessed the power of “big data” to find the scheme, analysing vast amounts of Medicare billing information for aberrations.

Such data mining has long been used in ecommerce, from music companies trying to anticipate the song you want to listen to next or tech marketers scanning your social media profile to make a pitch. Now it has become a federal fraud-busting tool. Government data analysts are monitoring eight other “hotspot” cities to track potential Medicare fraud, including Detroit, where, in one case, analytics helped confirm a tip that a doctor was prescribing expensive chemotherapy treatments for patients who did not have cancer.

Fraudulent billings are estimated to make up as much as 10 per cent of Medicare spending in the US, according to the most recent study. Medicare, which funds hospital visits, prescription drugs and other services for retirees and the disabled, paid over $600bn to provide medical services to 51m Americans in 2013, according to the US Government Accountability Office.

Healthcare takes the lead

Though still in start-up mode, US investigators’ embrace of big data analysis could save taxpayers billions of dollars a year from healthcare fraud alone. Ultimately, the US Department of Justice hopes to adapt these tactics to crack down on other forms of fraud.

The DoJ says the scheme is already paying off. For every dollar spent to combat healthcare fraud, the US government has collected $8 in recoveries from forfeiture, asset seizures and fines, amounting to $4.3bn in 2013 and a total of $19.2bn over five years.

Do not chat! (Poster), 1941. Artist: Vatolina, Nina Nikolayevna (1915-2002)©Alamy

The propaganda poster advising Russians not to gossip that adorned a clinic where a $50m fraud took place

Data mining was launched as an experiment in 2007 in Miami, a hotbed of healthcare fraud. The DoJ, the FBI and the Department of Health and Human Services’ office of inspector-general wanted to see if data could be as good as a human at rooting out fraudsters. “You might see one medical equipment provider getting referrals for 500 wheelchairs from the same doctor, or a home health agency that’s getting 60 per cent of its referrals from the same doctor,” says Leslie Caldwell, chief of the DoJ’s criminal division. “A lot of this can be gleaned from the data.”

Ms Caldwell said the ability to scour billing data also gives investigators an advantage by allowing them to watch crimes unfold. “The idea of using real-time data to generate fraud cases is unique,” she said. “We have the ability to suspend — [when] there’s reasonable suspicion — [those] who are engaged in fraud even before they are prosecuted and indicted.”

Using big data as a fraud-fighting tactic is the brainchild of Kirk Ogrosky, a 36-year-old prosecutor from Harrodsburg in Kentucky. He worked for five years as a federal prosecutor specialising in healthcare fraud in Miami before a stint at a private firm in Washington.

But in 2006, the DoJ asked him to return to crime-fighting, as the head of the healthcare unit. Mr Ogrosky said he would only do it if they agreed to completely rethink how they prosecute healthcare fraud, with an emphasis on real-time prosecutions. Mr Ogrosky thought the DoJ should take a proactive approach. “I started looking at claims data and tried to identify the worst offenders,” he said. “The questions were how and where is the government taking the biggest beating.”

Culling billing data by postcode, he looked for communities where patient spending was three or four times the national median. From there he narrowed the search for providers in those communities that were the top billers. “Most times, those zip codes would help generate a list of providers that had what I would call ‘medically impossible’ claims. [It was] like peeling an onion ring by ring — and yes, it always burnt my eyes at some point.”

Often it turned up a false lead, such as a major hospital, but just as frequently it revealed the name of a small clinic. Mr Ogrosky would then do some old-fashioned sleuthing: driving past the clinic to see if it existed, checking whether the doctors and patients were alive and requesting bank records to see where and how the money was flowing from federal agencies. The results were striking.

In Miami-Dade county, billings for durable medical equipment — wheelchairs, iron lungs and the like — went from $73m in late 2006, before the new data-led programme started, to $40m by the first quarter of 2007. Billings fell to just above $10m by early 2013, according to the office of inspector-general, the federal watchdog. The drop was linked to the rise in prosecutions.

Investigators scouring billing data in 2009 discovered some serious anomalies from a clinic in Brooklyn. It was billing physical therapy sessions three times a week, with nearly all patients receiving special extensions to continue the care. This was their introduction to Bay Medical. “They were billing $20m a year. Everything popped off the charts,” said Thomas O’Donnell, a health agency special agent overseeing the case.

Breaking the silence

But data would only get them so far. They also needed witnesses, but Bay Medical served a very tight-knit Russian-speaking community. “The Russian population as a whole usually doesn’t talk,” Mr O’Donnell said. “We couldn’t do traditional methods. You have to have undercovers.”


Amount Bay Medical received in illegal payments from Medicare

A New York state investigator originally from Russia worked with the “strike force” to recruit two elderly residents in November 2009. They agreed to wear a wire and carry cameras embedded in satchels. The next month, one of them, working undercover, recorded Bay Medical employee Elena Girenko saying patients could receive $50 to $150 for agreeing to receive certain treatments, according to court filings. Using their cameras, the patients recorded their own payouts, every other Friday, from the “kickback” room.

The evidence was used to secure a court-authorised wiretap that allowed the installation of the secret camera. Nine months after identifying the clinic, agents made their initial arrests early one morning in May 2010. (Ms Girenko later pleaded guilty.)

Lewis Morris, a former chief counsel at the federal watchdog, called the data-based model “highly effective” at catching fraud cases, but says “the real smart fraud schemes don’t steal a lot. They steal a little bit a lot of the time.”

Detroit detection

In Detroit, agents say, the data led them to focus on home healthcare agencies, which provide service to elderly or disabled patients at their residence. From 1984 until 2002, the number of home healthcare agencies registered in Michigan remained relatively static, dropping slightly from 187 to 185. Over the next 10 years, the number of registered agencies exploded to 652, a 250 per cent increase. The Medicare population in the state grew by 18 per cent over the same period — raising suspicions among investigators, particularly the FBI.

“We can use [data] to lead us in the right direction, investigatively, and we can also use it to confirm and corroborate leads that we have from more traditional sources,” said Paul Abbate, the special agent in charge of the FBI’s Detroit office. “It’s made us more efficient overall in terms of what we do.”

In August 2013, investigators received a tip about Dr Farid Fata, an oncologist, who was allegedly ordering unnecessary medical treatments for patients. Prosecutors and agents analysed his billings — and saw a crime scene in the making.

Agents interviewed current and former employees. A doctor at one of his practices said Dr Fata had ordered 56 doses of a treatment for non-Hodgkin lymphoma in two years. The normal dosage, he said, was 12 doses over the same period, court documents say.

A nurse told agents that Dr Fata ordered chemotherapy for patients whose cancer had already gone into remission. Within a week of that tip, Mr Fata was arrested. A year later, facing decades in prison, he pleaded guilty to committing healthcare fraud. Federal authorities says Dr Fata falsely submitted $225m in Medicare claims between August 2007 and July 2013.

David Korff, a retired financial analyst for ITT Corp, said the doctor did more than deceive the government.


False Medicare claims submitted by Dr Fata between August 2007 and July 2013

Mr Korff went to see Dr Fata after he was diagnosed in 2006 with myelodysplasia, a blood condition that can be a prelude to leukaemia if not treated. Dr Fata started him on chemotherapy for three days a week and then more. “He had me coming in seven days in a row getting an IV [intravenous drip] that would last for about one to two hours,” Mr Korff said. At consultations, Dr Fata told him: “If you stop chemo you’re dead.” The treatment continued for seven years.

“It was like a factory,” Mr Korff recalled. “They had about 30 chairs and it was people sitting in a waiting room for half an hour. As soon as somebody got up the next guy came in.”

Mr Korff believes excessive chemotherapy impaired his body’s ability to manage an unrelated artery disease. When he got a bruise on his leg, he said, it turned into a sore that would not heal. While he was seeing Dr Fata, Mr Korff had one leg amputated and then the other. “At the time we thought this was a terrible case of artery disease,” Tracy, Mr Korff’s wife recalled, until a different “doctor started to say that they had never seen that before”.

Mr Korff’s last appointment was on the same day agents arrested Mr Fata. He has since switched to another doctor, who has taken him off all drugs. Mr Korff has filed a civil malpractice lawsuit against Mr Fata but he also faults the government. The data should have told them something, he said.

“At the rate the man was billing, someone should have known,” he said.


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Legal Tender9 hours ago

Private insurance companies have been doing this for 20 years and would never have paid for tens of billions in claims per year.

Markdoc3 hours ago

Your faith in the market is touching, if charmingly naive. Alas, private insurers are also subject to fraud – to take the case of Dr. Fata mentioned in the article, of the 225 million he billed fraudulently, 91 million was paid by private insurers – suggesting that on a percentage basis they were carrying slightly more fraud than the Fed.s. Medicare is the biggest target of healthcare fraud, but that’s simply because it’s the biggest payer. Nothing suggests that private insurers are better at detecting fraud – if anything, they appear to be slightly worse. It’s a well-known problem in business, but one which is almost impossible to police in the US’s byzantine and bureaucratic health care system.

A Wild Marriage Proposal

Despite the fact that I’m a Democrat I have a profound admiration for Republican congress man Mark Sanford. To me he is what a conservative politician should be; very smart, very professional, open to discussion and to compromise when necessary. Yesterday afternoon I got the news that he and his fiance Maria Belen Chapur had broken off their engagement. I have been with an incredible woman from Buenos Aires for 14 years. The romance between Mark and Maria touched my heart because he also is with an incredible woman from Buenos Aires.

It appears that Maria gave him an ultimatum for a wedding date and he did not react in the way that she was expecting.

Let me take you back to 1968. I was a young college student working 4:00 PM to 12:00 PM to get through college. The lady who became my first wife called me from our apartment around nine in the evening and said the following words: “I’m at home and standing here naked. I demand that you come home immediately!”

All of you males know this is an invitation that no man could say no to. I excused myself with my supervisor on the grounds that I had an emergency at home. I rushed home. True to her words my fiance greeting me at the door nude. Off to her side all of her bags were packed as if she was ready to leave. She said to me: “Marry me by Saturday or I’m walking out.”

Of course I agreed to her demand. You can imagine what happened afterwards.

A Marijuana Cigarette For Christmas

I get countless invitations to play computer games. I always decline these invitations.
Let me tell you why. In 1976 I put a joint of marijuana in a small jewelry box. I wrapped it and gave it to my mother as a joke Christmas gift. I expected to “get a big rise out of her” as she screamed and told me to remove an unlawful substance from her house.

When mother opened her gift, her reaction was a huge surprise to me. She knew what I had given her without me saying anything. She looked at the small box for the longest time. She then handed it back to me. She said to me: “Son I already have enough addictions. If I smoked this marijuana cigarette, I would have a new one.”

The moral of the story is that I’m afraid that if I started to play computer games I would get addicted to them.

39 Years In Prison For A Crime That He Did Not Commit

My dear friends the CBS News cast had an unforgettable and troubling last segment. It was about a man who spent 39 years in an Ohio prison for a murder that he did not commit. More troubling is that he avoided the electric chair only because a prior Ohio governor commuted the death sentences of several African American inmates on the grounds that African Americans were given a disproportionate number of death sentences. The horrible part of this is that this man was convicted of murder and sentenced to death based on an eyewitness identification of a man who was 12 years old in 1975. It came out in the CBS newscast that homicide detectives of the Cleveland Police Department had coached this young man to lie. What kind of awful criminal justice system do we have in this country? Elena made a comment about the Cleveland Police Department: “What kind of thrill does one get about killing an innocent man?”