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Millions of dollars in Medicare reimbursements are being distributed based on fraudulent claims, according to an article at News4Jax.com. According to the article, the Center for Medicare and Medicaid Services (CMS) has allowed alleged businesses who claim to be medical equipment suppliers to sign up for Medicare reimbursement eligibility when they were in fact sham businesses that never provided medical supplies to patients. The Medicare reimbursement process is supposed to work by legitimate medical equipment companies providing medical supplies to Medicare eligible patients pursuant to a legitimate doctor’s prescription. The medical equipment supplier then bills Medicare for the cost of the medical supplies given to the patient. In one example from the article, a business used a utility closet as the address it provided Medicare and no one found out until after $77,000 in Medicare reimbursements were paid out.

What often happens is that sham companies enroll in the Medicare reimbursement program and submit reimbursement claims for supplies that were never provided or for amounts much greater than the value of the supplies provided. The CMS has indicated an intention to change the enrollment procedures for Medicare reimbursement eligible companies to try and prevent fraudulent claims. The idea is to make sure medical supply companies meet certain standards before they become eligible to bill Medicare for supplies they provide patients.

Among the changes that have been suggested to change the Medicare enrollment process are: requiring suppliers to maintain supporting records from doctors, limiting the use of cell phones or pagers as a business’s primary contact number and setting up a competitive bidding process for medical equipment.

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Two people were killed after being hit by a suspected drunk driver in Clearwater, Florida according to an article at www.news4jax.com. Local police said the alleged drunk driver made a left turn in front of a motorcycle ridden by two people, both of whom died as a result of the accident.

The suspected drunk driver was arrested on two counts of DUI manslaughter. In Florida, the crime of DUI carries significantly greater penalties when a person dies as a result. DUI manslaughter can be a first or second degree felony depending on the facts of the case. Those people in Florida convicted of DUI manslaughter face up to 15 years in prison and a $10,000 fine along with a permanent driver’s license revocation, although there is the possibility of obtaining a hardship driver’s license after five years (if no prior DUI convictions). If a person kills someone while driving drunk and leaves the scene of the accident, he/she can be charged with a first degree felony and may face up to 30 years in prison and a $10,000 fine.

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The answer is yes in federal criminal court. Most of us understand the criminal system in Florida to provide that if a criminal defendant is acquitted (i.e. found not guilty by a jury) of a crime, that defendant should not serve any prison time based on that criminal charge. That seems to make sense; a criminal should only be punished for crimes he/she actually committed. However, it often does not work that way in the federal criminal system. In federal court, a defendant who is found guilty of one charge but not guilty of a second charge may have the conduct related to both charges considered to increase his/her sentence.

For instance, consider a case where a criminal defendant was charged with possession of cocaine in one count and illegal possession of a firearm in a second count. The jury convicts the defendant of the cocaine charge but finds him not guilty of the gun charge. The judge can, and likely will, also consider the defendant’s conduct related to the gun charge in determining the sentence even though the jury acquitted the defendant of that charge. Further, in order to convict a defendant of a crime, the jury must find that the defendant committed the crime beyond a reasonable doubt, which is a fairly high standard. The judge is only limited by a preponderance of the evidence standard when deciding whether to consider conduct for which the defendant was found not guilty of a crime in ordering his/her sentence. The preponderance of the evidence standard (greater than 50% likelihood) is much lower than the beyond a reasonable doubt standard.

Therefore, a defendant in a federal criminal case has to be concerned not just with crimes he/she may have committed, but also with crimes that he/she did not commit but were still charged by the prosecutor. This raises another issue as to whether a prosecutor might add questionable charges against a defendant knowing that a jury may likely find the defendant not guilty but also that the conduct based on those extra charges can be used against the defendant during sentencing if he/she is convicted of at least one charge.

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More than 60 people were arrested for drug related crimes in Flagler County, Florida last week according to the Flagler County Sheriff’s Office. Apparently, the drug arrests were the result of a lengthy drug investigation involving the Flagler County Sheriff’s Office, the Florida Department of Law Enforcement and the Florida Attorney General’s Office. Law enforcement officials indicated that the alleged drug operation involved drug dealers in Miami, Orlando and the NE Florida area. The information released by the Flagler County police did not specify what drug or drugs were involved but indicated that more than $330,000 worth of drugs were seized by the police.

The investigation into drug dealing in Flagler County, Florida began over two years ago according to an article on www.news4jax.com, and the investigation is apparently ongoing so more arrests may be forthcoming

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Drug abuse from prescription drugs has become more of a problem in Florida than more commonly reported illegal drugs such as cocaine, crack, heroin, ecstasy, crystal meth and marijuana, according to an article from Reuters. According to the Florida Medical Examiners Commission, deaths from abuse or misuse of prescription drugs exceeded deaths from all illegal drugs combined in 2007. In the 45-54 age group, deaths from prescription drugs exceeded is the number one cause of accidental death, displacing auto accidents.

One reason for the increase in prescription drug abuse is the ease with which people are able to obtain prescription drugs such as Oxycontin, Vicodin, Percocet, Xanax and others over the Internet without a prescription from a legitimate doctor, an issue which has been discussed here previously. According to the article, medical treatment for abuse of painkillers increased by 321% from 1995 to 2005.

The article points out that perception makes a difference and is fueling this problem. For instance, a parent may be more concerned about a child using marijuana than a dangerous drug like Oxycontin due to the stigma associated with marijuana and the relative lack of knowledge of the effects of taking various dangerous prescription drugs.

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Two mothers were recently arrested in Clay County, Florida for the crime of shoplifting for allegedly using their children to hide clothing, according to an article on News4jax.com. In a prior post, I discussed the various signs police and loss prevention officers look for to detect shoplifters. One of those signs is entering the store with something that can be used to conceal and steal merchandise. Common examples include loose clothing, large shopping bags and strollers, but anything that can be used to conceal items can bring a shopper to the attention of the authorities.

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In Florida, the legal limit for a driver’s blood or breath alcohol level (BAC) is .08. In other words, a driver in Florida may be arrested for, and convicted of, the crime of DUI if he/she drives with a BAC of .08 or higher. According to a recent article on Foxnews.com, a driver in Rhode Island was arrested after crashing on the highway and submitting to the Breathalyzer test which showed results of .489 and .491. According to the DUI officers, this was the highest BAC reading the police department had seen.

A breath or blood alcohol content reading over .40 is extremely rare during DUI investigations. It is amazing (and scary) that this person was able to start and operate a car at all in that condition. To put this in perspective, I have included an alcohol consumption chart which gives estimations as to the number of drinks a person needs to consume to have a BAC of 0.08 or higher. Please note that everyone is different, and this chart is a rough estimate. Factors such as: a person’s weight, body fat percentage, the amount of food and other liquid in the system, amount of time it took to consume the drinks, gender, body chemistry, the Breathalyzer machine itself and other factors can alter the BAC score for different people who have consumed the same number of drinks.

The alcohol consumption chart also discusses how a person’s blood alcohol level is likely to affect his/her normal faculties, which is another factor in a DUI investigation. According to the chart, when a person reaches a BAC of .30, he/she is likely in a stupor, does not know what is going on and is likely to pass out. At .40 or higher, the chart says the person should be in a coma and has a good chance of dying.

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The Jacksonville State Attorney’s Office recently decided to take another look at an incident where a Jacksonville Beach suspect (Theodore Gersdorf) cut off another person’s finger with a machete, according to an article at Jacksonville.com. Apparently, when Jacksonville police originally investigated the incident, the suspect claimed that he used the machete in self defense, and charges of aggravated battery against him were not pursued. However, according to the article, witnesses to the incident said that the suspect said he was going to his car to get “something that would take care of” the alleged victim and then left and returned with the machete. This, according to Jacksonville police, calls into question the suspect’s initial claim of self defense.

In Florida, the law pertaining to self defense allows a person to use deadly force to reasonably protect him/herself or another person from death or serious bodily harm and/or to prevent the occurrence of a forcible felony such as rape, robbery, burglary or kidnapping. In 2005, the law regarding self defense was changed to allow a person to use deadly force in public in one of the situations described above even if they could have fled the scene to avoid the threat. Prior to the change, a person who used deadly force in such a situation in public would have to show that he/she could not have otherwise escaped the threat. People in Florida were already permitted to use deadly force without fleeing in such a situation in their homes, vehicles or businesses.

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In Florida, it is illegal to have gambling operations that reward customers with cash, alcohol or cigarettes. Violation of the Florida gambling laws can subject an offender to administrative penalties (such as the loss of a business license and/or licenses to sell alcohol and tobacco) and criminal penalties as well as seizure and forfeiture of gambling apparatus and proceeds from gambling activity.

Recently, the Division of Alcohol, Beverages and Tobacco (ATB), the Department of Business and Professional Regulation (DBPR) and the local police department jointly investigated suspected gambling operations in Port Charlotte, Florida, according to a news release on the DBPR website. Those law enforcement officials seized video gaming machines at local restaurants and bars and made several arrests for the crime of keeping a gambling house, which is a third degree felony.

Any person or business that keeps gambling machines that pay cash or allow the customer to exchange a ticket for cash, alcohol or tobacco may be subject to such an investigation and the corresponding penalties and seizures. These investigations typically begin with undercover law enforcement officers playing the games and receiving the cash, alcohol or tobacco rewards and usually end with a raid, arrests and the seizure of all gaming machines and whatever cash and proceeds law enforcement officials want to say are related to the gambling operations.

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In the St. Augustine, St. Johns County, Florida area, police officers conducted a sting and caught several store clerks selling alcohol to a minor. Apparently, the St. Johns County Sheriff’s Office had a 17 year old investigative aid go into various stores and attempt to purchase alcohol, according to an article on Firstcoastnews.com. In seven of those stores, the clerks sold the alcohol to the minor and were arrested.

Under Florida law, it is a crime to sell, give or serve alcohol to a person under the age of 21. A violation of this law is a second degree misdemeanor and carries a maximum prison sentence of 60 days, a $500 fine and the possible loss of driving privileges.

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