Executive Charged With Fraud
According to a report in the October 19, Wisconsin State Journal "A Philippines corporation and its chief executive officer defrauded the U.S. military's health-care program of nearly $1 million, according to a 75-count indictment unsealed Tuesday in U.S. District Court in Madison. The indictment was returned by a grand jury in July 2005 but was sealed until Thomas Arthur Lutz, 39, of Olongapo City, Philippines, appeared Tuesday in a court in Guam. It alleges that Lutz, who is an American citizen, and Health Visions Corp. devised a scheme to defraud the federal Tricare program and charges them with 32 counts of mail fraud, 41 counts of filing a false claim, one count of conspiracy and a forfeiture count.
"The indictment was brought in Madison because Wisconsin Physicians Service processed and paid the alleged fraudulent claims for Tricare, which provides health-care benefits for active and retired U.S. military personnel worldwide.
"According to the indictment, between October 1998 and August 2004 Lutz and Health Visions entered into a kickback scheme with a medical provider in the Philippines which paid 50 percent of the billed amount for Tricare patients back to Health Visions. Lutz and Health Visions also allegedly inflated the bills of other providers by at least 100 percent before submitting them for payment."Lutz and Health Visions also allegedly created a sham insurance program to circumvent Tricare deductible requirements and submitted fictitious Tricare claims, the indictment alleges."
"The indictment was brought in Madison because Wisconsin Physicians Service processed and paid the alleged fraudulent claims for Tricare, which provides health-care benefits for active and retired U.S. military personnel worldwide.
"According to the indictment, between October 1998 and August 2004 Lutz and Health Visions entered into a kickback scheme with a medical provider in the Philippines which paid 50 percent of the billed amount for Tricare patients back to Health Visions. Lutz and Health Visions also allegedly inflated the bills of other providers by at least 100 percent before submitting them for payment."Lutz and Health Visions also allegedly created a sham insurance program to circumvent Tricare deductible requirements and submitted fictitious Tricare claims, the indictment alleges."
posted by OlongapoCity Zambales at
8:26 AM
2 Comments:
I have worked for the said company for 4 years. The accusations by Tricare are not as clear cut as it is written.
IT is unfortunate that Mr. Tom Lutz is taking all the blame for these crimes. It is to my knowledge that all the billings were already padded up by the health care providers (even some cases there were phantom billings) before it got to the company.
Since I've work here i have lost my respect for medical doctors in particular.
By
Anonymous, at 11/10/2006 3:15 AM
It is sad to note that because of these fraudulent claims by a single company, all other legitimate and honest doctors are also affected.
In a way, maybe TRICARE should really set a standard with regard to what or how much is allowed per region. Like for example, setting the allowable rates for the Philippines, so that if ever a provider would "overbill" TRICARE would only refund what the due rate for this region is. That would in turn minimize potential frauds.
By
Anonymous, at 4/25/2008 9:02 PM
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