Stakeholder Engagement Meetings for the Illinois Medicaid 1115 Waiver: Jan 9, 2013 - Chicago/ Jan 10 - webinar RSVP

Health and Medicine Policy Research Group (HMPRG) would like to invite Illinois' Medicaid stakeholders to participate in a Stakeholder Engagement meeting regarding Illinois' Medicaid 1115 Waiver Application Draft. These meetings will be held on January 9 and 10, 2014.   Representatives from the Governor's Office, Health Management Associates (HMA), and HMPRG will be available to discuss, answer questions, and hear comments regarding a draft of the application for the Medicaid 1115 Waiver, which will be made available on the State's 1115 Medicaid Waiver page in advance of the Stakeholder Meetings.   Two meetings will be held: Meeting A: Thursday, January 9, 2014:  10:00 a.m. - 12:00 p.m. at the Thompson Center, Auditorium, on the Lower Concourse Level (Register here) Meeting B: Friday, January 10, 2014: 10:00 - 12:00 p.m., via webinar (Register here) For Meeting A, feel free to send more than one participant from your organization.  Videoconference, webinar, and teleconference options will not be available for Meeting A.   Meeting B will be a webinar that can be accessed online or participants can call in for audio only.  The webinar has been set up to facilitate remote participation to ensure stakeholder access to this process.  The same information will be presented at each meeting, and a summary of public comments made at these meetings will be made available.    In November, stakeholders had the opportunity to discuss the Path to Transformation Concept Paper.  Written comments were submitted to HMPRG and are being taken into consideration as HMA develops the 1115 Waiver application.  The meetings on January 9 and January 10 will focus on the draft waiver application and will replace the previously scheduled and postponed December 19 and 20 meetings.   If you need accommodations for accessibility or translation services, please call: 312-372-4292 or email info@hmprg.org.    Background: The State of Illinois has launched an effort to develop a Path to Transformation Medicaid Waiver under the Centers for Medicare and Medicaid Services waiver authority, Section 1115 of the Social Security Act. Section 1115 waivers allow states to test new approaches in Medicaid that differ from federal program rules.  For more information on the 1115 Waiver process, see the State's 1115 waiver page or HMPRG's page regarding stakeholder engagement.

Chicago Writers Association 3rd Annual Book of the Year Awards: Traditional Fiction is Susan Nussbaum for Good Kings Bad Days,

By Kathryn Pulkrabek, Gapers Block

The Chicago Writers Association has announced the winners of its 3rd Annual Book of the Year Awards. Categories included Traditional Fiction; Non-Traditional Fiction; Traditional Non-Fiction; and Non-Traditional Non-Fiction. 

The winner in the category of Traditional Fiction was Susan Nussbaum for Good Kings Bad Days, which follows a group of teens in a home for juveniles with disabilities. The book, Nussbaum's first novel, is also the winner of the PEN/Bellwether Prize for Socially Engaged Fiction. Nussbaum is a playwright and disability rights activist.

The Non-Traditional Fiction category was awarded to 30 Days to Empathy, a collaborative, crowdsourced novel written by 31 Whitney Young High School students ("The 31") and edited by their teacher, Jay C. Rehak. 30 Days to Empathy tells the tale of high school student Jake Hollomon as he discovers the meaning of empathy by spending a day as each of his classmates. 

Bree Housley took the award for Traditional Non-Fiction for We Hope You Like This Song. The book is a memoir about her relationship with her best friend since childhood, who died prematurely from complications from preeclampsia, a potentially fatal condition in pregnant women. (Gaper's Block's Lara Levitan recently interviewed Housely here.)

The award for Non-Traditional Non-Fiction went to Any Road Will Take You There by David W. Berner. Inspired by Jack Kerouac's On the Road, Berner embarks on a 5000- mile road trip on which he explores the many issues that arise between fathers and sons, as well as the legacies that fathers leave behind.

An awards ceremony will take place on January 18 at the Book Cellar where authors will read from their work and autograph books. The event is free and open to the public. 

Image courtesy of Chicago Writers Association

http://gapersblock.com/bookclub/2013/12/16/chicago_writers_association_3rd_annual_book_of_the_year_awards/

Illinois: Sandburg H.S. student Amanda Trezek helps train service dogs to assist people with disabilities

By Janice Neumann, Special to the Chicago Tribune

December 17, 2013

For Amanda Trezek, volunteering to garner community service hours has turned into a mission to help dogs and people.

Trezek, a junior at Sandburg High School in Orland Park, spends four hours every Tuesday at Heartland Service Dogs training puppies in basic obedience and adult canines to be service dogs for people with disabilities. The service dogs at the Mokena non-profit are eventually given to people with mobility problems, hearing impairments, post traumatic stress disorder and diabetes — where the canines alert their owners of their low blood sugar.

The service dog training includes getting the dogs used to wearing a harness and tolerating pressure on their backs while remaining calm. Trezek started volunteering at the training center about four years ago to gain community service hours needed for high school graduation.

[photo: Sandburg High School student Amanda Trezek spends four hours a week training puppies to be service dogs for people with disabilities. (Submitted by Linda Fox, Heartland / December 17, 2013) ]

"You keep them in that one position so they know they need to stay in that place for when the (disabled) person is getting up," said Trezek. "They have to get used to it."

Trezek's volunteerism also includes attending fundraising events, including a disability pet parade event in Chicago during the summer with the dogs, where she educates kids and adults of canine abilities.

One of Trezek's success stories was a yellow lab named Drifter who proved indispensable to a 19-year-old disabled woman. Drifter, who was a stray dog before his training at Heartland, helped a young woman with mobility issues caused by a muscular disease.

"She basically gained back her independence because before she had to use a wheel chair or walker," said Trezek.

Drifter can no longer be a service dog because of a medical issue but is now living with his handler, according to Trezek.

Linda Fox, who directs Heartland, said Trezek has become indispensable to the non-profit. Fox said the teen not only helps represent the importance of Heartland and service dogs but also doesn't mind cleaning up after the dogs or spending hours with a new puppy that is too small to be left unattended with its siblings and must be bottle-fed.

"She started out as a shy teenager…she has just blossomed with this," said Fox. "She now is a most fabulous ambassador for us."

Fox said during the summer Trezek spent Saturdays with her at a farmer's market in Mokena, showing the dogs to kids.

Helping dogs comes naturally to Trezek, who has tended to family pets since she was 6. She has three dogs, all rescues, and also helps take care of the family's two fish and her sister's gerbil. Trezek, who has volunteered in religious education classes at Saint Francis of Assisi Parish in Orland Park, said she intends to volunteer at an animal shelter next summer.

After high school and college, Trezek hopes to work in special education, possibly using dogs to help kids.

"You know the end result is the dog is going to be able to change someone's life and to have a little part in that is just a really great feeling," Trezek said.

http://www.chicagotribune.com/news/local/suburbs/orland_park_homer_glen/ct-sandburg-student-service-dog-ssw-tl-1219-20131218,0,2460920.story

Copyright © 2013 Chicago Tribune Company, LLC

Governor Quinn Announces Illinois Healthcare Research Coalition Awarded $7 Million to Battle Chronic Illnesses

State of Illinois
FOR IMMEDIATE RELEASE
December 17, 2013

Governor Quinn Announces Illinois Healthcare Research Coalition Awarded $7 Million to Battle Chronic Illnesses
Unprecedented Collaboration of 20 Health and Hospital Organizations Earns Federal Award to Study and Deliver Best Practices for Treating Diseases

	CHICAGO – Governor Quinn today announced that a coalition of 20 health and hospital organizations from Illinois has been awarded an 18-month, $7-million federal award to establish a clinical data research network (CDRN). Awarded by the Patient-Centered Outcomes Research Institute (PCORI), the award will allow the coalition to be part of a larger national network that will model how healthcare institutions in complex urban settings improve health outcomes and drive down costs for both rare and common conditions such as sickle cell disease, asthma, anemia, recurrent clostridium difficile, obesity and diabetes. “Through this unique collaboration of our incredibly talented researchers, Illinois is helping lead the fight against chronic illnesses that affect millions of Americans,” Governor Quinn said. “This coalition will be able to touch millions of lives and make a positive impact on disease prevention and improving health outcomes.” The coalition, the Chicago Area Patient Centered Outcomes Research Network (CAPriCORN), will pool data from more than 1 million patients so researchers locally and nationwide can learn how providers can overcome barriers of competition, care fragmentation and limited resources. This will aid in the development, testing and implementation of effective strategies to improve care for diverse populations and reduce health disparities. The Chicago Community Trust and the Illinois Medical District Commission will facilitate and administer this unprecedented collaboration. Better decision-making, greater engagement PCORI, established in 2010, is authorized by Congress to conduct research to provide information about the best available evidence to help patients and their healthcare providers make more informed decisions. The mission of CAPriCORN is to provide a data and informatics infrastructure to support collaboration among Chicago-area scientists in conducting patient-centered outcomes research, with an ultimate goal of improving patient outcomes. The award will be used for numerous activities across the CAPriCORN initiative, including: compiling clinical data; designing systems to conduct Comparative Effectiveness Research trials and observational studies in the Chicago area and nationally; establishing procedures for clinical data standardization and sharing across participating healthcare delivery institutions that can be used for performance measurement and quality improvement; engaging patients, clinicians and health system leadership in governance and use of CAPriCORN data resources; and recruiting and surveying clinical research study participants. Collaborating for an important cause Participating healthcare delivery institutions include: Alliance of Chicago’s Federally Qualified Health Centers Cook County Health and Hospital Systems Loyola University Health System NorthShore University HealthSystem Northwestern Medicine Rush University Medical Center University of Illinois Hospital & Health Sciences System University of Chicago Medicine Veterans Administration Hospitals (Hines, Jesse Brown) Other CAPriCORN partners include: The Chicago Community Trust Illinois Medical District Commission University HealthSystem Consortium (UHC) University of Illinois at Chicago Chicago Health IT Regional Extension Center (CHITREC) Medical Research Analytics and Informatics Alliance Center for Medical Technology Policy Clinical Directors Network RAND Tufts University CTSI Vanderbilt University CAPriCORN is supported by the Illinois Department of Healthcare and Family Services, the Illinois Office of Health Information Technology, the Cook County Government and the Chicago Department of Public Health. Advocacy groups supporting CAPriCORN include: Respiratory Health Association, Chicago Asthma Consortium, Sickle Cell Disease Association of Illinois, Peggy Lillis Mills Foundation, Have a Heart for Sickle Cell Anemia Foundation and Next Step/STRIVE. Blue Cross and Blue Shield of Illinois is also a supporter of CAPriCORN. In preparation for this award, CAPriCORN sites collaborated with a planning grant from the National Institutes of Health Clinical and Translational Science Awards. They also pooled clinical data from electronic health records as part of a project funded by the Ortho Sprague Institute to identify patients and potential study participants for the anticipated research. In addition, five of the CAPriCORN institutions already collaborate with the Chicago-based UHC, an alliance of 119 nonprofit academic medical centers, more than 300 affiliated hospitals and nearly 100 faculty practice plans. UHC will expand its role to serve as a data aggregator for all CAPriCORN sites. About PCORI The Patient-Centered Outcomes Research Institute (PCORI) is an independent, non-profit organization authorized by Congress in 2010. Its mission is to fund research that will provide patients, their caregivers and clinicians with the evidence-based information needed to make better-informed health care decisions. PCORI is committed to continuously seeking input from a broad range of stakeholders to guide its work. More information is available at http://pcori.org. PCORI has awarded a total of $464.4 million since it began funding CER in 2012. For more information about PCORI funding, visithttp://pcori.org/funding-opportunities. http://www3.illinois.gov/PressReleases/PressReleasesListShow.cfm?RecNum=11780

Is Pittsburgh Breaking Down Barriers: Creating a more disability-friendly city

Use of creative thinking and technology could spark new ways to improve accessibility

By Tina Calabro, Pittsburgh Post-Gazette, Dec 16, 2013

Can Pittsburgh become a more accessible community -- not simply by providing more wheelchair ramps and automatic doors, but actually serving all types of disabilities and touching every aspect of daily life?

With the abundance of technology brainpower in our city, can we create solutions to access barriers that not only enhance lives here but help people elsewhere?

These two questions were the centerpiece of Pittsburgh's first "Accessibility Meetup," held last week at Google's offices in Larimer. Organized by local disability advocates Gabe McMorland, 31, and Chris Maury, 27.

The Pittsburgh endeavor takes a cue from similar efforts in Chicago, Toronto and other cities with a progressive agenda to become barrier-free.

The local Accessibility Meetups, which will be held monthly in various locations, are open to a wide range of participants: people with disabilities, people who have a professional interest in the subject and those who simply like to solve problems. Google's offer to host the inaugural meeting underscores the fact that many access solutions involve technology and out-of-the box thinking.

Mr. McMorland, a Pittsburgh native with a background in urban planning, and Mr. Maury, a technology developer from San Francisco, joined forces to launch the meetups after being introduced by a mutual friend and realizing their common interest in creating a more disability-friendly city. Both men have a medical condition that leads to vision impairment during young adulthood.

Pittsburgh's historic leadership in disability services and its capacity for solving problems through technology, they said, present a rare opportunity to push boundaries and improve lives.

The key to nurturing sparks of innovation at the meetups will be the input of creative people who may never have considered these situations. "Sometimes the best person to solve an access problem is not a person trained in access," Mr. McMorland noted.

Among the 50 attendees last week were professionals in robotics and design who were attracted to the challenge. "Bring your friends," Mr. McMorland urged them. "You don't have to be an engineer to attend, just an interest."

Attendees' suggestions for topics for future sessions included:

• How to get existing technology in the hands of people who need it.

• Making medication prescription labels accessible to people with vision impairment.

• Accessible website design, especially employment sites.

• Mapping accessible routes for pedestrians, similar to bike maps.

• How to inform local officials about curb cuts and other access features in disrepair.

• Improving consumer product design, especially those for household appliances, to take accessibility into account.

"The ADA [Americans With Disability Act] is about minimal compliance. It creates the floor. I'd like to see the ceiling," said Todd Reeves, executive director and president of the Western Pennsylvania School for Blind Children, who attended the session.

"I love the fact that the people are here because they're interested in the subject and getting to know one another," said Kirsten Ervin, an art educator who specializes in access to art-making.

By coincidence, on the day following the meetup, Carnegie Mellon's School of Computer Science held a talk "How Can We Make Our World Accessible?"

Chieko Asakawa, a research scientist at IBM Japan and frequent CMU collaborator, presented new technology prototypes that increase access for people who are blind. She lost her vision in an accident at 14.

As both creator and user of assistive technology, Ms. Asakawa's messages about accessing an increasingly complex world could not have been more compelling. The audience of about 100 people, mostly students, were rapt as she demonstrated how she navigates without sight, and the promise of emerging technology to create ever fuller encounters.

For information about Pittsburgh Accessibility Meetups, visit meetup.com/Pittsburgh-Area-Accessibility-Meetup, call 412-719-3424, or join the Twitter conversation on #A11yPGH.

Read more: http://www.post-gazette.com/news/health/2013/12/16/Creating-a-more-disability-friendly-city/stories/201312160014#ixzz2nkRRX0AX

EasyJet on trial in France for refusing disabled passengers using wheelchairs

Agence-France Presse – Mon, Dec 16, 2013 

EasyJet goes to court in France this week to fight two separate legal challenges by disabled passengers who it refused to fly, in the latest accusations of discrimination against the budget airline.

The British company is being challenged over its refusal to allow two female wheelchair-users -- one of whom was travelling to her son's funeral in Portugal -- to fly unaccompanied.

The airline has argued that it acted for safety reasons, and in compliance with British and European laws.

The first case, to be heard Monday in the Paris appeals court, dates back to March 2010 when Marie-Patricia Hoarau boarded an EasyJet plane from Paris to the French Riviera city of Nice.

Hoarau, who has been in a wheelchair for decades following a mountain bike accident, had travelled from Nice to the French capital the previous day without any problems.

But this time round, cabin crew asked her whether she could get to an emergency exit on her own. When she said no, they told her she had to be accompanied by someone.

A pilot travelling on the same flight agreed to step in and sit next to the 39-year-old, but the airline's management said this was not adequate and ordered the captain to disembark Hoarau.

Hoarau later took another flight, saying she was "humiliated and rejected", but she decided to take EasyJet and the captain to court after contacting France's disabled association APF.

In May 2012, a French court let the captain off but fined the airline 5,000 euros ($6,900), and ordered it to give Hoarau an additional 5,000 euros in damages.

The British company appealed the verdict, saying it was in compliance with British law when it refused to let her board for security reasons.

The second case, to be heard on Thursday in the Paris suburb of Bobigny, involves another wheelchair user who was refused onto a flight from Paris because she was travelling alone.

She was forced to buy a last-minute return ticket with another company to get to her son's funeral in Portugal.

This is not the first time that EasyJet has been taken to court over allegations of discrimination.

In January last year, a French court fined the airline 70,000 euros for refusing to allow three wheelchair users to board its planes between November 2008 and January 2009, in what a lawyer for the plaintiffs said was a "landmark ruling".

Airbus A320 airplanes run by low-cost airline EasyJet pictured at Paris Roissy Charles de Gaulle airport in Roissy-en-France, north of Paris on April 29, 2013

Services for Students with Disabilities - Columbia College Chicago

Services for Students with Disabilities

•  623 S. Wabash Ave., Suite 304
•  312.369.8296
•  colum.edu/ssd

The Services for Students with Disabilities (SSD) Office provides services and accommodations for students who have a documented disability. The SSD Office coordinates support services for all students who self-identify and provide verification of their disability while they attend Columbia. Students with a disability must register with the SSD Office in order to receive accommodations based upon their disability. The Office of SSD has adaptive equipment and software in a dedicated computer lab. SSD staff also works with faculty to provide in-class or other campus accommodations.

Grievance Procedure for Students with Disabilities

If a Columbia student believes that he or she has been discriminated against because of a disability by any Columbia personnel, he or she has the right to seek a review of such concerns. A student with a disability has the option of pursuing either an informal complaint or a formal grievance. If a student opts to pursue an informal complaint, he or she may later pursue a formal grievance if not satisfied with the resolution of the informal process. A student who is uncertain about filing a formal grievance may consult informally with the 504 Coordinator, Associate Vice President and Dean of Students, or personnel in the Vice President of Academic Affairs’ Office.

Columbia’s current 504 Coordinator:

Sharon Wilson-Taylor, Ph.D.
Associate Vice President and Dean of Students
623 S. Wabash Ave., Room 301
312.369.7221
swilson-taylor@colum.edu

http://students.colum.edu/handbook/support/services-for-students-with-disabilities.php

State of Illinois: 111 children dying from abuse & neglect - DCFS annual report

the broken State systems in Illinois continues...

Illinois State Senator Hunter says abuse and neglect deaths are unacceptable, demands improvement

Frustrated by the number of children dying from abuse and angered by the tragic story of one Chicago girl’s recent death, Illinois State Senator Mattie Hunter (photo) confronted the state’s child welfare agency on Tuesday and demanded changes.

“We have 111 children that have died. That is not acceptable. Every single one of you all need to resign,” Hunter, a Chicago Democrat, told top administrators at the Illinois Department of Children and Family Services during a hearing.

Hunter, a member of the Senate Democrat’s leadership team, has long been an advocate for the state’s neediest children. Tuesday’s convening of a special Senate panel examining issues at DCFS comes in response to record high child fatality numbers and the high-profile death of an 8-year-old Chicago girl.

Gizzell Ford died in July after repeatedly suffering abuse and living in squalor. Two family members now face murder charges.

Hunter wants to know how the young girl slipped through the cracks at DCFS and what can be done to try to ensure it never happens again.

DCFS officials previously said 111 children died from abuse in neglect during the most recent annual report – one that covered July 1, 2012, to June 30, 2013. At Tuesday’s hearing, the agency director revised that number down to 104 and said the record levels were mostly due to the agency redefining what types of deaths are included in abuse and neglect cases.

as posted by Illinois Senate Democratic Caucus blog http://www.illinoissenatedemocrats.com/index.php/caucus-news/blog-archive/3830-protecting-our-children

Media coverage of Tuesday’s hearing can be found at the following sites:

Chicago Tribune: Senate panel grills DCFS over child death data

CBS Chicago: DCFS Comes Under Criticism At State Senate Hearing

Chicago Sun-Times: DCFS undercounted deaths from abuse, neglect over five years

Criminalising Disability in the Media Has Disastrous Consequences for Vulnerable People: article

as reported by  The Huffington Post UK, Dec 15, 2013

Hari Covert

Development worker for the Creative and Supportive Trust (CAST)

Recent research from the University of Glasgow has shown a 43% increase in newspaper articles relating to disability in 2010 and 2011 as compared to the 2004-5 period. As part of a small charity which supports women with mental health issues (which are among some of the most invisible impairments) you'd think we would be celebrating such an increase in public dialogue. Alas, the research findings confirm an increasingly narrow and pejorative representation of disabled people in tabloids like the Sun, the Daily Mail and the Express.

The recent media analysis, conducted by Briant, Watson and Philo, revealed a 118% increase in tabloid articles that associate benefit claimants with fraudulent and criminal activity. It was found that those with mental health issues are systematically labelled as 'benefit frauds' and lumped into the falsely constructed category of 'undeserving' disabled people. Depressingly, it was shown that the media is shifting blame from health service professionals, government policies, economic and labour market problems, towards the claimants themselves. This echoes the changing agenda of the coalition government peddling the notion that 'scroungers' are responsible for bringing the 'strivers' down; that is, to re-define what it means to be disabled in order to reduce welfare costs and somehow rescue the economy... stupid.

So what happens to the mass of people with mental health issues who are now told they are 'non-disabled people pretending to be disabled'? They are simply re-classified as 'fit to work', and subsequently vilified by Conservative party-supporting tabloids like the Daily Mail who claim that 75% of incapacity benefit claimants are 'trying it on'.

The real human impact of these dangerous discourses, government cuts and criminalisation of vulnerable people is what the Creative and Supportive Trust (CAST) is faced with every day from our base in Islington, North London. One service user, Mandy*, who attends free classes at CAST, described to me her struggles with accessing Disability Living Allowance (DLA) to support her in her struggle with bi-polar, personality disorder, mild schizophrenia and a physical condition. Despite her recent diagnosis and history of episodes she has been repeatedly interrogated and made to feel like she's lying about her condition. It's not surprising that her assessor, a physiotherapist, had difficulty understanding her specific needs as lack of appropriate training is a common complaint against Atos lodged by disabled claimants. The fact she was able to attend her assessment and wore makeup on that day was actually used to undermine her claim. This is a catch 22 faced by many claimants, resulting from widespread stereotypes about what it means to be 'disabled'. This echoes what Sarah Wooleston has recently called 'the tick box process' which ignores the variable and destabilising nature of mental illness, whereby different symptoms present themselves on different days and one's capacities are always vulnerable to change.

Six months earlier Mandy was verbally harassed, humiliated and denied entry on a London bus by passengers and the driver because she had presented a freedom pass and did not appear to be visibly disabled. This abuse, which echoes the draconian chorus of the coalition's cuts, had a severe and long-term impact on Mandy's wellbeing, causing her to self-harm and self-destruct over a number of months. Only recently has she been able to return to classes at CAST. Mandy describes the continual lack of respect shown to her by the police, paramedics and hospital staff when they discover that she has mental health problems. Mandy now carries a criminal record for a crime she did not commit but admitted to in order to avoid disclosing her mental health issues to the police, whom she believed would not understand.

Not only does the state seem to be criminalising people through Atos assessments and their changing criteria, but the level of discrimination and marginalisation perpetuated by certain media outlets also forces people to criminalise themselves in response to the deterioration of public attitudes and the institutional erasure of mental health as a very real and disabling issue. The destruction of our benefit system represents a structural violence which will paradoxically disable people further. As Wooleston says, it is wrong to equate mental health issues with criminality as is a common theme in capability assessment hearings. However for those with mental health issues who have already been crow-barred into the category of offenders, CAST provides holistic support. In a moment of frustration Mandy exclaimed "I wish the government knew what this illness was" - we too think that more should be done to educate policy makers and assessors about the lived experience of all kinds of disability.

*names have been changed

http://www.huffingtonpost.co.uk/hari-covert/criminalising-disability-in-the-media_b_4449308.html

FBI & IRS Announce Charges in Multimillion-Dollar Medicare/Medicaid Fraud Scheme against N.Y. Pharmacy Owner Preet Bharara

Manhattan U.S. Attorney, FBI, And IRS Announce Charges Against Pharmacy Owner In Multimillion-Dollar Medicare/Medicaid Fraud Scheme

FOR IMMEDIATE RELEASE

Friday, December 13, 2013

The Defendant Allegedly Sold, and Received Reimbursement from Medicare and Medicaid For, Illegally Diverted Pharmaceuticals Obtained From Patients

Preet Bharara, the United States Attorney for the Southern District of New York, George Venizelos, the Assistant Director-in-Charge of the New York Field Office of the Federal Bureau of Investigation (“FBI”), and Toni Weirauch, the Special Agent-in-Charge of the New York Field Office of the Internal Revenue Service, Criminal Investigation (“IRS-CI”), announced that PURNA CHANDRA ARAMALLA was arrested yesterday for engaging in a scheme to defraud Medicaid and Medicare through the sale of illegally diverted prescription drugs. ARAMALLA was also charged with a related money laundering offense. ARAMALLA was arrested yesterday morning and was presented in Manhattan federal court before U.S. Magistrate Judge Debra Freeman yesterday afternoon. A preliminary hearing is scheduled for January 13, 2014.

Manhattan U.S. Attorney Preet Bharara said: “The illegal diversion of prescription medications threatens the health of those induced to sell their medication rather than take it. It threatens the health of those who unwittingly purchase the repackaged drugs believing them to be factory-fresh. And, as alleged here, Purna Aramalla’s diversion scheme defrauded millions of dollars from Medicare and Medicaid, taxpayer-funded programs established to provide health care assistance for the elderly and indigent. This Office is committed not only to punishing and preventing fraud, and safeguarding Medicare and Medicaid, but also to protecting the public.”

FBI Assistant Director-in-Charge Venizelos said: “As alleged in the complaint, Aramalla conspired to defraud our government health care programs and profit from the illness and misfortune of others. Aramalla treated our American health care system as a vehicle to fuel his greed and line his own pockets. The FBI, in conjunction with our law enforcement partners, will continue to investigate and bring to justice criminals who bilk the system and defraud the American taxpayer.”

IRS-CI Special Agent-in-Charge Weirauch said: “The illegal sale of prescription drugs by pharmaceutical professionals is an escalating problem. Not only does it put potentially dangerous medications in the wrong hands, but fraudulent Medicare and Medicaid reimbursements divert resources from the government. The money laundering statutes have always been effective tools in the fight against illegal drugs. We are now applying these same laws to the illegal prescription drug business, tracing the lucrative proceeds that the sales of these drugs generate.”

According to the allegations contained in the Criminal Complaint unsealed today:

ARAMALLA operates A Fair Deal Pharmacy Inc. in Queens, New York, and Quality Health Drug Inc. in Bronx, New York. Using these pharmacies, ARAMALLA allegedly carried out a multimillion-dollar scheme to defraud New York State Medicaid and Medicare programs through the sale of diverted pharmaceutical drugs, that is, drugs not obtained from legitimate sources.

As part of the scheme, ARAMALLA purchased pharmaceuticals, including high-cost medications used to treat HIV, that were obtained from patients who sold the pharmaceuticals rather than use them to treat their illnesses. ARAMALLA then repackaged and resold those pharmaceuticals to his customers, as if the pharmaceuticals were new drugs obtained from legitimate sources. ARAMALLA requested and received reimbursement from Medicaid and Medicare in connection with these sales, even though Medicaid and Medicare would not have been willing to reimburse the cost of second-hand drugs. In addition, in some cases, Medicaid or Medicare had already paid for the pharmaceuticals when they were initially dispensed. In order to make the diverted pharmaceuticals appear to be new pharmaceuticals from legitimate sources, ARAMALLA and his co-conspirators used lighter fluid and other means to dissolve the adhesive on the patient labels on prescription bottles so that they could be removed and replaced with new labels.

ARAMALLA also sought and obtained reimbursement for pharmaceuticals that were never actually dispensed to patients. Instead, customers with prescriptions for pharmaceuticals essentially “sold” their prescriptions to ARAMALLA, agreeing not to take delivery of the pharmaceuticals in exchange for a share of the reimbursed proceeds.

From October 2010 to August 2012, ARAMALLA purchased approximately $1.7 million of certain branded HIV medications from two legitimate, licensed wholesalers that were his primary sources of legitimate drugs. During that same period, he received approximately $4.3 million in reimbursements from Medicare and Medicaid for those same drugs, an amount far in excess of what he would have been entitled to had he only sought reimbursement for the legitimately obtained drugs.

*                      *                      *

ARAMALLA, 65, of Port Washington, New York, is charged with one count of conspiracy to commit health care fraud and wire fraud, which carries a maximum term of 20 years in prison, and one count of money laundering, which also carries a maximum term of 20 years in prison. He was ordered detained pending satisfaction of bail conditions, including a $2 million personal recognizance bond.

Mr. Bharara praised the outstanding investigative work of the FBI and the IRS. He also thanked the U.S. Department of Health and Human Services, Office of Inspector General, the New York State Office of Medicaid Inspector General, and the New York City Human Resources Administration.

The New York FBI Health Care Fraud Task Force was formed in 2007 in an effort to combat health care fraud in the greater New York City area. The task force comprises agents, officers, and investigators from the FBI, NYPD, the New York State Insurance Fraud Bureau, U.S. Department of Labor, U.S. Office of Personnel Management Inspector General, U.S. Food and Drug Administration, New York State Attorney General's Office, New York State Office of Medicaid Inspector General, New York State Health and Hospitals Inspector General, and the National Insurance Crime Bureau.

If you think you may have purchased second-hand prescription drugs or were otherwise victimized by this scheme, you can call the FBI Hotline at 212-384-3555.

The case is being prosecuted by the Office’s Complex Frauds Unit. Assistant U.S. Attorney Niketh Velamoor is in charge of the prosecution.

The charges contained in the Complaint are merely accusations, and the defendant is presumed innocent unless and until proven guilty.

13-384

 U.S. v. Purna Chandra Aramalla Complaint

http://www.justice.gov/usao/nys/pressreleases/December13/PurnaAramallaArrestPR.php