A Standard Reporting. Proposition 211 is designed to unearth the ultimate source of all campaign funding. Make no mistake, the FBI will actively pursue those seeking to fraudulently profit from the pandemic. Follow the U.S. Attorneys Office, District of Arizona, on Twitter @USAO_AZ for the latest news. You will need Adobe Reader to open PDFs on this site. must be sent to the person filing the grievance or request for investigation, to the AHCCCS OHR for persons who need Special Assistance, and to other parties as required by A.A.C. 49th Annual Peace Officers Memorial Service, Elder Abuse Information and Training Guide, Data Breach Notification Form Individuals, Medicaid Fraud Control Unit Complaint Form, Billing for a higher level of service than was performed, Denial of necessary services or procedures, or denial of access to specialists, Unsafe, dangerous or unsanitary living conditions. Hn0:@%Y]QIS KVl ;5G9ika 8$EH=`"'iXS}0,3''GWsCf~0%9SDM ypY{Q_F\eU7\yc@q}`?Wh @H R#r+wo And while the agency said it is bringing new people on board, it said it can take a year to properly train them. 5. The investigator must: a. For Star subscribers: The Arizona Department of Education said it was inundated with last-minute requests to get funding. Abuse can be physical, emotional or sexual. District of Arizona The documents also show that the state used the station's reports as part of its . AHCCCS declined an interview request with ABC15. The Arizona Attorney Generals Office conducted this investigation along with investigators from the Office of Inspector General for the U.S. Department of Health and Human Servicesand the Officeof Inspector General for AHCCCS. The legislature's express provisions in the AHCCCS statutes granting AHCCCS broad authority to investigate matters of suspected fraud 36-2903 and -2918(G)necessarily imply an exception to the privilege for AHCCCS investigations and proceedings. RELEASE NUMBER: 2021-054_Hensons. Office of Special Investigations (OSI)/AHCCCS Office of Inspector General (AOIG). tG4!#T;vJ+5JJo=SNYD43cI(eJLo-(Wctfa[PEo+I;9VP)?Us{ccnjoe1GHWaXYV Q n'gT~4 wv-nSjs`kDWCjtJaoPTB;+"0.5"Sr]sUA&SbCZ,os6&(.37{ITm>EDW d Now more than ever, the integrity of our healthcare system is paramount as we fight a global pandemic, said United States Attorney Michael Bailey. (MFCU) of the Arizona Attorney General, the Federal Bureau of Investigations (FBI), Drug Enforcement Agency (DEA), Health and Human Services (HHS) OIG, local police and law enforcement agencies, county . Officials at Sunrise Native Recovery in Scottsdale said the change will result in up to a 90% cut in funding if the proposal goes through. For more information on the U.S. Attorneys Office, District of Arizona, visit http://www.justice.gov/usao/az/ A .gov website belongs to an official government organization in the United States. The sample size was determined using Cochran's formula, 110 teachers were selected, and 108 teachers completed the questionnaires. AHCCCS, in a response to the audit, said part of the problem was related to the COVID outbreak. Additionally, the OIG works closely with federal, state, and local law enforcement agencies to detect, If you suspect that Medicaid fraud has occurred, or abuse, neglect or exploitation has occurred in a Medicaid facility or by someone working for a Medicaid provider, immediately report the incident to the Medicaid Fraud Control Unit Monday - Friday 8:00-5:00pm at the Office of Attorney General: 2005 N Central Ave 567 0 obj <> endobj U.S. Attorney's Office, District of Arizona, United States Attorney's Office Announces Charges in Fraud Cases Related to COVID-19, Phoenix Man Sentenced for Importing Counterfeit N95 Masks from Asia, Phoenix Woman Sentenced to Prison for Paycheck Protection Loan Fraud, Gilbert Man Sentenced to Prison for PPP Fraud. The complaint alleges that Alsadi and the Dengas falsely billed AHCCCS for more than 1,500 non-emergency medical transports in April 2020 when those transports never occurred. AHCCCS, formed in 1982, is the states Medicaid program. ;~F` i_-|tI?=WOpTa#R}w]=lNDP` @ AHCCCS has a contract for unlimited searches for a basic monthly charge. PHOENIX, Ariz. The United States Attorneys Office unsealed three criminal complaints filed in Federal District Court charging multiple individuals with health care fraud associated with the COVID-19 pandemic. District of Arizona AHCCCS receives County inmate data for more than 90% of the state to assist with eligibility compliance. 583 0 obj <>/Filter/FlateDecode/ID[<4704BC82282EC0439DECB24A83985C10>]/Index[567 39]/Info 566 0 R/Length 84/Prev 129300/Root 568 0 R/Size 606/Type/XRef/W[1 2 1]>>stream 605 0 obj <>stream Please visit the, Resources for Foster/Kinship/Adoptive Families, Accessing Behavioral Health Services in Schools, AHCCCS Whole Person Care Initiative (WPCI), Emergency Triage, Treat and Transport (ET3), Report Concerns About Quality of Care Received, ALTCS Electronic Member Change Request (EMCR), Quality Assessment and Performance Improvement Strategy, Pre-Admission Screening and Resident Review (PASRR), Demographics, Social Determinants and Outcomes, Tribal Court Procedures for Involuntary Commitment, Contracted Health Plan Audited Financial Statements, Monkeypox Virus and Vaccination Information, Federal Funding Accountability and Transparency Act. Flagstaff: (928)556-0833 But even then, she said, the agency did not complete its preliminary inquiry within the year as required under its policy. While Auditor General Lindsey Perry says . And Perry said there clearly are such cases. Policy and procedures regarding referrals to OSI are outlined as follows: This site works best with JavaScript enabled, AHCCCS Office of Inspector General (AOIG), OSI - Potential Fraud Referral Requirements. The charges include healthcare fraud, wire fraud, money laundering, and aggravated identity theft. The Medicaid Fraud Control Unit is a federally funded unit charged with investigating and prosecuting: Medicaid (AHCCCS) fraud; fraud in the administration of the Medicaid program; and abuse, neglect or financial exploitation occurring in Medicaid facilities or committed by Medicaid providers or their employees. 602.364.0411 (fax). The problems, the report says, are not limited to patients. The couple was charged earlier this month by the federal grand jury in a 58-count indictment. AHCCCS had not completed a preliminary investigation of 87% of potential provider fraud or abuse to the Attorney Generals Office within three months, the time frame established in an agreement between the two agencies, Perry said. Copyright 2023 Centene Corporation, LLC. Two other complaints charge a total of six individuals associated with five Phoenix-area businesses that purport to provide non-emergency medical transportation services on the Navajo Nation. He predicts the proposed change will have an absolutely massive impact on the ability for some people to get outpatient treatment. Suicide or significant suicide attempt by a Member; Unauthorized absence of a Member from a locked behavioral health inpatient facility; Sexual assault while a Member is a resident of a locked behavioral health inpatient facility; or. One complaint charges Jeremiah Faber, 45, of Gold Canyon, Arizona, the CEO of Harmony Healthcare, LLC dba Harmony Medical Care, with one count of health care fraud and one count of money laundering. An individual is presumed innocent until evidence is presented to a jury that establishes guilty beyond a reasonable doubt. She pointed out that in the last fiscal year, AHCCCS reported that it either recovered or saved about $48.1 million in state and federal funds. Uber offering horse drawn carriage rides in honor of royal coronation. For example, at Sunrise Native Recovery their reimbursement has been $1,300 per patient per day. Email ABC15 Investigator Anne Ryman atanne.ryman@abc15.com, call her at 602-685-6345, or connect onTwitterand Facebook. Pay Your Premium One goes back to August 2014 with allegations that another adult was living in and contributing financially to the household. Phoenix, Arizona 85004 The OIG is designated as a criminal justice agency and is authorized by the Federal Bureau of CONTROLLED SUBSTANCES PRESCRIPTION MONITORING PROGRAM (A.R.S 362602; A.R.S. Native Americans are enrolled in a special subset of AHCCCS called Fee-For-Service. OIG works closely with federal and state partners, including the Medicaid Fraud Control Unit (MFCU) of the Arizona Attorney General, the Federal Bureau of Investigations (FBI), Drug Enforcement Agency (DEA), Health and Human Services (HHS) OIG, AHCCCS needs to crunch down on what they're authorizing." Hatathlie said the sober living providers can make a lot of money by going through a process to become certified as an Indian Health . Without outpatient services, people will relapse, said Robin Byrne, Purpose Healing co-founder. The suspect must work for a Medicaid provider, such as a doctor, nursing home . Two Renaissance Square 40 N. Central Avenue, Suite 1800 Today, he is studying to be an electrician technician. And if it is not, Perry said, AHCCCS should work with the legislature to provide more funds. The office has statutory authority to issue subpoenas and place local police and law enforcement agencies, county prosecutors, contracted health plans, and other state agencies. Subscribe to Newsletters A possible quality of care incident can involve a facility, the staff, a physician, or another entity providing a health care services to the member. 1 on Yelp's SW best eateries, Pac-12 mailbag: Is an Arizona departure worst-case scenario for Pac-12? persons under oath to obtain evidence for investigations. endstream endobj 573 0 obj <>stream Phoenix, AZ 85004, Phoenix: (602) 514-7500 These appeal rights, as set forth in the Arizona Uniform Administrative Hearings Procedures, (A.R.S. Audit: AHCCCS lagging in investigating abuse, fraud, Tucson's west-side resort, Starr Pass, sold for $110 million, Cocktails on a train car and boutique bowling coming to Tucson, Tucson restaurant lands No. Im living proof. Residential rehab centers, which arent subject to the proposed cuts, worry about what will happen once they discharge their patients. Please see the provider manual section on IAD reporting for further information. Before treatment, the 36-year-old didnt have a home or a job. The goal of The Quality Department Investigations is to identify adverse outcomes whether at the provider level or a systemic issue; develop and implement plan of correction to reduce likely hood of reoccurrence or similar outcome, improving the care our members receive. 7) Allen Jeter, 57 {2@3 9)TgOx,d7?y,F77gw]w"_7Tj[Oo The general public and participants may submit their requests through any of the following methods: Two departments are responsible for acting on the requests. grTkae`jK5]+wn_} Ox [hV2k1Y! @Uc$' x!Wmz I "|U;D&NL# Ce. Tucson: (520) 620-7300 Fee-for-Service Fee Schedules, Contact Us General Questions and Fraud Reporting AHCCCS said the proposed change may impact about 223 providers or about 10 percent of more than 2,200 providers. 9) Trisha Wright, 38 Covered Services The Phoenix Division of the Federal Bureau of Investigation conducted the investigation in this case. Plus expansion candidates and more, Green Valley bite reminder that it's rattler season in Tucson, Yentzer booted from ballot in race for Tucson mayor, Award-winning journalist takes helm of Arizona Daily Star, state news operations, Arizona coach Tommy Lloyd says Wildcats are 'in great shape' despite current holes in roster, Tucson to study creating city-run electric utility; TEP opposed, Threats cause Catalina Foothills School District to cancel meeting, 40 fun events happening in Tucson this weekend April 27-30 , 30 places in Tucson where you can often find live music, Northern lights spotted over Tucson after powerful solar activity, Pac-12 basketball picks: Soon-to-depart USC is early league favorite; Arizona slotted 3rd, Arizona's top prosecutor wants Legislature to clarify abortion laws, Conservation groups sue over Mexican wolf restoration program, Abortion, border big topics in Arizona Senate debate, Prop. An indictment is simply a method by which a person is charged with criminal activity and raises no inference of guilt. You have permission to edit this article. The agency estimates the change would save $1.1 million over five months. R9-20-203 or in A.A.C. Abdul Jabbar owns and operates Freedom AZ, LLC, and is also affiliated with Desert Mobile, LLC. Evidence that potential fraud occurred during the current or previous application period (initial or renewal). 0 CycIA4[QMciX 9; 362903). Subscribe to stay connected to Tucson. When the investigation is concluded, The Health Plan issues a decision letter to the grievant (and the . Investigations must be conducted pursuant to A.A.C. A .gov website belongs to an official government organization in the United States. AHCCCS' Office of Inspector General (OIG) registers all of AHCCCS' medical providers, such as doctors and home healthcare agencies. Tucson: (520) 620-7300 Share sensitive information only on official, secure websites. The indicted defendants are listed below: 1) Dale Henson, 53. A subscription helps you access more of the local stories that keep you connected to the community. Health Insurance for Children, Provider Enrollment A concern about the quality of health care provided, or the appropriateness of the medical treatment received. These statutes provide for a computerized central database tracking system to track the AHCCCS appeared to finish its investigation of the incident in September, according to records reviewed by ABC15. In addition to criminal 211 targets 'dark money' in Arizona campaigns, Instagram mom convicted for fabricating story about kids' kidnapping, King Charles and Queen Camilla's will use thrones recycled from King George VI's coronation, Rare images captured of butterflies taking flight after emerging from chrysalis, Ride like royalty! 4) Paul Flaa, 56 5) Ariel Dix, 34 AHCCCS conducts pre-approval investigations to ensure its members are eligible to receive benefitsThe A Quality Incident can be detrimental to a members health or safety and may reflect that the care provided was below the professional standards of care. The complaint alleges that Faber used Harmonys Facebook and other social media sources to offer free COVID-19 testing if patients also completed Harmonys Comprehensive Whole-Body Assessment. These are intensive services, provided at least three hours a day and at least three days a week. AHCCCS also noted that "It does not appear that ASH conducted an additional investigation as required" given that the hospital's second decision letter was "identical" to the first. AHCCCS in all but a few instances is the "payor of last resort," meaning that if an AHCCCS member has other insurance coverage, that insurer must pay for the medical expenses incurred. In November 2020, AHCCCS upheld part of Contreras' grievance, noting that surveillance footage backed up his claim about being kept in restraints. Instead of reimbursing providers a percentage of their charges, they will get a flat rate per patient per day. The FBI thanks the U.S. Department of Health and Human Services Office of the Inspector General (HHS-OIG), and the Arizona Health Care Cost Containment System Office of the Inspector General (AHCCCS-OIG) for their partnerships and collaboration on these cases. OIG provides appeal rights on its notices that fall under the state statutory definition of appealable agency actions, %PDF-1.6 % All defendants are presumed innocent until proven guilty in a court of law. If the incident needs immediate attention, and it is not during regular business hours, call 911 immediately. The second complaint charges Miguel Denga, Husam Alsadi, and Tamarria Denga with conspiring to commit health care fraud. Its absolutely horrific, he said of the proposal. AHCCCS said it was having difficulty in subpoenaing needed information from the member and the members employer because the member had moved and changed jobs multiple times since 2014. The Office of Inspector General (OIG) is responsible for the integrity of the AHCCCS budget, nearly $18 billion in State Fiscal Year 2023. . He wasnt even sure what day it was. Submit all potential quality issues using the Arizona Complete Health Quality of Care Notification Form (PDF)to the following: AzCHQOC@AZCompleteHealth.com. 602.542.3881 Doug Ducey to call a special legislative session to let lawmakers provide "additional clarity'' , For Star subscribers: A federal judge has blocked the state from enforcing a new law that he said could inadvertently make felons out of volun. 11) Sharon Lawson, 48 For Star subscribers: The state can pursue its claim that the Biden administration acted illegally when it enacted policies allowing thousands. Mary Group Home II. The complaint further alleges that their false billings in April 2020 generated a total of more than $2.75 million in fraudulent payments from AHCCCS to the three businesses. Policy. endstream endobj 571 0 obj <>stream FAA workers may submit their requests to investigate potential fraud using the investigation referral process. In fact, nearly 60% had been open for longer than a year. The CNAP Manual contains policy for Arizona's Cash and Nutrition Assistance Programs administered by the Family Assistance Administration (FAA). Their work was vital to these investigations." The money funds group therapy and cultural activities at the center as well as transportation to and from the center, meals and housing. R9-21-402 et seq. Nez received outpatient services through Sunrise Native Recovery, an outpatient drug-and-alcohol treatment center. Follow the U.S. Attorneys Office, District of Arizona, on Twitter @USAO_AZ for the latest news. A lot of people are gonna fall through the cracks, said Allen King, Sunrises chief administrative officer. 01 Participant Initiated Changes. In a statement, the agency acknowledged that some providers may see a reduction in reimbursement based on how they currently bill. The agency estimates the change would save $1.1 million over five months. Richie.Taylor@azag.govMediaRequests@azag.gov, Attorney General Mark Brnovich Announces 13 Individuals and 14 Related Business Entities Indicted in Alleged Massive Health Care Fraud Billing Scheme, 49th Annual Peace Officers Memorial Service, Elder Abuse Information and Training Guide, Data Breach Notification Form Individuals, Lutheran Association of Missionaries and Pilots U.S., Inc. (d/b/a Lutheran Indian Ministries), Mary Group Home,a.k.a. The investigation developed allegations of multiple forms of fraudulent billing, including overbilling/double billing for services, billing for services that had not been rendered, and billing for AHCCCS members/patients who were deceased. Investigators were not able to conduct-in person visits to homes and schools as part of their investigations, which impacted their ability to verify the reported number of members living in the home and contributing to the household, the report said. CASE NUMBER: CR 21-000601-PHX-DJH But he said the solution is not to change the funding for all providers. information in our investigations. PHOENIX Arizonas health care program for low income clients is not doing a good job of investigating potential incidents of fraud or abuse committed by providers or patients, the state Auditor Generals Office has concluded. PHOENIX Attorney General Mark Brnovich announced that a State Grand Jury has indicted 13 individuals and 14 related business entities on criminal charges of Illegal Control of an Enterprise, Theft, Conspiracy, and Fraudulent Schemes and Artifices. hb```,N'Ad`0p```Pm@j P k.zA&\`hh`h0`h` `3 A1|~);mYqfH~xQ,xp# f`Qp 90 We assist individuals, entities, and other law firms with criminal and parallel issues related to healthcare fraud and abuse allegations in state and federal enforcement actions. It exists to prevent, detect, and recover improper payments due to Medicaid fraud, waste, and abuse. This research ends to investigate factors affecting the teachers' job performance in Agricultural High School in Mazandaran province, Iran. Sunrise would see a drastic funding cut because all of its patients are Native American. An official website of the United States government. Their work was vital to these investigations.. The unit is located in the Attorney General's Office, 2005 N Central Avenue in Phoenix. And ultimately what will happen is without that support, they will most likely use or drink again, said Gabriel Tomaeno, co-founder of Purpose Healing Center, a residential treatment center with locations in Phoenix and Scottsdale. Finally, AHCCCS risks compromising its ability to gather evidence and follow leads that might become stale as cases age.. AHCCCS is primarily federally funded, and it provides healthcare programs for Arizonas low-income residents. The unit consists of attorneys, investigators, an auditor, a nurse investigator, paralegal and support staff. Already, the culturally based addiction treatment center with two locations has moved its 70 patients to a single location in preparation for the potential funding changes, which are scheduled to take effect May 1. Download the free version of Adobe Reader. 6) Charles Temple, 36 The statistical population includes 127 teachers. Secure .gov websites use HTTPS A sentinel event is defined as any of the following: If you have any issues with the QMS Portal or need technical assistance, please contact the Quality of Care Team at AzCHQOC@AZCompleteHealth.com. Im 16 months sober, he said. AHCCCSOnline Website The OIG is designated as a criminal justice agency and is authorized by the Federal Bureau of Investigation and the . nr Cd86C3Y-LU'~WU0O3Z2P/O 58j!iPv@8:PEz/>#WVf?OK3J5Nw7QsnG:40'F7SRiM#4=( g]*3f$2TAAix91ix}d23B )nf:kFYR{3X\^&ZHhaS+ip *SWX*v RmSiZv6n*M7UXZlVtJxghJ@N'Gn/yrf_4 R7t|> 8I4"8^T~^v30,'!d9Py d90HH6_E\}Y+M`+'tew6 4 ) or https:// means youve safely connected to the .gov website. This material may not be published, broadcast, rewritten, or redistributed. Healthcare Fraud & Regulation. The goal of The Quality Department Investigations is to identify adverse outcomes whether at the provider level or a systemic issue; develop and implement plan of correction to reduce likely hood of reoccurrence or similar outcome, improving the care our members receive. . 13) Kayla Sol, 34 violation of and in accordance with federal and state statutes, rules, and regulations. Through the AHCCCS prepayment coordination of benefits process, roughly $1.3 billion in health care expenses are covered by other carriers, including Medicare. The Office of Inspector General (OIG) is responsible for the integrity of the AHCCCS budget, nearly $18 billion in State Fiscal Year 2023. (AHCCCS) Quality Management System (QMS) Portal is used for the . As a result, AHCCCS has continued, for nearly eight years, to pay hundreds of dollars every month in capitation payments for members who may be ineligible for health care coverage, Perry said. The allegation was that had this persons income been included in the application, the household would not have been eligible for AHCCCS coverage. The OIG also conducts unannounced site visits at certain providers' offices. endstream endobj startxref including but not limited to, provider terminations, credible allegation of fraud payment suspensions, final overpayment findings, and the imposition of civil monetary penalties. Main Office: A locked padlock The FBI thanks the U.S. Department of Health and Human Services Office of the Inspector General (HHS-OIG), and the Arizona Health Care Cost Containment System Office of the Inspector General (AHCCCS-OIG) for their partnerships and collaboration on these cases. Main Office: These same provisions also exhibit an intent to provide law enforcement access to . Examples include, but are not limited to: If you suspect that a vulnerable adult has been abused or neglected, report it immediately toAdult Protective Servicesat 1-877 SOS ADULT. IADs must be submitted by the provider within 2 business days of the incident. endstream endobj 572 0 obj <>stream REFERENCES: AHCCCS Contractor Operations Manual (ACOM), Policy 446 This Policy applies to the Division of Developmental Disabilities and their subcontractors and outlines procedures related to grievances and investigations conducted by AHCCCS and the subcontractors under A.A.C. Health Care-Acquired and Provider Preventable Conditions as described in the AHCCCS AMPM Chapter 900. Policy Manuals The indicted defendants are listed below: 2) Kevin Maulson, 60 Because there's gonna be literally no services.. Have a question about Government Services? Individuals are presumed innocent until proven guilty beyond a reasonable doubt. Out-of-State Toll Free: 1-800-523-0231, How to Apply Secure .gov websites use HTTPS A lot of people who are seeking recovery, this is going to hurt them a lot, he said. Obtain a copy of the Medicaid Fraud Control Unit Complaint Form. Im living proof. But heres the thing: As of this past July, Perry said the case was still under investigation. So we can figure things out and talk with the AHCCCS program, let them really understand.. He wasnt even sure what day it was. fraud actions related to the suspension of providers; and, when necessary, terminates providers in Loabneh, and Lawabni own and operate A&N Services, LLC. That will just result in fewer services overall. The Health Plan follows the investigation process described in Arizona Administrative Code Title 9, Chapter 21 (9 A.A.C. Wi?~GQwS}|mYMGVi6YAu5iy\Ed@uOJ^KS" The agency confirmed to ABC15 that most of the affected patients are Native American. Careers law enforcement agency. An official website of the United States government. Tamarria Denga owns and operates COS 1, LLC. AHCCCS said the proposed change may . The Arizona Attorney General's Office conducted this investigation along with investigators from the Office of Inspector General for the U.S. Department of Health and Human Services and the Office of Inspector General for AHCCCS. The suspect must work for a Medicaid provider, such as a doctor, nursing home, hospital, adult care home, or home health agency. The Criminal Division is comprised of eight sections: . Arizona Health Care Cost Containment System, known as AHCCCS, is proposing to change the way it reimburses providers for outpatient treatment services through the Fee-For-Service program. We remain committed to rooting out and prosecuting any individual who would use this crisis as an opportunity to defraud individuals or the government.. A locked padlock Yuma:(928) 314-6410. A U.S. As noted above, after the Governor of Arizona and the President of the Navajo Nation both declared COVID-19 public emergencies, the need for non-emergency medical transports dramatically decreased. Today, he is studying to be an electrician technician. AHCCCS had not completed a preliminary investigation of 87% of potential provider fraud or abuse to the Attorney General's Office within three months, the time frame established in an agreement . Yuma:(928) 314-6410. The couple is alleged to have submitted $1.2 million in fraudulent bills to AHCCCS over a 9-month period in 2019-2020, and then to have used some of the proceeds to purchase a $1.3 residence in Gilbert, Arizona. The complaint alleges that Abdul Jabbar, Loabneh, and Lawabni falsely billed Arizonas Health Care Cost Containment System (AHCCCS) for more than 9,000 non-emergency medical transports in April 2020 when those transports never occurred. A complaint is simply the method by which a person is charged with criminal activity and raises no inference of guilt. AHCCCS is primarily federally funded, and it provides healthcare programs for Arizona's low-income residents. Share sensitive information only on official, secure websites. witness interviews, subject matter expert opinion analysis, and evidentiary review in order to determine preliminary findings. Harmony then fraudulently submitted claims for reimbursement to Mercy Care, Arizonas health care benefit program, by billing for services that were medically unnecessary and for services provided in the names of physicians who had no role in the assessment.
