Four Pharmacists Sentenced for $13M Medicare Fraud Scheme
March 18, 2025 | JacobiJournal.com — A Medicare fraud scheme carried out by four pharmacy owners led to over $13 million in losses, targeting Medicare, Medicaid, and Blue Cross Blue Shield of Michigan. The defendants orchestrated fraudulent billing practices at five pharmacies across Michigan and Ohio, including Eastside Pharmacy, Harper Drugs, Wayne Campus Pharmacy, Heartland Pharmacy, and Heartland Pharmacy 2. Following a federal jury conviction on Sept. 5, 2024, each pharmacist received a prison sentence corresponding to their role in the scheme. Sentences Handed Down Fraudulent Billing Scheme Four Pharmacists Sentenced: Court documents and evidence presented at trial revealed that the pharmacists billed Medicare, Medicaid, and Blue Cross Blue Shield of Michigan for medications they never dispensed. The fraudulent activities occurred at these pharmacies: The defendants used these pharmacies to orchestrate the scheme, resulting in millions of dollars in fraudulent claims. Following their conviction by a federal jury on Sept. 5, 2024, each pharmacist was sentenced for their specific roles in the conspiracy. Law Enforcement’s Response Supervisory Official Antoinette T. Bacon of the Justice Department’s Criminal Division, Special Agent in Charge Cheyvoryea Gibson of the FBI Detroit Field Office, and Special Agent in Charge Mario Pinto of the Department of Health and Human Services Office of Inspector General (HHS-OIG) led the investigation. “The defendants exploited public health systems to line their pockets,” said Antoinette T. Bacon. “These sentences should send a strong message that such criminal behavior will not be tolerated.” Ongoing Efforts to Combat Fraud The FBI Detroit Field Office and HHS-OIG conducted a thorough investigation into the Medicare fraud scheme, meticulously gathering evidence and coordinating across state and federal agencies. Trial Attorneys Claire Sobczak Pacelli, Kelly M. Warner, and S. Babu Kaza of the Criminal Division’s Fraud Section successfully prosecuted the case, demonstrating the government’s commitment to holding individuals accountable for orchestrating such fraudulent activities. Their efforts highlight the ongoing vigilance required to detect, investigate, and dismantle complex Medicare fraud schemes that exploit public healthcare systems. Report Suspected Fraud If you suspect fraudulent activity, report it to HHS-OIG or your local law enforcement agency. Source: U.S. Department of Justice FAQs: Medicare Fraud Scheme What is a Medicare fraud scheme? A Medicare fraud scheme involves intentionally submitting false claims to Medicare for reimbursement, often for services or items not provided, resulting in financial losses to the program. How can I report suspected Medicare fraud? Suspected Medicare fraud can be reported to the U.S. Department of Health and Human Services Office of Inspector General (HHS-OIG) through their hotline or website. What are the penalties for Medicare fraud? Penalties for Medicare fraud can include substantial fines, restitution, and prison sentences, depending on the severity and scope of the fraudulent activity. How does Medicare fraud impact healthcare costs? Medicare fraud increases healthcare costs by diverting funds from legitimate services, leading to higher premiums and reduced resources for beneficiaries. Stay informed on the latest developments in healthcare fraud and other critical news by subscribing to JacobiJournal.com. Don’t miss out on essential updates delivered straight to your inbox. Read More from JacobiJournal.com
Texas Insurance Fraud Investigations Recover $58M in 2024
March 17, 2025 | JacobiJournal.com — Insurance fraud investigations by the Texas Department of Insurance’s (TDI) Fraud Unit successfully recovered nearly $58 million in court-ordered restitution last year, targeting major cases that affected both insurance companies and consumers. In 2024, more than 20 investigators from the Texas Department of Insurance’s Fraud Unit examined over 350 allegations of insurance fraud, prioritizing cases with the greatest financial impact. The agency employs advanced data analytics and cross-agency collaboration to identify suspicious claims, uncover complex schemes, and build strong legal cases. By aggressively targeting fraudulent activities, TDI not only recovers restitution for insurers and consumers but also helps stabilize insurance premiums and protect legitimate policyholders from the consequences of widespread fraud. This proactive approach underscores the importance of continued vigilance in detecting and preventing insurance fraud throughout the state. TDI’s Aggressive Fraud Crackdown More than 20 investigators across Texas examined over 350 insurance fraud allegations, prioritizing cases with the highest financial impact. By cracking down on fraudulent claims, the agency aims to prevent premium hikes for policyholders. “If we recoup restitution for insurance companies and consumers, hopefully that causes less of an increase in premiums,” said TDI attorney Kyson Johnson. “Those companies and consumers are no longer exposed to the fraud.” Dallas Doctors Caught in Fraud Scheme One high-profile investigation led to the takedown of Dallas-based doctors Desi and Deno Barroga. The duo, both 51, were indicted in November 2023 and pleaded guilty in May 2024 to conspiracy to commit healthcare fraud. They had been overprescribing opioids and falsely billing health plans for millions of dollars. “These doctors exploited drug users’ vulnerabilities, requiring them to submit to monthly visits in exchange for controlled substance prescriptions, then billing their insurance providers for services the patients did not need nor receive,” said U.S. Attorney Leigha Simonton in September 2024. “In a bizarre attempt to cover up their crimes, the defendants feigned giving injections without actually piercing the patients’ skin.” A TDI investigator played a key role in assisting the FBI and other agencies in building a criminal case. As a result, a U.S. district judge sentenced the doctors to prison and ordered them to pay $9 million in restitution. Additionally, both were stripped of their medical licenses. Fighting Fraud The 2024 results from Texas highlight the critical role of robust insurance fraud investigations in protecting both consumers and insurers. By recovering millions in restitution and prosecuting high-profile cases, TDI demonstrates that fraudulent activities will not be tolerated. Consumers play a key role as well—reporting suspicious claims can help prevent further losses and reduce the financial burden on honest policyholders. Staying vigilant and informed ensures that insurance fraud schemes are identified early and addressed effectively, maintaining the integrity of the state’s insurance system. For more information on reporting insurance fraud and protecting yourself from fraudulent schemes, visit the Texas Department of Insurance Fraud Reporting Page. FAQs: Insurance Fraud What are Texas insurance fraud investigations? The investigations are efforts by the Texas Department of Insurance’s Fraud Unit to detect and prosecute instances of insurance fraud across the state. How much restitution was recovered from fraud cases in Texas in 2024? In 2024, Texas investigators recovered nearly $58 million in court-ordered restitution from various insurance fraud cases. Who were the key individuals involved in the Dallas healthcare fraud case? Drs. Desi and Deno Barroga, twin brothers running a pain management clinic in Dallas, were sentenced for their roles in a major insurance fraud scheme involving false billing and unnecessary prescriptions. How can consumers report suspected frauds in Texas? Consumers can report suspected insurance fraud to the Texas Department of Insurance by visiting their official fraud reporting page. Stay informed on the latest developments in insurance fraud and other critical news by subscribing to JacobiJournal.com. Don’t miss out on essential updates delivered straight to your inbox. Read More from JacobiJournal.com
Investment Fraud Tops List: FTC Reports Consumers Lost $12.5 Billion to Scams in 2024
March 11, 2025 | JacobiJournal.com — Investment Fraud Tops List: Consumers lost over $12.5 billion to scams in 2024, a 25% increase from 2023, according to Federal Trade Commission (FTC) data. Despite 2.6 million fraud reports, the percentage of consumers reporting financial losses rose from 27% in 2023 to 38% in 2024. Investment scams caused the most losses, totaling $5.7 billion, followed by imposter scams at $2.95 billion. Investment Scams Lead in Losses Scams saw a 24% increase in losses as scammers targeted consumers with fraudulent investment schemes. Bank transfers and cryptocurrency were the most common payment methods. Christopher Mufarrige, Director of the FTC’s Bureau of Consumer Protection, warned, “Scammers are evolving. Consumers must stay vigilant.” FTC Returns $25 Million to Victims Investment Fraud Tops List: The FTC is issuing $25.5 million in refunds to consumers tricked into purchasing unnecessary computer repair services from Restoro Cyprus Limited and Reimage Cyprus Limited. The FTC accused the companies of using deceptive marketing tactics to exploit consumers. Following a settlement order, both companies are banned from misrepresenting security issues or engaging in deceptive telemarketing. Biggest Increases in Scam Losses The largest losses came from: Contact Methods Used by Scammers Scammers contacted victims most often via email, followed by phone calls and text messages. The FTC urges consumers to report suspicious activities on its website to aid future investigations. Read more at FTC.gov. FAQs: Investment Fraud FTC Report How much did consumers lose to scams in the latest investment fraud? The investment fraud FTC report revealed that consumers lost $12.5 billion in 2024, a 25% increase from the previous year. What types of scams caused the biggest losses in the investment fraud? Investment scams led with $5.7 billion in losses, followed by imposter scams at $2.95 billion. How is the FTC responding to issues highlighted in the investment fraud? The FTC issued $25.5 million in refunds and banned companies like Restoro Cyprus Limited from deceptive marketing practices. Why does the investment fraud matter for consumers? It shows scams are evolving, with bank transfers and cryptocurrency becoming the most common payment methods used by fraudsters. Stay informed on financial crime, fraud enforcement, and regulatory action. Subscribe now at JacobiJournal.com for trusted coverage and analysis. Read More from JacobiJournal.com
Minnesota Bill Targets AI-Generated Deepfake Pornography
March 8, 2025 | JacobiJournal.com — A Minnesota deepfake pornography bill aims to combat AI-generated explicit content by cracking down on companies that provide “nudification” technology. The legislation, introduced by Democratic Sen. Erin Maye Quade, would impose civil penalties of up to $500,000 on websites and apps that allow users in Minnesota to generate explicit fake images. The deepfake pornography bill is seen as a direct response to growing public concern over AI-driven exploitation. Advocates argue that current laws do not adequately address the harm caused when nonconsensual explicit images are created, even if they are not widely distributed. By targeting platforms that enable the generation of these images, Minnesota lawmakers hope to close a dangerous legal gap, protect victims from reputational damage, and set a precedent for other states considering similar legislation. Why Advocates Say the Law Is Needed Supporters argue the law is necessary because AI deepfake technology has evolved rapidly, making it easy to create realistic, nonconsensual explicit content. Molly Kelley, a Minnesota woman, testified that someone she knew used AI to generate fake nude images of her and at least 80 other women, all with ties to the offender. “It’s not just about the distribution of these images—it’s the fact that they exist at all,” Maye Quade emphasized. Privacy experts add that victims of AI-generated abuse often face long-lasting harm, including reputational damage, emotional trauma, and difficulty removing images once they spread online. According to the Cyber Civil Rights Initiative, more than 90% of individuals impacted by nonconsensual explicit imagery report significant mental health effects, underscoring why advocates argue swift legislative action is critical. State and Federal Efforts to Regulate AI Deepfakes Minnesota’s proposal aligns with growing nationwide efforts to regulate AI-generated sexual content. The U.S. Senate recently passed a bill requiring social media platforms to remove nonconsensual AI-generated explicit images within 48 hours. Meanwhile, states like Kansas, Florida, and New York are introducing legislation to criminalize AI-generated child exploitation material. Legal analysts note that this patchwork of state and federal measures reflects both the urgency of the issue and the complexity of regulating rapidly evolving technology. The National Conference of State Legislatures (NCSL) reports that more than a dozen states considered or passed laws addressing deepfakes in 2024 alone, ranging from criminal penalties for nonconsensual sexual imagery to rules against election interference. This trend suggests lawmakers across the country are racing to establish guardrails before the technology becomes even harder to control. Legal and Constitutional Challenges Despite the bill’s intentions, AI law experts warn it may face constitutional challenges under the First Amendment. Riana Pfefferkorn of Stanford University notes that restricting content creation—rather than distribution—could conflict with existing federal internet laws. However, Maye Quade insists her bill is legally sound. “This technology is inherently harmful. Tech companies cannot keep unleashing it without consequences.” Learn more about the policy and legal challenges of AI technology in society by visiting the Brookings Institution’s deepfake research. FAQs: Minnesota Deepfake Pornography Bill What does the Minnesota deepfake pornography bill propose? The bill would fine websites and apps up to $500,000 if they allow users to generate explicit AI images. Why was the deepfake pornography bill introduced? It was introduced to address the rise of nonconsensual AI-generated explicit content that harms victims, many of whom are targeted by acquaintances. How does the Minnesota deepfake pornography bill compare to federal efforts? The bill aligns with federal action requiring platforms to remove AI-generated explicit content within 48 hours. Could the deepfake pornography bill face legal challenges? Yes. Experts warn it may face First Amendment challenges, though supporters argue the bill is legally sound and urgently needed. Stay ahead of the latest legal battles over AI, technology, and public safety. Subscribe now at JacobiJournal.com for trusted reporting and expert insights. Read More from JacobiJournal.com
CFPB Drops Lawsuit Against Major Banks Over Alleged Zelle Fraud
March 7, 2025 | JacobiJournal.com — Alleged Zelle Fraud: The Consumer Financial Protection Bureau (CFPB) has dismissed its lawsuit against JPMorgan Chase, Bank of America, Wells Fargo, and Zelle’s parent company, marking another Biden-era case abandoned by the agency. The lawsuit alleged that the banks’ lack of safeguards turned the payment network into a “gold mine for fraudsters.” The case stemmed from widespread reports of Zelle fraud, where consumers said they were tricked into authorizing payments or saw unauthorized transfers with little chance of recovery. Critics argued that Zelle’s design, which moves money instantly, made it highly vulnerable to scams compared to traditional payment systems. Consumer advocates had hoped the CFPB lawsuit would push banks to reimburse more victims, set stricter fraud detection standards, and increase accountability for financial institutions tied to the platform. Banks Welcome the Decision The lawsuit, filed late last year, accused the financial institutions of rushing Zelle’s rollout without proper fraud protections, leaving victims with little recourse. However, banks pushed back, arguing the case was baseless. A Zelle spokesperson stated, “This lawsuit was without merit and legally and factually flawed.” Executives from JPMorgan Chase, Bank of America, and Wells Fargo have long maintained that Zelle is a secure payment platform when used properly. They emphasized that fraud incidents often stem from consumers being deceived into authorizing transactions, rather than from system flaws. By framing the issue as one of customer education rather than institutional negligence, the banks sought to distance themselves from broader accountability. Supporters of the decision also pointed out that the dismissal helps protect innovation in the fast-growing peer-to-peer payments industry. They argue that excessive litigation could stifle competition and prevent platforms like Zelle from continuing to expand their services. Still, critics counter that without regulatory pressure, banks have little incentive to enhance fraud protections or reimburse defrauded customers. A Shift in CFPB Enforcement Alleged Zelle Fraud This move follows the CFPB’s recent dismissal of cases against Capital One, Rocket Cos., and fintech lender SoLo Funds. The agency’s enforcement approach is shifting ahead of President Donald Trump’s nominee, Jonathan McKernan, taking charge. This move follows the CFPB’s recent dismissal of cases against Capital One, Rocket Cos., and fintech lender SoLo Funds. The agency’s enforcement approach is shifting ahead of President Donald Trump’s nominee, Jonathan McKernan, taking charge. Consumer advocates note that this trend could weaken protections for individuals facing Zelle fraud, as fewer lawsuits may mean less pressure on banks to adopt stricter safeguards. At the same time, industry groups view the shift as a sign that regulators may favor collaboration and compliance guidance over costly litigation. More information about this case here. FAQs: About the Alleged Zelle Fraud What isfraud and how does it impact consumers? Zelle fraud refers to scams or unauthorized transfers made through the Zelle payment network, often leaving victims with limited options for reimbursement. Why did the CFPB drop its lawsuit related to fraud? The CFPB dismissed its lawsuit against major banks, claiming insufficient grounds to prove liability, even though critics argue Zelle fraud remains a serious consumer risk. How are banks responding to growing concerns about the fraud? Banks argue they have strengthened security and consumer education to reduce Zelle fraud cases, while regulators push for clearer protections for victims. What steps can consumers take to protect themselves from fraud? Consumers should verify payment requests, avoid sending money to unknown contacts, and report suspected Zelle fraud directly to their bank and the CFPB. For ongoing coverage of banking and consumer protection, visit JacobiJournal.com. Read More from JacobiJournal.com
Birth Injury Compensation Fund Executive Sentenced to 9 Years for $6.7M Embezzlement
Embezzlement: A former financial executive of Virginia’s Birth-Related Neurological Injury Compensation Program has been sentenced to nine years in prison for embezzling more than $6.7 million intended for families of infants with birth-related disabilities. Luxury Spending and Financial Misconduct Embezzlement John Hunter Raines, the program’s former chief financial officer and deputy director, exploited his position to transfer funds into personal accounts. Prosecutors detailed extravagant spending, including luxury golf carts, a Chevrolet Suburban, private jet travel, gambling, and precious metals. Raines also funneled money toward his mortgage, student loan debt, and payments to his wife and an intimate partner. Embezzlement Obstruction of Audits and Delayed Oversight In addition to financial fraud, Raines obstructed legally required audits by withholding critical financial records, delaying oversight efforts for more than three years. His actions directly impacted funds meant to cover medical care, rehabilitation, and essential services for families. Legal Proceedings and Sentencing Embezzlement Raines pleaded guilty to mail fraud and money laundering on October 8, 2024. The Virginia Birth-Related Neurological Injury Compensation Program issued a statement condemning the breach of trust, emphasizing that the stolen funds could have supported families in need. Stay Updated on Financial Crimes For more coverage on fraud cases and financial misconduct, visit JacobiJournal.com. Read More:
Fertilizer Manufacturer Fined $400K After Worker Dies from Toxic Gas Exposure
Pasco, WA – Fertilizer Manufacturer Fined $400K: The Washington State Department of Labor & Industries (L&I) has fined Two Rivers Terminal LLC $394,200 for safety violations that led to a worker’s death at its Pasco facility. The fertilizer manufacturer failed to implement critical safety measures, resulting in a preventable tragedy. Worker Dies from Toxic Hydrogen Sulfide Exposure On June 7, 2024, surveillance footage captured Viktor Voloshin, 56, entering a tanker truck to clean it. Toxic hydrogen sulfide gas from fertilizer residue filled the enclosed space, leading to his sudden death. Voloshin, a dedicated employee of 11 years and father of 12, lost his life due to the company’s failure to enforce proper safety protocols. Company’s History of Safety Violations Fertilizer Manufacturer Fined $400K: L&I cited Two Rivers Terminal for multiple willful and repeat violations, including a lack of air monitoring, inadequate ventilation, and failure to provide protective gear. This isn’t the company’s first penalty. It previously faced fines totaling $672,320, which remain under appeal. Now, the company is also contesting the latest penalties, despite its longstanding history of safety infractions. Where Do the Fines Go? The fines will be directed to the workers’ compensation supplemental pension fund, which provides financial support for injured workers and their families. Stay Updated on Workplace Safety & Legal Actions For more in-depth coverage on worker safety violations, corporate negligence, and labor laws, visit JacobiJournal.com. Read More: Former Florida Broker and Others Indicted in Major Insurance Fraud Schemes Former Ohio Insurance Agent Sentenced for $1.4M Fraud Scheme Florida Contractor Sentenced for Workers’ Compensation Fraud After Fatal Fall Detroit Man Jailed for $1M Unemployment Fraud Targeting Multiple States Source: Washington State Department of Labor & Industries
Out of Bounds for Workers Compensation: Frito-Lay Employee’s Injury Denied Coverage
Out of Bounds for Workers Compensation: Richmond, VA – A Frito-Lay forklift driver who tore his Achilles tendon during a company basketball game won’t receive workers’ compensation benefits, as ruled by the Virginia Workers’ Compensation Commission (VWCC). The commission determined that his voluntary participation in an off-duty, off-premises event does not meet the legal requirements for coverage. Why the Workers’ Comp Claim Was Denied Under Virginia workers’ compensation law, injuries are only compensable if they occur “in the course of employment.” The law excludes injuries from voluntary, employer-sponsored recreational activities that are not part of an employee’s job duties. The VWCC applies three key principles to determine if a recreational activity qualifies as work-related: In this case, the basketball tournament failed to meet these conditions. Frito-Lay’s Role in the Tournament Frito-Lay covered the entry fees for two teams and posted sign-up sheets at its warehouse. Employees with basketball experience were chosen to participate. While some players felt a sense of pride, the company did not require participation, sponsor the event, or offer compensation. Additionally: Employee Morale and Public Relations: Not Enough for Compensation The commission also ruled that the event did not significantly impact employee morale. Out of 500 employees, only a few participated. Furthermore, the primary beneficiary of the tournament was a local free clinic, not the company itself. Although positive public relations may have been a factor, it did not make the tournament a core part of employment. Since participation was completely voluntary, the claim fell out of bounds for workers’ compensation. Stay Informed on Workers’ Compensation Cases For more legal updates on workers’ rights, workplace injury claims, and employer liability, visit JacobiJournal.com. Read Other Articles:📌 Maryland Woman Scams USAA for $58K—Then Tries Again📌 Tennessee Gynecologist Charged with Fraud and Unnecessary Medical Procedures📌 Iowa Sues Bitcoin Depot and CoinFlip Over Millions Lost in Crypto Scams 🔗 Source: Virginia Workers’ Compensation Commission
Iowa Sues Bitcoin Depot and CoinFlip Over Millions Lost in Crypto Scams
Des Moines, IA – Iowa Attorney General Brenna Bird has filed lawsuits against Bitcoin Depot and CoinFlip, the state’s largest cryptocurrency ATM operators, accusing them of facilitating millions in fraud. According to the lawsuits, the companies failed to prevent scams, allowing Iowans—particularly seniors—to transfer large sums to fraudsters through their kiosks. State Investigation Uncovers Widespread Crypto Scams In October 2023, the Attorney General’s office launched a groundbreaking investigation into cryptocurrency ATM operators. Officials subpoenaed 14 companies, requesting a list of Iowans who had transferred money through the machines. Investigators then contacted these individuals, reviewed complaints, police reports, and self-reported scams. The findings were alarming: Hundreds of Iowans sent over $20 million through Bitcoin Depot and CoinFlip ATMs within less than three years. Most victims were over the age of 60. Attorney General Calls Out “Evil” Scammers Attorney General Bird condemned the scammers, stating: “Con artists are evil and will stop at nothing to steal everything you have. They specifically target older Iowans—some even comb through obituaries to find widows. They manipulate victims into using crypto ATMs, while these companies take a cut of the profits. It’s not just wrong—it’s illegal.” Bird emphasized her commitment to recovering stolen funds and forcing crypto ATM companies to implement safeguards. How Bitcoin Depot and CoinFlip Profit From Scams The investigation revealed that Bitcoin Depot pockets 23% of each transaction, while CoinFlip takes 21%—directly profiting from fraud victims. The lawsuits allege that both companies: Lawsuits Aim to Protect Iowans from Future Fraud Attorney General Bird is suing both companies for consumer fraud and demanding major changes in their operations. The broader investigation into crypto ATM companies remains ongoing. Stay Updated on Consumer Protection Cases For the latest news on financial fraud and consumer protection, visit JacobiJournal.com. Stay informed and safeguard your hard-earned money.
Tennessee Gynecologist Charged with Fraud and Unnecessary Medical Procedures
Memphis, TN – Fraud and Unnecessary Medical Procedures: Federal authorities have charged Dr. Sanjeev Kumar, a Memphis-based gynecologist, with health care fraud and misconduct. Prosecutors allege that he performed unnecessary medical procedures using unsanitary, re-used devices. He now faces multiple charges, including adulterating and misbranding medical devices and persuading patients to cross state lines for illegal sexual activity. Serious Allegations of Medical Misconduct From September 2019 to June 2024, Kumar subjected female patients to unnecessary procedures. Investigators claim he re-used medical devices that should have been discarded or sterilized. Furthermore, he failed to inform patients and falsely billed Medicare and Medicaid, pretending to have used new, sanitary equipment. Fraud and Unnecessary Medical Procedures One of Tennessee’s Top-Paid Medicare Providers Kumar ranked as Tennessee’s highest-paid provider for hysteroscopy biopsies, a procedure used to examine the uterus. Given the scope of his practice, authorities suspect additional patients may have been affected and urge them to come forward. Authorities Condemn Abuse of Medical Trust Acting U.S. Attorney Kevin Ritz strongly criticized Kumar’s actions, stating: “The allegations suggest Kumar acted as a predator in a white coat, using medical exams as a cover to exploit patients and enrich himself.” Ongoing Investigation and Legal Proceedings At this point, Kumar has not responded to requests for comment. His legal representation remains unclear. Federal investigators continue to gather evidence and encourage potential victims to share their experiences. Stay Informed on Medical Fraud Cases For the latest updates on health care fraud and patient safety, visit JacobiJournal.com. Stay informed and protect your rights.