Telemedicine and Fraud: A Double-Edged Sword
June 11, 2025 | JacobiJournal.com – Telemedicine fraud is rising alongside the boom in virtual healthcare. As telemedicine reshapes healthcare access, it also opens new opportunities for deception. While virtual care brings convenience, bad actors exploit its digital nature to commit large-scale schemes. From fake billing to identity theft, the risks are mounting — and healthcare professionals must stay vigilant. The Rise of Telemedicine Fraud and Virtual Care Challenges Telemedicine surged during the pandemic, making healthcare more accessible for millions. However, this rapid adoption also left gaps that fraudsters eagerly filled, fueling a surge in telemedicine fraud. Scammers have exploited the virtual nature of care, taking advantage of lax verification processes and limited oversight in remote consultations. They used stolen identities, fake provider credentials, and inflated claims to siphon funds from government programs like Medicare and Medicaid. In many cases, telemedicine fraud involves billing for services never provided, fabricating patient encounters, or exaggerating the complexity of care delivered. This fraudulent activity not only drains public resources but also undermines trust in digital health services, creating barriers for legitimate telehealth providers and patients seeking convenient care options. Red Flags in Remote Care Fraudsters have grown more sophisticated. Some create fictitious clinics that never see patients but still bill for services. Others submit claims for expensive tests or procedures that never occurred. Additionally, providers have reported instances where patients were billed for telehealth visits they never scheduled. Enforcement Agencies Step In Thankfully, government watchdogs have significantly increased enforcement efforts to combat telemedicine fraud. Agencies like the Department of Justice (DOJ), the Office of Inspector General (OIG), and the Centers for Medicare & Medicaid Services (CMS) are working together to investigate and prosecute telehealth-related fraud schemes more aggressively. Recent enforcement actions include coordinated nationwide takedowns targeting fraudulent telemedicine providers who exploited Medicare and Medicaid. These operations often uncover complex networks involving fake clinics, unlicensed practitioners, and fraudulent billing practices. Despite these efforts, many telemedicine fraud schemes remain undetected due to the digital and often anonymous nature of virtual healthcare, costing taxpayers billions annually. Regulators are also investing in advanced data analytics and cross-agency collaborations to better identify suspicious patterns in telehealth billing. This enhanced scrutiny aims not only to catch current offenders but also to deter future fraud in the rapidly growing virtual healthcare sector. What Healthcare Organizations Can Do To stay ahead of fraud, healthcare organizations must implement robust compliance programs. Regular audits, identity verification, and secure digital platforms help reduce the risk. Moreover, training staff to recognize unusual billing or patient activity strengthens the first line of defense. A Call for Balanced Innovation Ultimately, telemedicine offers undeniable benefits—but it must evolve with fraud prevention in mind. As the industry grows, so must the systems that protect it. With proper safeguards, healthcare providers can embrace innovation while keeping fraud at bay. Learn more about healthcare fraud prevention from the HHS Office of Inspector General here. FAQ: Understanding Telemedicine Fraud What is telemedicine fraud and how can patients protect themselves? Telemedicine fraud occurs when scammers exploit virtual healthcare services to submit false claims, use stolen identities, or bill for services never provided. Patients can protect themselves by verifying their telehealth provider’s credentials, keeping track of services received, and monitoring their insurance statements for unauthorized charges. Reporting suspicious activity to healthcare authorities can also help prevent further fraud. Stay informed on telemedicine fraud trends and healthcare enforcement updates. Subscribe to JacobiJournal.com for weekly insights into fraud prevention and regulatory news. 🔎 Read More from JacobiJournal.com:
FTX Investor Lawsuit Narrowed Against Tom Brady, Steph Curry
May 9, 2025 | JacobiJournal.com – FTX Investor Lawsuit: A federal judge has narrowed but not dismissed a lawsuit that seeks to hold celebrities like Tom Brady, Stephen Curry, and Shohei Ohtani accountable for promoting the failed cryptocurrency platform FTX. The investors allege that the celebrity endorsers ignored red flags and secretly accepted millions to serve as FTX brand ambassadors. They claim these actions amounted to a civil conspiracy to defraud customers. Most Claims Dismissed, But Key Allegations Survive On May 8, U.S. District Judge K. Michael Moore dismissed 12 of 14 claims, finding the investors failed to show the celebrities knew FTX was a fraudulent operation. He ruled that accepting payment alone does not prove conspiracy. However, the judge let two claims survive. He found it plausible under Florida law that the defendants helped FTX sell unregistered securities. A related Oklahoma claim was also allowed to proceed. These remaining claims rely on strict liability statutes, which do not require proof of intent or knowledge of wrongdoing. Celebrity Endorsers Still Facing Legal Pressure The lawsuit continues against several high-profile figures, including: Plaintiffs say these endorsers misled the public by promoting FTX without disclosing their compensation or performing proper due diligence. Investors Plan to Expand Lawsuit Adam Moskowitz, who represents the investors, called the ruling a win. He announced plans to file an amended complaint that could include Major League Baseball and Formula 1 Racing as new defendants. Some celebrities, including Shaquille O’Neal and Trevor Lawrence, have already settled. Background: FTX’s Fall and Bankman-Fried’s Conviction FTX Investor Lawsuit: FTX filed for bankruptcy in November 2022. In October 2023, a judge approved a plan to repay customers. Founder Sam Bankman-Fried was convicted of fraud and sentenced to 25 years in prison, though he is currently appealing. The case is being heard in the Southern District of Florida under the title:In re FTX Cryptocurrency Exchange Collapse Litigation, No. 23-md-03076. This case shows that celebrities who promote financial products—especially unregistered securities—may face legal consequences, even if they claim ignorance. It also signals stricter accountability in how influencers promote digital assets. Source FAQs: About the FTX Investor Lawsuit What is the FTX investor lawsuit about? The FTX investor lawsuit targets celebrities like Tom Brady and Steph Curry for allegedly promoting FTX without due diligence. Investors claim these endorsements misled the public and contributed to major financial losses. Why are only two claims moving forward in the FTX investor lawsuit? The judge dismissed most claims but allowed two under strict liability for promoting unregistered securities. These don’t require proof the celebrities knew of wrongdoing, keeping the FTX investor lawsuit alive. What are the implications of the FTX investor lawsuit for celebrity endorsements? The FTX investor lawsuit sets a precedent for holding influencers legally accountable when endorsing financial products. It signals growing regulatory attention on crypto and financial promotions. Stay informed on high-impact financial litigation and regulatory crackdowns—subscribe to JacobiJournal.com for exclusive legal insights and compliance updates. 🔎 Read More from JacobiJournal.com:
Fired State Employees Exposed Personal Data of 33K Texans
May 1, 2025 | JacobiJournal.com – Fired State Employees Exposed Personal Data of 33K Texans: Late Wednesday, the Texas HHSC data breach was confirmed when the Texas Health and Human Services Commission (HHSC) notified 33,529 recipients of state benefits that fired state employees had improperly accessed their private information. This latest announcement follows an ongoing investigation into breaches involving state employees who accessed Medicaid, food stamp, and other assistance programs’ data. Three months ago, the agency notified 61,104 Texans about the breach of their personal information by state employees. Seven employees were fired at that time, including two who had stolen from recipients’ food stamp cards. Texas HHSC Data Breach: State Employees Involved in Unauthorized Access In February, HHSC notified lawmakers that two more employees had been fired, raising the total to nine employees who accessed individuals’ accounts without legitimate reasons. These employees are now responsible for breaching the personal data of another 33,529 account holders who applied for or received assistance between June 2021 and January 2025. HHSC has not yet determined how many of those individuals had their benefits compromised. Fired State Employees Exposed Personal Data of 33K Texans Recommendations for Affected Texans HHSC urges affected individuals to carefully review their accounts and examine statements from health care providers, insurance companies, and financial institutions to ensure that their account activity is correct. They should report any questionable charges to the respective provider and notify law enforcement promptly. The agency recommends that Supplemental Nutrition Assistance Program (SNAP) recipients check their Lone Star Card transactions for fraudulent activity. Individuals can do this by visiting YourTexasBenefits.com or using the mobile app. If they suspect SNAP fraud, they should call 2-1-1, select a language, and choose option 3 to report the fraud to the Texas Health and Human Services Office of the Inspector General. Affected individuals should also contact law enforcement and visit a local HHSC benefits office to replace their stolen benefits. Details of the Breach and Available Resources HHSC reports that the compromised data includes full names, addresses, phone numbers, dates of birth, email addresses, Social Security numbers, Medicaid and Medicare identification numbers, and other personal information. The agency offers two years of free credit monitoring and identity theft protection services to those affected. Individuals can also call 866-362-1773, using engagement number B139792, for further assistance. Contractor Employee Terminated Over Improper Access HHSC has notified one of its contractors, Maximus, about an employee suspected of misusing personal data from HHSC’s systems. Maximus terminated the employee for improperly accessing protected health information of Texans enrolled in state benefits between May 8, 2023, and February 28, 2025. The Texas HHSC Office of the Inspector General is conducting an investigation into these data breaches. For more information, visit the Texas Tribune. FAQs: About the Texas HHSC Data Breach What personal information was exposed in the data breach? The breach involved names, addresses, phone numbers, Social Security numbers, Medicaid and Medicare IDs, and other sensitive personal data of over 33,000 Texans. What should Texans do if they were affected by the data breach? Affected individuals should monitor their accounts for suspicious activity, review Lone Star Card transactions, report any fraud to HHSC and law enforcement, and use the free credit monitoring services offered. How is the HHSC responding to the data breach? HHSC is investigating the breach, providing two years of free credit monitoring, working with law enforcement, and has terminated employees and contractors responsible for improper access. Get the latest updates on workers’ compensation fraud and other critical industry news. Stay ahead by reading more insightful articles and case analyses on JacobiJournal.com. 🔎 Read More from JacobiJournal.com:
San Diego Construction Firm Penalized $157K for Deadly Trench Collapse
March 31, 2025 | JacobiJournal.com – The California Division of Occupational Safety and Health (Cal/OSHA) fined W.A. Rasic Construction, a San Diego construction firm, $157,500 for multiple violations of safety regulations. This fine follows a fatal trench collapse on August 28, 2024, in which an employee tragically lost their life while working in an unprotected excavation. What Happened: Fatal Trench Collapse in San Diego On August 28, 2024, at around 3:00 a.m., a worker was inside a 17-foot-deep trench at the construction site when the trench suddenly collapsed. The collapse displaced a concrete pipe, pinning the worker and causing fatal injuries. Cal/OSHA’s investigation revealed several serious violations related to excavation and trench safety. Cal/OSHA Findings: Serious Violations at the San Diego Construction Site Several critical safety violations contributed to the fatal incident: Cal/OSHA Chief’s Statement Cal/OSHA Chief Debra Lee emphasized the importance of enforcing safety regulations: “No worker should lose their life due to preventable safety failures. We will continue to enforce trench safety rules and hold employers accountable.” Workers’ Rights and Employer Appeals Employers, including San Diego construction firms, have the right to appeal any Cal/OSHA citation. Appeals must be filed within 15 working days. For further details, visit the Cal/OSHA Appeals Page. Additionally, workers, regardless of immigration status, are protected under Cal/OSHA regulations. They can file confidential complaints with Cal/OSHA’s district offices if they encounter any safety hazards. FAQs: San Diego Construction Firm Penalized Why was the San Diego construction firm penalized by Cal/OSHA? The San Diego construction firm penalized received $157K in fines for failing to provide cave-in protection, conduct inspections, and implement a safety program. What safety violations were linked to the San Diego construction firm penalized by Cal/OSHA? Violations included no Injury and Illness Prevention Program, inadequate trench inspections, and lack of protective systems against cave-ins. Can a construction firm penalized by Cal/OSHA appeal its citation? Yes. Employers have 15 working days to appeal Cal/OSHA citations through the Cal/OSHA Appeals Board process. How can workers report unsafe conditions at a construction firm penalized for safety violations? Workers can confidentially report hazards to Cal/OSHA district offices, regardless of immigration status, to protect workplace safety. Stay informed on workplace safety enforcement and fraud investigations. Subscribe to JacobiJournal.com for ongoing updates on Cal/OSHA penalties, legal cases, and compliance news. 🔎 Read More from JacobiJournal.com:
Florida Grand Jury Finds No Criminal Activity in COVID Vaccine Development, but Raises Concerns
January 9, 2025 | JacobiJournal.com — COVID Vaccine Development: A Florida grand jury, convened at the request of Governor Ron DeSantis, has found no criminal wrongdoing in the development of COVID-19 vaccines. The grand jury’s report, unsealed on Tuesday, concluded there was no evidence of criminal activity. However, it did raise significant concerns about the process of vaccine development and safety monitoring in the U.S. Key Findings and Policy Recommendations While the grand jury did not uncover criminal actions, it highlighted serious issues with the vaccine process. As a result, the grand jury recommended increasing transparency in clinical trials and banning pharmaceutical advertisements. The CDC has defended the COVID-19 vaccines, emphasizing that they underwent rigorous safety checks. Even after FDA approval, these vaccines continue to be closely monitored to ensure safety. Public health experts note that the vaccines are effective in preventing severe disease, hospitalization, and death, with only rare serious side effects. DeSantis Requested Investigation Ahead of Presidential Bid Governor DeSantis initiated the investigation in 2022, aiming to challenge pandemic restrictions and gain national attention. He suggested that the probe could help hold wrongdoers accountable and provide more information from pharmaceutical companies on the vaccines and their potential side effects. Florida’s statewide grand juries typically focus on criminal activities and systemic issues, often issuing policy recommendations. Past investigations have addressed topics like immigration and school safety. You can read the original report from AP News. FAQs: COVID Vaccine Development What did the Florida grand jury conclude about COVID vaccine development? The Florida grand jury found no criminal wrongdoing in the COVID vaccine development process but highlighted transparency and monitoring concerns. Why did Governor DeSantis request a grand jury investigation? Governor Ron DeSantis requested the probe to challenge pandemic policies, increase scrutiny of pharmaceutical companies, and raise national awareness. What policy recommendations came from the grand jury? The report recommended more transparency in clinical trials and banning pharmaceutical advertising related to COVID vaccines. How have health agencies responded to the grand jury’s findings? The CDC and FDA reaffirmed that COVID vaccines were rigorously tested, continue to be monitored, and remain effective in preventing severe illness. Are COVID vaccines being restricted? COVID vaccines are not being restricted in Florida. They remain available statewide. What’s changing is the political scrutiny surrounding them, especially as leaders debate advertising limits and transparency rules. How do you look up COVID vaccine records in Florida? Florida residents can access their COVID vaccine records through the Florida SHOTS system or by requesting records from their doctor, local health department, or the pharmacy where they received the vaccine. Does Florida allow vaccine exemptions? Yes. Florida allows certain vaccine exemptions, including medical and religious exemptions. These exemptions apply mainly to school and workplace requirements, and they’ve become a point of discussion as state leaders continue to scrutinize COVID-19 policies. Stay informed on critical public health and legal updates. Subscribe to JacobiJournal.com today for trusted reporting on fraud cases, grand jury findings, and integrity investigations. 🔎 Read More from JacobiJournal.com:
Faith-Based Fund with $24 Billion in Assets Influences Corporate Policies in America
Jim Lake (Photo by Margaret Albaugh/Bloomberg) January 5, 2025 | JacobiJournal.com — Faith-Based Fund. Jim Lake, a devout Christian from Washington state, recently redefined his investment strategy. Guided by a financial adviser, he moved his portfolio into faith-oriented funds, including those managed by GuideStone Funds. This Texas-based firm, founded over 100 years ago, manages about $24 billion in assets and serves primarily Southern Baptist retirees. It has also gained traction among new faith-driven investors like Lake and his wife. The Rise of Faith-Based Investment Coalitions GuideStone is part of a growing coalition of conservative Christian investors. These investors are using their shareholder influence to challenge corporate practices, such as supporting Pride events or reimbursing employees for abortion-related travel. They are also confronting banks accused of closing accounts based on political or religious views. Will Lofland, who leads shareholder advocacy at GuideStone, estimates that half a trillion dollars are invested in conservative faith-based funds. This influence extends across private funds, state pension funds, and more. Key players in this coalition include Inspire Investing, the leading faith-based ETF manager, as well as Republican state treasurers and organizations like Alliance Defending Freedom. Faith-Based Fund The Growth of Faith-Based Funds While faith-driven investing has been around for decades, conservative faith-based funds are gaining momentum. This trend has been fueled by the rightward shift in U.S. politics and a growing resistance to diversity, equity, and inclusion (DEI) programs. More everyday investors are showing interest in faith-based funds. Tim Macready of Brightlight, an advisory firm, notes that assets in these funds surpassed $100 billion last year. Over three years, net inflows grew by 12%. Inspire Investing alone saw a net gain of $334 million in assets last year. GuideStone’s Advocacy and Future Plans GuideStone has expanded its role beyond managing Baptist church pensions. The firm is now actively engaging in shareholder advocacy. As progressive groups have ramped up shareholder proposals, GuideStone has voted its shares to reflect its values. In late 2023, GuideStone supported a proposal asking Microsoft to report on compensation gaps related to reproductive and gender dysphoria care. Although the proposal received only 1% of votes, Lofland stressed the importance of building a larger coalition to increase their influence. Looking ahead, GuideStone plans to focus on the issue of “debanking” in 2025. This refers to the practice of financial institutions closing customer accounts based on perceived risks related to legal or reputational concerns. GuideStone intends to press financial institutions on this issue to protect religious freedoms in the financial sector. Additional information on this topic can be found in the original report by Bloomberg. FAQs: Faith-Based Fund What is a faith-based fund and how does it work? A faith-based fund is an investment vehicle that aligns portfolios with religious principles, often excluding companies or practices that contradict specific moral or ethical beliefs. GuideStone Funds, for example, uses shareholder influence to promote policies consistent with Christian values. How does a faith-based fund influence corporate policies? Faith-based funds engage in shareholder advocacy, voting on proposals, and coordinating with other investors to influence company decisions on issues like reproductive care, DEI programs, or “debanking” practices. Who invests in faith-based funds? Faith-based funds attract religious individuals, church pension plans, and conservative coalitions. Investors like Jim Lake and Southern Baptist retirees use these funds to integrate faith with financial goals. What are the future trends for faith-based funds? The trend is growing, with assets surpassing $100 billion in recent years. Future focus areas include increasing shareholder influence, addressing perceived debanking, and expanding faith-aligned investing strategies across ETFs and institutional funds. What is the largest faith-based mutual fund? GuideStone Funds, managing approximately $24 billion in assets, is one of the largest faith-based mutual funds in the U.S., primarily serving Southern Baptist retirees while attracting new faith-oriented investors. What are faith-based funds? Faith-based funds are investment vehicles that align portfolios with religious or moral principles. They often avoid companies or practices that contradict the investors’ values and use shareholder advocacy to influence corporate policies, as demonstrated by GuideStone and other conservative Christian funds. What Fortune 500 companies are faith-based? While most Fortune 500 companies are publicly traded and not explicitly faith-based, some are influenced by faith-driven shareholder coalitions that push for policies aligned with religious values, such as GuideStone’s engagement with Microsoft and other large corporations. Which president suggested we rely on faith-based initiatives to help society? President George W. Bush promoted faith-based initiatives, encouraging partnerships between religious organizations and government programs to address social issues. This approach parallels how faith-based investors now use financial influence to support values-driven corporate change. Stay informed on the intersection of faith, finance, and corporate accountability. For more in-depth analysis of faith-based investing and its impact on corporate America, visit JacobiJournal.com. 🔎 Read More from JacobiJournal.com:
Former Sewerage & Water Board Employee Arrested for Workers’ Compensation Fraud
January 2, 2025 | JacobiJournal.com — Compensation fraud is at the center of a recent case in Louisiana. The Louisiana Bureau of Investigation (LBI), under Attorney General Liz Murrill, has arrested Ederik Trask, a former employee of the Sewerage & Water Board of New Orleans. Trask, who resides in Metairie, is accused of workers’ compensation fraud. Specifically, he allegedly misrepresented his employment status while receiving benefits. Cases of compensation fraud like this highlight how even trusted employees can exploit benefit systems designed to protect injured workers. When individuals misrepresent their employment status or income, it not only undermines public trust but also drives up costs for both taxpayers and honest policyholders who rely on fair claims processes. Complaint and Investigation On August 27, 2024, the Sewerage & Water Board formally complained to the LBI, alleging fraudulent activity by Trask. Investigators soon discovered that Trask had been working for a rideshare company while collecting workers’ compensation benefits. This dual employment, however, violates Louisiana law, which mandates truthful reporting for benefit claims. The discovery underscores how compensation fraud often involves hidden employment or unreported income, making it difficult for regulators to detect without thorough investigations. Such cases not only jeopardize the financial stability of the benefits system but also place an unfair burden on honest workers and employers who rely on these programs for legitimate claims. Legal Action Taken by Sewerage & Water Board After gathering sufficient evidence, LBI Special Agents quickly obtained an arrest warrant for Trask. He is now charged under Louisiana Revised Statute 23:1208 C.1, which forbids false statements about claims exceeding $10,000. Subsequently, on December 20, 2024, Trask surrendered at the Orleans Parish Jail. There, authorities arrested and booked him without any issues. This legal action highlights Louisiana’s strict stance on compensation fraud, particularly cases involving significant financial misrepresentation. By pursuing charges under state law, investigators aim to uphold the integrity of the benefits system while deterring other employees from attempting similar schemes that exploit taxpayer-funded resources. Ongoing Investigation The investigation is ongoing, as authorities continue to examine the details surrounding the alleged fraud. Meanwhile, the Louisiana Attorney General’s Office emphasizes its commitment to holding individuals accountable for abusing public resources. Consequently, they are determined to maintain the integrity of the workers’ compensation system. Authorities note that tackling compensation fraud remains a critical priority because such schemes drain valuable resources and weaken protections for legitimately injured employees. By pursuing this case, the Louisiana Attorney General’s Office aims to send a clear message that fraudulent claims will be met with serious consequences, reinforcing the state’s broader strategy to deter abuse within the workers’ compensation framework. For additional insights into fraud prevention and workers’ comp cases, visit the Louisiana Workforce Commission, which provides official resources on compliance, claims, and enforcement. FAQs: Workers’ Compensation Fraud What is workers’ compensation fraud in Louisiana? Workers’ compensation fraud occurs when someone provides false information to obtain benefits, such as working another job while collecting payments. What happened in the Sewerage & Water Board workers’ compensation fraud case? Investigators found that former employee Ederik Trask allegedly worked for a rideshare company while receiving workers’ comp benefits. What penalties apply for workers’ compensation fraud in Louisiana? Those convicted can face fines, restitution, criminal charges, and loss of benefits under Louisiana Revised Statute 23:1208. How does Louisiana investigate workers’ compensation fraud? The Louisiana Bureau of Investigation works with state agencies to review claims, track financial discrepancies, and prosecute fraudulent activity. What are the consequences of workers’ compensation fraud in Louisiana? Consequences can include criminal charges, fines, restitution, loss of benefits, and possible jail time. Convictions also damage the individual’s credibility and can affect future employment opportunities. Is workers’ compensation fraud a federal crime? Workers’ compensation fraud is generally prosecuted under state law. However, if the fraud involves federal programs, interstate activity, or mail and wire fraud, federal charges could apply alongside state penalties. What are the red flags for workers’ compensation fraud? Red flags include collecting benefits while working another job, inconsistent medical records, sudden lifestyle changes, exaggerated injuries, or suspicious claims that don’t match documented work duties. Stay informed on fraud investigations, legal actions, and public accountability cases. Subscribe to JacobiJournal.com for updates and expert reporting on workers’ compensation fraud and related financial crimes. 🔎 Read More from JacobiJournal.com:
Lifetime-Banned Fraudster Faces New Charges in $100M Workers’ Compensation Scheme
December 30, 2024 | JacobiJournal.com — Compensation fraud scheme involving a lifetime-banned fraudster: In a stunning development, a man previously banned from California’s workers’ compensation system for life has been charged with orchestrating a fraud scheme that racked up nearly $100 million in fraudulent claims. David Fish, alongside a San Diego-based neurosurgeon and two other alleged co-conspirators, faces 13 felony counts, including insurance fraud and conspiracy. The alleged scheme highlights the sophisticated methods fraudsters can employ to exploit the workers’ compensation system. Authorities say the defendants used a network of medical providers and management companies to funnel patients and inflate medical billing. These tactics included directing referrals to specific clinics, submitting unnecessary tests and treatments, and utilizing compound pharmacies to maximize reimbursements. Such schemes not only burden insurers with significant financial losses but also jeopardize the integrity of the system, potentially delaying care and compensation for legitimate injured workers. Law enforcement and insurance fraud investigators continue to emphasize the importance of vigilance and rigorous oversight in preventing such large-scale abuses. The Alleged Scheme Lifetime-Banned Fraudster: David Fish, 55, of Laguna Niguel, collaborated with Martin Brill, 78, Robert Lee, 61, and Dr. Vrijesh Tantuwaya to form Southern California Injured Workers (SCIW), a management company providing medical services. They also created a medical group, Injured Workers Medical Group, where Dr. Tantuwaya acted as CEO. Through this network, SCIW reportedly steered patient referrals to a limited group of providers who agreed to pay illegal referral fees. These services ranged from diagnostic testing to prescriptions from compound pharmacies. Between 2020 and 2023, the defendants allegedly billed workers’ compensation insurers close to $100 million, funneling profits from unlawful referrals back into the network. Charges and Potential Penalties The Orange County District Attorney’s Office charged the group following a three-year investigation. The 13 felony counts include violations of labor laws, conspiracy statutes, and insurance fraud regulations. If convicted: Deputy District Attorney Kelly Albright of the Insurance Fraud Unit is leading the prosecution. Ongoing Issues in Workers’ Compensation This case highlights the challenges California’s workers’ compensation system faces in combating fraud. Illegal schemes not only drain resources but also harm injured workers who depend on the system for proper medical care and fair compensation. For full details on charges and the investigation, visit the Orange County District Attorney’s Office official page. FAQs: Workers’ Compensation Fraud Scheme What is the workers’ compensation fraud scheme David Fish is accused of? David Fish and his alleged co-conspirators are accused of funneling patient referrals and medical billing into a $100M workers’ compensation fraud scheme. Who are the main defendants in the compensation fraud scheme? David Fish, Martin Brill, Robert Lee, and Dr. Vrijesh Tantuwaya are charged in connection with the alleged scheme in Southern California. What penalties could result from this fraud scheme? If convicted, the defendants face multiple years in prison, including up to 18 years for David Fish, under California insurance fraud and conspiracy laws. How does this compensation fraud scheme affect the system? Fraud schemes drain resources, increase costs for insurers, and can compromise care and benefits for legitimate injured workers. What are the penalties for David Fish and the co-conspirators? David Fish and the other defendants could face long prison terms if convicted under California insurance fraud and conspiracy laws. Subscribe to JacobiJournal.com for ongoing updates on workers’ compensation fraud, legal enforcement actions, and investigations impacting California employees and insurers. 🔎 Read More from JacobiJournal.com:
West Haven Recovers $1 Million in Stolen COVID Relief Funds
December 28, 2024 | JacobiJournal.com — Stolen COVID Relief Funds: The city of West Haven, Connecticut, has secured more than $1 million in reimbursement from its insurance provider after two city employees embezzled federal pandemic relief funds three years ago. The recovery effort comes after lengthy investigations and multiple prosecutions that exposed how federal CARES Act money, intended to support local communities during the pandemic, was diverted for personal gain. This reimbursement marks a critical step toward restoring public trust and alleviating the financial burden placed on taxpayers. Swift Action Leads to Recovery of the Stolen COVID Relief Funds Former state Rep. Michael DiMassa and John Bernardo orchestrated a scheme that defrauded West Haven taxpayers of $1.2 million. In response, Mayor Dorinda Borer acted swiftly to recover the stolen COVID-19 funds, which resulted in a $1.2 million settlement with The Hartford Financial Services Group. According to The Hartford’s fidelity crime claims division, after subtracting the $79,177.98 received in court-ordered restitution and a $100,000 deductible, the insurance will cover a net loss of $1,037,363.82. “This is a huge victory for our taxpayers,” Mayor Borer stated. Details of the Fraud Authorities arrested DiMassa, 32, on October 20, 2021, and he pleaded guilty on November 1, 2022, to three counts of conspiracy to commit wire fraud. In May 2023, a court sentenced him to 27 months in prison, followed by five years of supervised release. Additionally, he must perform 100 hours of community service and pay $856,844.45 in restitution. Similarly, Bernardo pleaded guilty on June 14, 2022, to one count of conspiracy to commit wire fraud. By March 2023, he received a 13-month prison sentence and was ordered to pay $58,927.25 in restitution. How the Schemes Unfolded DiMassa, serving as an administrative assistant to the West Haven City Council, had the authority to approve COVID-19 relief funds for reimbursement. Between July 2020 and September 2021, West Haven received $1,150,257 in CARES Act funds. Exploiting this role, DiMassa submitted fraudulent invoices for services and goods that were never provided. One scheme involved Compass Investment Group, LLC, a company DiMassa formed with Bernardo. They fraudulently billed the city $636,783.70 for consulting services that were never performed. Court documents revealed that DiMassa withdrew large sums of cash from the Compass account, which he used for gambling at Mohegan Sun Casino. Moreover, DiMassa conspired with his wife, Lauren DiMassa, to submit fake invoices for a youth violence prevention program. Lauren collected $147,776.10 for services she never delivered. She pleaded guilty on July 14, 2022, and received a six-month prison sentence along with a restitution order for the full amount. In another scheme, DiMassa partnered with John Trasacco, using fraudulent invoices from two companies, L&H Company and JIL Sanitation Services. They received $431,982 for bogus services, including work on a vacant school building. A jury found Trasacco guilty in December 2022, and he was sentenced to 96 months in prison with a restitution order of $143,994. Investigation and Legal Outcomes The Federal Bureau of Investigation and the U.S. Department of Housing and Urban Development led the investigation. Attorneys from the office of Vanessa Roberts Avery, U.S. Attorney for the District of Connecticut, prosecuted the case. Read the official release here. FAQs: Stolen COVID Relief Funds How did West Haven recover the stolen COVID relief funds? West Haven secured reimbursement through an insurance settlement with The Hartford Financial Services Group, which covered over $1 million of the stolen COVID relief funds. Who was involved in embezzling the stolen COVID relief funds in West Haven? Former state Rep. Michael DiMassa, his wife Lauren DiMassa, John Bernardo, and John Trasacco all played roles in the schemes that diverted stolen COVID relief funds from the city. What penalties were issued in connection with the stolen COVID relief funds case? Sentences included prison terms ranging from 6 months to 96 months, supervised release, community service, and restitution orders tied directly to the stolen COVID relief funds. Why is the West Haven stolen COVID relief funds case significant? The case demonstrates how oversight failures in federal relief programs can lead to fraud, and it highlights the importance of accountability in managing stolen COVID relief funds. What was the COVID relief fund? The COVID relief fund refers to federal financial assistance programs, like the CARES Act, designed to help individuals, businesses, and local governments cope with the economic impacts of the COVID-19 pandemic. In West Haven, these funds were intended to support city operations and community programs during the crisis. Who received COVID relief funds? COVID relief funds were distributed to eligible recipients, including state and local governments, businesses, nonprofit organizations, and individuals affected by the pandemic. In West Haven, the city government received CARES Act funds to support local programs, but a portion was illegally diverted by employees. Stay informed on high-profile fraud cases and government accountability. Subscribe to JacobiJournal.com for trusted updates and expert legal insights. 🔎 Read More from JacobiJournal.com:
OSHA Targets New Jersey Contractor with $328K Fine for Fall Hazards
December 27, 2024 | JacobiJournal.com — OSHA fine: A New Jersey contractor is facing $328,545 in penalties after federal inspectors cited repeated fall hazards and other workplace safety violations. The case highlights OSHA’s escalating enforcement efforts against companies with ongoing safety compliance issues. This OSHA fine also draws attention to broader industry concerns, as construction continues to rank among the most dangerous occupations in the United States. Regulators stress that fall hazards are one of the leading causes of worker fatalities nationwide, and repeat violations like those alleged in this case highlight the agency’s focus on deterring unsafe practices through significant financial penalties. OSHA Inspections Uncover Safety Violations OSHA first inspected an RRC Home Improvement worksite in Dover in June 2024 after reports surfaced of employees working on a roof without fall protection. Following a warning about this safety issue, OSHA initiated further inspections in July 2024 at two additional RRC worksites in Lodi. At these sites, inspectors once again observed employees without proper fall protection. In addition to fall-related hazards, the inspections revealed other violations, including: These findings highlight serious lapses in workplace safety protocols. Severe Penalties Issued for Violations New Jersey Contractor: After completing the three inspections, OSHA cited RRC Home Improvement for four willful and seven serious violations. These citations resulted in proposed penalties totaling $328,545. The company has a 15-business-day window to respond by complying, requesting an informal conference with OSHA’s area director, or contesting the findings before OSHA’s independent review commission. Repeat Offender Added to Severe Violators Program This is not the first time RRC Home Improvement has faced scrutiny from OSHA. Since 2017, the agency has conducted five inspections and issued citations for failing to provide adequate fall protection. Due to the willful nature of these offenses, OSHA has now added the company to its severe violators program. About RRC Home Improvement Inc. RRC Home Improvement provides commercial roofing, specialty roofing, and residential roofing services across New Jersey, New York, and Pennsylvania. Despite its regional presence, the company’s safety practices have repeatedly come under fire, underscoring the importance of strict compliance with federal workplace safety standards. For industry observers, the company’s repeated OSHA citations raise concerns not only about regulatory compliance but also about the potential risks faced by both workers and clients who rely on these services. Contractors operating across multiple states are expected to maintain consistent safety standards, and repeated violations can jeopardize business reputation, client trust, and future contract opportunities. The company’s addition to OSHA’s severe violators program means that any future infractions could result in even harsher penalties and stricter monitoring. For businesses in the construction and roofing sectors, the $328,545 OSHA fine serves as a critical reminder that safety lapses can carry not only financial consequences but also long-term damage to reputation and operational stability. For the full OSHA report on this case, visit the official OSHA website. FAQs: New Jersey Contractor OSHA Fine What led to the contractor OSHA fine? The fine was issued after OSHA inspections revealed repeated fall hazards and other serious safety violations at multiple worksites. How much is the OSHA fine for the New Jersey contractor? The contractor was fined $328,545 for four willful and seven serious violations involving workplace safety hazards. Why was the contractor added to OSHA’s severe violators program? Due to repeated safety violations since 2017, OSHA classified the company as a severe violator, which subjects it to heightened oversight. How can contractors avoid an OSHA fine? Contractors must enforce fall protection, provide safety equipment, and comply with OSHA regulations through regular inspections and training. What is the maximum fine for a violation of OSHA? OSHA fines or penalties vary depending on the severity of the violation. Willful violations can carry fines up to $145,027 per violation, while serious violations may result in fines up to $14,502 per violation, as reflected in the $328,545 total fine for RRC Home Improvement. What is the most expensive OSHA violation? The most expensive OSHA fines and violations typically involve willful or repeated safety breaches that put workers at serious risk, such as fall hazards or confined space violations. Multi-site, repeat offenders can accumulate penalties in the hundreds of thousands, similar to the RRC Home Improvement case. What are OSHA’s 3 most cited violations? The three most commonly cited OSHA violations include fall protection failures, hazard communication deficiencies, and scaffolding hazards. In this case, repeated fall hazards were a central factor in the citations issued to the New Jersey contractor. Stay informed on workplace safety enforcement — subscribe to JacobiJournal.com for weekly updates. 🔎 Read More from JacobiJournal.com: