N. Korean refugees investigated for insurance fraud

http://www.straitstimes.com/BreakingNews/Asia/Story/STIStory_820678.html

SEOUL (AFP) - South Korean police said on Tuesday they were investigating 27 North Korean refugees for swindling private insurance firms out of hundreds of thousands of dollars in bogus medical claims.

Police said the refugees faked illness in collusion with hospitals to claim a total of 1.04 billion won (S$1.16 million) from insurance firms between 2007 and 2010.

While listed as hospitalised, they frequented saunas, restaurants and even nightclubs. The scam also involved a 71-year-old doctor and five hospital employees who conspired with the refugees to claim a separate 104 million won from the state health insurance agency, police said.

Police are also investigating two brokers on suspicion of helping the refugees send some of the proceeds to relatives in the North.

Kickbacks, Honest Services, and Health Care Fraud after Skilling

http://papers.ssrn.com/sol3/papers.cfm?abstract_id=2018589


Joan H. Krause

University of North Carolina (UNC) at Chapel Hill - School of Law

August 8, 2012

Annals of Health Law, Vol. 21, No. 1, 2012
UNC Legal Studies Research Paper No. 2018589

Abstract:    
This essay considers how the 2010 Supreme Court decision in Skilling v. United States, which limited the situations in which mail and wire fraud cases may be premised on violations of the “intangible right to honest services,” has the potential to alter the future of health care fraud litigation. While Skilling is widely perceived to have closed the door to several types of common mail and wire fraud prosecutions, this may not turn out to be the case in health care. In health care, the renewed focus on kickbacks as evidence of an honest services breach instead may dovetail nicely with both the Obama Administration’s emphasis on criminal health care fraud enforcement and the jurisprudence of the Medicare & Medicaid Anti-Kickback Statute. This kind of leverage may prove very difficult for prosecutors to resist, and most certainly will require changes in the way the health law bar approaches common Anti-Kickback concerns.

Number of Pages in PDF File: 10

Keywords: health care fraud, Medicare, white collar crime

Accepted Paper Series

Date posted: March 8, 2012

Suggested Citation
Krause, Joan H., Kickbacks, Honest Services, and Health Care Fraud after Skilling (August 8, 2012). Annals of Health Law, Vol. 21, No. 1, 2012; UNC Legal Studies Research Paper No. 2018589. Available at SSRN: http://ssrn.com/abstract=2018589
Contact Information
Joan H. Krause (Contact Author)
University of North Carolina (UNC) at Chapel Hill - School of Law ( email )
Van Hecke-Wettach Hall, 160 Ridge Road
CB #3380
Chapel Hill, NC 27599-3380
United States
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