111 charged in Medicare scams worth $225 million (AP)

MIAMI – Federal authorities charged more than 100 doctors, nurses and physical therapists in nine cities with Medicare fraud Thursday, part of a massive nationwide bust that snared more suspects than any other in history.

More than 700 law enforcement agents fanned out to arrest dozens of people accused of illegally billing Medicare more than $225 million. The arrests are the latest in a string of major busts in the past two years as authorities have struggled to pare the fraud that's believed to cost the government between $60 billion and $90 billion each year. Stopping Medicare's budget from hemorrhaging that money will be key to paying for President Barack Obama's health care overhaul.

Health and Human Services Secretary Kathleen Sebelius and Attorney General Eric Holder partnered in 2009 to allocate more money and manpower in fraud hot spots. Thursday's indictments were for suspects in Miami, Los Angeles, Dallas, Houston, Detroit, Chicago, Brooklyn, Tampa, Fla., and Baton Rouge, La.

They show that "health care fraud is not easy money," Holder said at a press conference in Washington.

A podiatrist performing partial toenail removals was among 21 indicted in Detroit. Dr. Errol Sherman is accused of billing Medicare about $700,000 for the costly and unnecessary procedures, which authorities said amounted to little more than toenail clippings. The podiatrist billed Medicare for 20 nail removals on three toes of one patient, according to the indictment. He charged Medicare about $110 for each procedure.

A message could not be left at Sherman's office Thursday.

A Brooklyn, N.Y., proctologist was charged with billing $6.5 million for hemorrhoid removals, most of which he never performed. Dr. Boris Sachakov claimed he performed 10 hemorrhoid removals on one patient, which authorities said is not possible. An employee who answered at Sachakov's office declined comment Thursday.

Sachakov had been arrested last year on charges related to a separate scam. Sachokov denied the charges.

Authorities also busted three physical therapy clinics in Brooklyn, run by an organized network of Russian immigrants accused of paying recruiters to find elderly patients so they could bill for nearly $57 million in physical therapy that amounted to little more than back rubs, according to the indictment.

In Miami, two doctors and several nurses from ABC Home Health Care Inc. were charged with swindling $25 million by writing fake prescriptions recommending nurses and other expensive aids to treat homebound patients, authorities said. The services were never provided. A message left Thursday was not immediately returned.

In total, nearly three dozen defendants were charged in Miami in various scams that topped about $56 million.

Thursday's totals exclude busts two days earlier in Miami that netted 21 suspects accused of bilking $200 million from Medicare.

"These unprecedented operations send a clear message. We will not tolerate criminals lining their pockets at the expense of Medicare patients and taxpayers," HHS Inspector General Daniel R. Levinson said.

For decades, Medicare has operated under a pay-and-chase system, paying providers first and investigating suspicious claims later. The system worked when the agency was paying hospitals and institutions that couldn't close up shop and flee the country if they'd been overpaid. But as Medicare has expanded to one of the largest payer systems in the world, he agency has struggled to weed out crooks. There are about 1.3 million licensed suppliers nationwide with 18,000 new applications coming in every month.

"We can arrest and charge people every day and it still won't make a dent until changes are made to Medicare," said FBI special agent in charge John Gillies.

He called for criminal background checks and fingerprints of providers. He also suggested Medicare use unique, secure numbers for patients instead of Social Security numbers, making it easier to cancel Medicare cards in fraud cases.

Sebelius has promised more decisive action on the front end, by vigorously screening providers and stopping payment to suspicious ones, under greater authority granted by the Affordable Care Act.

Authorities also announced Thursday they were adding strike forces in Chicago and Dallas.

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Associated Press Writers Pete Yost in Washington, Tom Hays in New York and Curt Anderson in Miami contributed to this report.

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Man charged with 3 murder counts in N. Va. attacks (AP)

MANASSAS, Va. – A Salvadoran man who was ordered deported nearly a decade ago but never left has been charged with three counts of first-degree murder in a series of shootings and a knife attack in a Virginia suburb of Washington, authorities said Friday.

Jose Oswaldo Reyes Alfaro, an illegal immigrant, was charged in the pair of attacks blocks apart Thursday night that left three people dead and three others injured, Manassas Police Chief Doug Keen said.

Reyes Alfaro knew all of the victims, he said, but police were still sorting out the exact relationships. The county's chief prosecutor said he'll likely seek to upgrade the charges to capital murder, which could carry the death penalty.

The killings touched off further discussion of illegal immigration in Manassas and surrounding Prince William County, which was one of the early flashpoints in the national debate over whether local authorities should play a role in enforcing the nation's immigration laws.

"It's another abject failure of the federal government," said state Delegate Jackson Miller, R-Manassas, a former city council member and police officer. "Now we have three innocent victims in my city — about a mile from my house there's a murderous rampage. I am furious. ... Yet it happens over and over and over again, and then we have to hear all of these apologetic excuses as to why we shouldn't be addressing criminal illegal aliens on the state or local level. It's just disgusting."

A similar uproar ensued in August when an allegedly drunken driver struck a car carrying three nuns, killing Sister Denise Mosier, 66. The man charged in that crash, 23-year-old Carlos Martinelly Montano, had been turned over to immigration authorities but was released pending a deportation hearing.

Nancy Lyall of the immigrant advocacy group Mexicans Without Borders said it was misleading to link an isolated criminal case with the issue of illegal immigration. In Prince William County, she said, "the undocumented population is a very, very low percentage of those who are accused of violent crimes."

She predicted that advocates of tougher immigration enforcement would use the Alfaro case to "stereotype every person that's here without documentation."

Chief Keen said that an immigration judge ordered that Reyes Alfaro be deported in 2002 after he failed to show up for a hearing. Immigration and Customs Enforcement spokeswoman Cori Bassett said in a statement that Reyes Alfaro officially was classified as a fugitive in 2006 and that the agency placed a detainer on him Friday, after his arrest on the murder charges.

While the Georgetown South development where the killings happened has been plagued with crime and some gang activity, Keen said the slayings were not gang-related.

Brenda Ashcraft, 56, and her son William Ashcraft, 37, were shot and killed in the first attack, which was called into police shortly after 7 p.m. Thursday. A 34-year-old woman was injured and remains hospitalized, and a 15-year-old girl was treated and released.

In the second attack, Keen said 48-year-old Julio Cesar Ulloa was shot and killed, and a 77-year-old woman suffered head wounds from a large knife.

Brenda Ashcraft's niece, Melissa King, said Friday that her aunt had been a victim of domestic violence by her boyfriend, whom she only knew as "Jose."

"He'd been causing trouble but she was too afraid to call police," King said, standing a few doors outside Ashcraft's home.

"They were good, good family, just full of love and support. This was not drug-related. This was not gang-related ... It was just domestic violence."

King said she has lived in the same neighborhood as her aunt her entire life.

"I know it's a bad neighborhood with crime, but so many people came out last night to offer us support. It was really like one big family," she said. She called her aunt "one of the rocks in our family. She'd give you her last piece of bread, her last dollar."

Reyes Alfaro made an initial appearance Friday morning in Prince William General District Court, and was ordered held without bond. His court-appointed lawyer, Kimberly Irving, declined to comment Friday except to say that she had only spoken with her client briefly.

Prince William Commonwealth's Attorney Paul Ebert said Friday that it's likely the charges will eventually be upgraded to capital murder — which would make Reyes Alfaro eligible for the death penalty — but a final decision has not been made because the investigation is still ongoing.

"Of course it's a very heinous crime," Ebert said.

Manassas, a city of nearly 37,000 about 30 miles west of the nation's capital, has averaged about two homicides a year since 2005, according to annual crime reports through 2009.

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Associated Press writers Dena Potter in Richmond and Ben Nuckols in Washington contributed to this report.

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Philadelphia church official charged in scandal (AP)

PHILADELPHIA – Nearly a decade after the scandal over sexual abuse by priests erupted, Philadelphia's district attorney has taken a step no prosecutor in the U.S. had taken before: filing criminal charges against a high-ranking Roman Catholic official for allegedly failing to protect children.

"I love my church," said District Attorney Seth Williams, himself a Catholic, "but I detest the criminal behavior of priests who abuse or allow the abuse of children."

Williams announced charges Thursday against three priests, a parochial school teacher and Monsignor William Lynn, who as secretary of the clergy was one of the top officials in the Philadelphia Archdiocese from 1992 to 2004.

The three priests and the teacher were charged with raping boys. Lynn, 60, was accused not of molesting children but of endangering them. A damning grand jury report said at least two boys were sexually assaulted because he put two known pedophiles in posts where they had contact with youngsters.

"The rapist priests we accuse were well-known to the secretary of clergy, but he cloaked their conduct and put them in place to do it again," the report said.

The grand jury report went further and suggested that the archbishop at the time, Cardinal Anthony Bevilacqua, who retired in 2003, may have known what was going on. But no charges were brought against him. The report said that there is no direct evidence against the cardinal and that his lawyer testified that the 87-year-old Bevilacqua is suffering from dementia and cancer.

"On balance, we cannot conclude that a successful prosecution can be brought against the cardinal — at least for the moment," the grand jury said.

Lynn could get up to 14 years in prison if convicted. His attorney, Tom Bergstrom, said: "We certainly don't concede for a moment that he knew he was putting children at risk."

Mark Crawford, New Jersey state director of the Survivors Network of those Abused by Priests, joined a few other activists for a rally Friday outside the archdiocese headquarters to welcome the charges.

"It's really incredible it's taken this long to say, 'Enough is enough,'" he said.

Five years ago, Williams' predecessor as district attorney issued a scathing report accusing the church of protecting child-molesting priests. But no charges were brought against the church, a huge and powerful entity in the Philadelphia region, where about one-third of the population is Catholic. With 1.5 million Catholics, the archdiocese is one of the biggest in the country.

The Rev. Thomas Doyle, a canon lawyer and one-time church insider who has become an advocate for victims of clergy abuse, said the charges against the monsignor reflect the shrinking power and influence of the Catholic Church since the crisis erupted in Boston in 2002.

"Up until now, there have been threats and the possibility of indictment, but for political reasons, people did not want to move in on the Catholic Church. It's never happened," Doyle said. "I really think this is a major breakthrough and I really hope that it is a signal and a sign of encouragement for district attorneys and federal prosecutors around the country."

Lynne Abraham, Williams' predecessor as district attorney, said the reason there haven't been charges before isn't political. She said victims are afraid to come forward when the wrongdoers are in positions of authority. And by the time the scandal unfolded, the statute of limitations had expired in the cases she investigated, she said.

Cardinal Justin Rigali, who succeeded Bevilacqua, said in a statement that the church is cooperating with authorities and would consider the grand jury's recommendations. He also said there are no priests working in the archdiocese who "have an admitted or established allegation of sexual abuse of a minor against them."

Outside the U.S., one Catholic bishop in France was convicted of shielding a priest in a sex-abuse. Pierre Pican, bishop of Bayeux-Lisieux in northwestern France, was sentenced to a three-month suspended prison term.

Over the past decade, prosecutors have pressed high-ranking church officials in the U.S. to accept responsibility for covering up abuse but never actually brought criminal charges against them as individuals.

For instance, Phoenix Bishop Thomas O'Brien admitted in 2003 that he sheltered abusive priests, an acknowledgment made as part of a deal with prosecutors that gave him immunity from any potential obstruction-of-justice charge. He agreed to institute reforms and cede some authority to other church officials.

The Diocese of Manchester, N.H., admitted wrongdoing but avoided criminal charges in 2003. The Archdiocese of Cincinnati pleaded no contest in 2003 to charges of failing to tell authorities about sex abuse claims against priests, paid a fine and created a fund for victims.

And in 2005, the Boston Archdiocese struck a deal to avoid an unprecedented federal indictment on allegations of making a false statement to federal authorities. Among other things, the archdiocese agreed to closer scrutiny of its child-protection programs.

The Philadelphia District Attorney's Office also convened a grand jury in 2002 to look into abuse by priests since the 1960s. Its report, issued in 2005, said that there was evidence of abuse by at least 63 priests and that church officials had transferred offenders to other parishes and dioceses. While Bevilacqua and other church officials were criticized, none were charged.

Abraham, district attorney at the time of the 2005 report, which included names and photographs of allegedly abusive priests, said Friday that it was the statute of limitations that held her office back. She joined other advocates in pressing for Pennsylvania's child protection laws to be rewritten. She said the resulting changes helped clear the way for the charges Williams brought.

In a statement announcing the case against the five defendants Thursday, Williams said: "I know ultimately they will be judged by higher authority. For now, it is my responsibility as the elected district attorney of all the citizens of Philadelphia to hold them accountable."

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Lavoie reported from Boston. Associated Press Religion Writer Rachel Zoll in New York and videographer Angie Yack in Philadelphia also contributed.

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