Joshua Miller
SYRACUSE, NEW YORK — A licensed New York hearing aid dispenser and owner of Syracuse Hearing Aid Centers, LLC, was arrested Monday morning on charges that he operated a criminal scheme. According to a news release on November 23rd, the business is alleged to have fraudulently billed more than $1.6 million by selling public employees custom fit earbuds, but then billing the state insurance for hearing aids—worth more than three to ten times as much.
A grand jury indictment charged Joshua Miller, age 37, with first and second-degree grand larceny and first-degree healthcare fraud.
The business owner’s scheme lured hundreds of state employees into his criminal enterprise which was breathtaking in its scope, duration and pretense”
–Leahy Scott, New York Inspector General
Referral Fees, False Claims
In the course of investigation, the New York Inspector General’s office discovered that between May 2012 and December 2014, Miller solicited hundreds of state employees with promises of high quality earbuds or electronic hearing protection devices—all with no out-of-pocket expenses.
The individuals who came to Miller’s office were provided with either the Tunz Custom Audio Monitor earbuds or Audibel SoundGear or Magnum Ear electronic earplugs, which are marketed to hunters and sport shooters. After being fit with the devices, the company then billed United Healthcare insurance for $3,000 per ear—the maximum amount allowed for a hearing aid under the Empire Plan for NY state employees.
Most of the state employees that came to Miller’s office were solicited by a corrections officer who recruited his coworkers in the prison system, as well as the Upstate Medical University hospital. Miller is said to have paid the officer nearly $70,000 in referral fees.
Fraudulent charges of hearing aid fittings for relatives of those seen at Miller’s office were also discovered, when in fact, no devices were ever provided.
Continuing Investigation
A total of 575 allegedly fraudulent claims were billed through United HealthCare, amounting to $1.65 million dollars.
“This is a substantial fraud and theft perpetrated on the taxpaying citizens of the State of New York. As I have made clear on numerous occasions, stealing from taxpayers will be met with aggressive investigation and prosecution to the fullest extent of the law.” –Onondaga District Attorney, William J. Fitzpatrick
Miller was sent to the Onondaga County Jail on Monday, after being arraigned on the indicted charges.
According the Inspector General’s office, further arrests are expected in coming days of those who may have also knowingly been involved in the fraudulent billing scheme.
Take a look at this business’ BBB profile. Looks like BBB failed to report a previous fraud complaint and still maintains an A+ rating for the business.
Complaint: My husband and I attended the NYS Fair In Aug 2013 when we encountered Audibel Hearing in a booth in the Health Building at the fair. We were greeted by the owner, Mr **** ****** who explained to my husband the custom made earphones for ***** use. I was then asked if I would like to be fitted for a pair, and I said “No I have no interest in them. At that point my husband filled out the forms which asked for his ss#. He also asked if we wanted our 3 kids to be fitted, at that point Mr ****** said “just put their names on the sheet and you can ask them if they would like to come into the office. My husband then called Mr ******’s office 1 week later and told the office to take off our 3 kids that they did NOT wish to purchase or be fitted for the earphones. The office responded that they would take care of removing the names from the sheet of paper. In the beginning of october, I received 4 checks from the insurance company, one for me, my husband and 2 of our 3 children in the amount of of 3,000 each. I called our insurance company and asked “why were we getting these checks , the insurance company stated that Audibel put claims in for me, my husband and our 3 kids, I asked well we only got 4 checks where was the 4th check? The insurance company stated that one of the checks for my son (who never purchased this earphone) got sent to Audibel. I explained to the insurance company that there should have been only 1 claim submitted for my husband who filled out the form, I never gave audibel any information nor did my 3 kids . The insurance company told us to call Audibel and have them call the insurance company to get straightned out I called Audibel and spoke to the receptionist she stated that the other receptionist made a “mistake” and that they would call the insurance company to take care of it. I asked them what did they do with the 3,000 check that was sent for my son who never purchased this product and they stated that they cashed the 3,000 check and deposited it. I told them that they had to return that 3,000 to the insurance company. A few weeks later they called to let my husband know his earphones were ready to be picked up. I told them I refused to pick up the product until the check was returned to the insurance company. I then called the insurance company and they said they had NOT heard from Audibel. Beginning of Decemeber I was called by Audibel to pick up my earphones, again I let them know I would not pick up anything until the check was returned to the insurance company. In January I got a bill from the insurance company stating I OWED Audibel for 5 sets of earphones!!! Which were NOT purchased, other than the 1 pair!!! I called the insurance company and stated AUDIBEL never returned the check or contacted the insurance company, at that point I was connected to the FRAUD DEPARTMENT. The fraud department instructed me to write a detailed letter of the whole Fraudulent incident!! We sent back the uncashed insurance checks by certified mail. We are now waiting the investigation results!! This company is fraudulently filing claims!!! Had the checks gone straight to Audibel they would have cleaned up without nobody knowing!! How many other claims are out there!!! Fraud is what Audibel is all about they even offered my husband a $25.00 finder fee for any referral he could give them!! Billing our insurance for a over priced device that the insurance paid them $3,000 is a JOKE. Please investigate them!!! How many other people did they take advantage of!!
Desired Settlement: CLOSE THE DOORS ON THE BUSINESS THAT COMMITS FRAUD!
Business Response: BBB spoke to **** at business and the following was relayed: Insurance was billed and check that was received was returned. Nothing was ever paid.
Consumer Response: When you said that you contacted **** at Audibel, he said that he sent the check back to the insurance company. This was not true. His office informed me during our initial contact that they cashed the check. I returned the checks that I received, his office did not. When I received confirmation from my insurance company that they had received my returned checks I asked if they, Audibe, had returned the money that they were given and they did not.. The insurance company switched my name with my sons name (that was on the check Audibel received) in there files during our last phone conversation. Again, **** never sent back the insurance check. I had to straighten out the mess his office created myself with the help of my insurance company.
Business Response: BBB spoke to **** and he stated that this has all been resolved and taken care of. BBB has made multiple attempts to contact consumer and confirm but have been unable and no calls have been returned.
Here’s the Rest of The Story:
Corrections Officers Implicated in Healthcare Fraud
We see many unusual False Claims Act cases. Criminals can be very enterprising. Their creativity is often amazing. Ultimately, most get caught and usually after a whistleblower steps forward and reports their wrongdoing. Unfortunately, it appears that New York State corrections officers and troopers are at the heart of this fraud.
Our story begins with Joshua Miller and the business he owns, Syracuse Hearing Aid Centers. If what prosecutors are saying is accurate, Miller’s scheme is one of the more creative frauds we have seen.
Hearing aids are certainly not a glamour business. Unless you suffer from hearing loss, you probably have never seen the inside of a hearing aid store.
Onondaga County New York prosecutor William Fitzpatrick claims that our alleged fraudster, Joshua Miller, decided to expand his business into high end headphones. Commonly used to listen to music or play video games, these headphones retail between $200 and $300 apiece. Not many audiophiles visit their nearby hearing aid store when shopping for audio gear. Miller is not your ordinary entrepreneur, however.
Miller’s ticket to paradise? He sold them to state employees and billed the New York State employees healthcare plan, Empire, for $3000 a piece. Prosecutors say he bilked taxpayers and Empire out of an estimated $1.65 million dollars.
To make the scheme work, Miller told the state’s insurer that the headphones were actually high tech hearing aids and that they were “medically necessary. They weren’t. An audit later revealed that well over 90% of the recipients had no hearing deficit and didn’t need hearing aids (let alone music headphones).
Normally the story would end here. New York’s State Inspector General, Catherine Leahy Scott, claims that most of the headphones were obtained by corrections officers and troopers. After announcing Miller’s arrest, Leahy Scott said, “I will continue this investigation into the theft of state funds, follow the evidence wherever it leads, and pursue and hold accountable anyone who uses their state position … in furtherance of a criminal scheme.”
Where will the “evidence lead?” It appears to eight upstate New York prisons, a drug treatment center and at least one state trooper barracks. Published reports say that one corrections officer has already been implicated in the scam after reportedly receiving $70,000 in referral fees from Miller.
Thus far, there has only been one arrest, although more are expected.
And where is Joshua Miller? As of last week, he was in the Onondaga County jail, in lieu of $50,000 cash bail. If the prosecutor’s allegations are true, some of Miller’s jailers may soon become cellmates.
Healthcare fraud costs taxpayers billions each year. Because state employees receive taxpayer funded healthcare, fraud against the program is both a felony and a violation of the New York False Claims Act. The latter pays whistleblowers up to 30% of whatever the government collects from wrongdoers. Last year, the U.S. Department of Justice paid over $435 million in whistleblower awards.
Whistleblowers can make a real difference in the fight against fraud and corporate greed. To qualify for an award under the federal program (and in most states that have a state false claims law), one must retain a lawyer and file a sealed lawsuit in court. The suit must be based on original source (inside) knowledge. Generally only the first to file receives an award.
http://www.prisonpath.com/corrections-officers-implicated-in-healthcare-fraud/