Get a Good Deal on Your Health Insurance Without Getting Ripped-Off

Front Cover
Aji Publishing, 2007 - Business & Economics - 152 pages
Whether you currently have health insurance, are looking to purchase it, or believe it is simply something you cannot afford to buy, Get a Good Deal on Your Health Insurance Without Getting Ripped-Off offers every consumer a complete and concise guide to getting the most from individual, small business, Medicare, Medigap, and employer health insurance. This book and the accompanying website www.BestHealthInsuranceBook.com features: * Advice from health insurance agents and financial advisors. * A step-by-step process that guides you through buying health insurance * Plenty of sidebars and illustrations to keep a dry topic interesting * A method to compare your health insurance options, dollar-to-dollar, to get the best deal * Ways to avoid pitfalls, scams, and rip-offs using real world tips and examples * Tips to avoid losing health insurance when you leave a job, retire, retire early, or get laid off *Listings in the book and online that direct you to the right government, association, and business resources *A way to get your best deal whether you are young, old, healthy, or have a medical condition. Get a Good Deal on Your Health Insurance Without Getting Ripped-Off is concise, saving you time by not including any fluff or filler that you have to wade through, just useful information that is easy to understand and apply. Truly a hands-on cookbook for buying health insurance. Get a Good Deal on Your Health Insurance Without Getting Ripped-Off contains everything you need to know to make an educated decision about your health insurance and to be in control of this complex purchase.
 

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Brookline Doctor MAD DOG MILLIONAIRE a.k.a. Punyamurtula Kishore MD Pleads Guilty, Sentenced to Jail and Ordered to Pay $9.3 Million for Running Medicaid Kickback and False Billing Scheme
Dr. MAD DOG
to Surrender Medical License, Sentenced to House of Correction
BOSTON – A Brookline doctor MAD DOG MILLIONAIRE a.k.a. Punyamurtula Kishore MD has pleaded guilty, was sentenced to jail, and has been ordered to pay $9.3 million in restitution for running an intricate Medicaid fraud scheme involving millions of dollars in taxpayer funds, Attorney General Maura Healey announced today.
Dr. Punyamurtula Kishore, 64, along with his company Preventive Medicine Associates, Inc. (PMA), pleaded guilty on Monday in Suffolk Superior Court. PMA pleaded guilty to charges of Medicaid Kickbacks (8 counts), Medicaid False Claims (19 counts) and Larceny over $250 (11 counts). Dr. Kishore pleaded guilty to one count of Larceny over $250.
“Dr. Kishore orchestrated a complex kickback scheme to funnel a lucrative drug screening business to his laboratories and then billed taxpayers millions of dollars for those services,” AG Healey said. “This case exhibited blatant theft of state funds that were supposed to go toward care for some of our most vulnerable residents. This is fraud that undermines the integrity of our health care system.”
Today, Superior Court Judge Janet Sanders sentenced Kishore to 360 days in the House of Correction, with 11 months to serve and the balance suspended for 10 years. As a condition to his sentence, Kishore has also agreed to surrender his medical license. Judge Sanders also ordered Kishore and PMA to pay, jointly and severally, a total of $9.3 million in restitution.
Dr. Kishore previously owned and managed PMA, a network of 29 medical branches throughout Massachusetts, including physician office laboratories and one independent clinical laboratory. Based on the AG’s investigation, Dr. Kishore used bribes, or kickbacks, to induce sober house owners to send their residents’ urine drug screening business to his laboratories for testing. Residents were typically screened three times per week.
A urine drug screen may be billed to MassHealth by a physician if the screen is medically necessary. Drug screens generally are billed to the MassHealth program for approximately $100 to $200. Dr. Kishore manipulated his business relationships with sober house owners to illegally obtain tens of thousands of drug screens paid for by MassHealth for sober house residents who were never treated by PMA providers.
In September 2011, Dr. Kishore and PMA were indicted, and individually charged with Medicaid Kickbacks (8 counts), and Medicaid False Claims (8 counts). In November 2013, Dr. Kishore and PMA were indicted on additional charges of Medicaid False Claims (11 counts) and Larceny over $250 (11 counts) for billing MassHealth for millions of dollars in drug screens using the names of PMA physicians and nurse practitioners who were not actually treating the patients or determining the drug screens to be medically necessary. State regulations require that the services must be medically necessary and the provider must be physically present and actively involved in the treatment of the member.
Two other individuals previously pleaded guilty to one count of Medicaid Kickbacks in connection with their involvement in Dr. Kishore’s scheme to defraud MassHealth. In June 2012, Damion Smith, 42, of New Jersey, president of Fresh Start Recovery Coalition, was sentenced to two years in the House of Correction suspended for two years with probation. Carl Smith, 69, of Dorchester, manager of New Horizon House, pleaded guilty in January 2015 and was sentenced to two years in the House of Correction suspended for two years with probation.
The case against Thomas Leonard of Malden, the part owner and manager of the Marshall House, a sober house located in Malden, is ongoing. John Coughlin of Carver, president of Gianna’s House Inc., which operates several sober houses located in Wareham, New Bedford
 

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Page 13 - Under 18 years 1 8 to 24 years 25 to 34 years 35 to 44 years 45 to 54 years 55 to 59...
Page 9 - Reading about health insurance is not at the top of my list of fun things to do, and reading the source materials on the topic has helped me to fall asleep on many occasions.

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