DAILY UPDATE: UnitedHealth Group Alert as Stocks End Slightly Mixed

Posted on May 16, 2025 by Dr. David Edward Marcinko MBA MEd CMP™

MEDICAL EXECUTIVE-POST – TODAY’S NEWSLETTER BRIEFING

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The Justice Department is investigating UnitedHealth Group for possible criminal Medicare fraud, the WSJ reported. The healthcare-fraud unit of the Justice Department’s criminal division is overseeing the investigation and it has been an active probe since at least last summer. Apparently the federal investigation is focusing on the company’s Medicare Advantage business practices. UnitedHealth said in a statement it hadn’t been notified by the Justice Department of the criminal investigation. The statement said the company stands “by the integrity of the Medicare Advantage program.”

CITE: https://tinyurl.com/2h47urt5

🟢 What’s up

  • Foot Locker exploded 85.70% on the news that Dick’s Sporting Goods will acquire the footwear retailer for $2.4 billion. Dick’s shares sank 14.58%.
  • Speaking of shoes, Boot Barn soared 16.66% thanks to the Western footwear seller’s record revenue last quarter.
  • And in more shoe news, Birkenstock gained 5.89% after the purveyor of the world’s ugliest sandals missed revenue estimates but beat on profits.
  • Under Armour rose 4.47% after the sportswear retailer issued a “meh” earnings report and pulled its fiscal forecast.
  • Cisco climbed 4.85% after the networking company beat Wall Street analysts’ expectations and also issued better-than-expected fiscal guidance.
  • Hopefully you botta ’da stock: Ibotta rocketed 20.01% higher on strong earnings for the cash-back app.

What’s down

  • Apple fell 0.41% on news that President Trump scolded Tim Cook for trying to build iPhones in India.
  • Meta Platforms dropped 2.35% thanks to a Wall Street Journal report that the social media giant has delayed the debut of its flagship AI model.
  • UnitedHealth Group plummeted 10.93% on a Wall Street Journal report that the health insurer is being investigated for criminal Medicare fraud.
  • Ubisoft plunged 13.28% after the video game studio reported a 20.5% decline in net bookings last quarter.
  • Coinbase crumbled 7.20% on news that hackers bribed employees to steal customer information and that it will take $400 million to fix the mess.
  • DXC Technology sank 3.26% thanks to shockingly low fiscal guidance from the IT company.
  • Fiserv’s CFO said that the fintech’s retail payment system will see similar volume next quarter. Shareholders hoping for stronger growth were disappointed and pushed shares down 16.19%.

CITE: https://tinyurl.com/tj8smmes

Visualize: How private equity tangled banks in a web of debt, from the Financial Times.

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SCAMS: Pig Butchering

Posted on February 15, 2025 by Dr. David Edward Marcinko MBA MEd CMP™

By Staff Reporters

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What Is a Pig Butchering Scam?

Pig butchering scams get their colorful (and gory) name from the process of fattening hogs before slaughtering them. Except in this case, it’s a scammer making friends with you before taking your money. These cons have four distinct phases:

  1. Initial contact is made by a scammer. The scammers are often enslaved by organized crime rings who force them to contact potential victims through social media platforms, dating apps, online networking sites, and job boards.
  2. Fattening, a phase where the scammer gets to know and builds trust with a victim. They may pretend to be romantically interested in the victim, befriend the victim, or offer the victim a job.
  3. Slaughter refers to the phase where the con pays off. Scammers may persuade victims to send them money, invest in a fake company or cryptocurrency, or reveal sensitive personal information that can be used for identity theft. Over time, scammers ask for large sums of money threatening to end contact if victims refuse to pay.
  4. Shaming and disappearance. Scammers will continue their relationship with the victim until the victim is unable to pay or catches onto the scam. Scammers may taunt their victims to shame them into silence, or they may simply vanish along with any accounts, websites, or apps they’ve been using.

How to Avoid Pig Butchering Scams:

To avoid becoming a victim of a pig butchering type scam, watch for these red flags and know how to protect yourself:

  • Unexpected contact: Never respond to unsolicited messages from unknown contacts, even about seemingly benign topics, especially via text message and on encrypted messaging applications.
  • Refusal to participate in video chats: If someone you’ve been messaging with consistently declines to interact face-to-face, they likely aren’t the person from the profile photo.
  • Request for financial information: Don’t share any personal financial information with individuals you’ve never met in person. If a new virtual friend or romantic connection starts making financial inquiries, put the brakes on the relationship.
  • Invitation to invest in specific financial products: Be wary of any unsolicited investment advice or tips, particularly from someone you’ve only spoken to online and even if they suggest you trade through your own account. Always question what a source has to gain from sharing tips with you and whether the transaction fits with your financial goals and investment strategy.
  • Unknown or confusing investment opportunity: Carefully evaluate the product, as well as the person and/or company requesting your investment. Along with a basic search, try adding words like “scam” or “fraud” to see what results come up. Consider running recommendations by a third party or an investment professional who has no stake in the investment, and use FINRA BrokerCheck to see if the promoter is a registered investment professional.
  • Unfamiliar trading platforms: Do extensive research before moving any money, particularly in an emerging market like cryptocurrency, which has hundreds of exchanges and new avenues for trading continuing to evolve. Who controls the platform? What security measures are in place? How can you withdraw funds if needed? If you don’t know the answers to those questions, don’t put your assets there.
  • Exaggerated claims and elevated emotions: Take a closer look at any investment that offers much higher than average returns or is touted as “guaranteed.” Fraudsters will also often use their knowledge about you to appeal to your emotions—something like, “Don’t you want to have money to send your kids to college?”
  • Sense of urgency about an upcoming news announcement or share price increase: Remember that insider trading is illegal, and you should never trade in shares of a company on the basis of material, nonpublic information.

MORE:

Learn more about how to protect your money from fraud and get more insight from the FBI and the Financial Crimes Enforcement Network (FinCEN) on pig butchering schemes involving cryptocurrency.

If you think you’ve been a victim of a pig butchering stock scam, submit a regulatory tip to FINRA. If you think you’ve been the victim of internet fraud, file a report with the FBI’s Internet Crime Complaint Center.

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PODCAST: CMS Over-Payments to Medicare Advantage [Part C] Plans

Posted on December 5, 2022 by Dr. David Edward Marcinko MBA MEd CMP™

By Eric Bricker MD

RISK ADJUSTMENTS EXPLAINED

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UPDATE: SPACS, Markets and Covid-19 Fraud

Posted on September 21, 2022 by Dr. David Edward Marcinko MBA MEd CMP™

By Staff Reporters

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Chamath Palihapitiya, the billionaire investor who once claimed to be the next Warren Buffett, is winding down two of his special purpose acquisition companies (SPACs) and returning $1.5 billion to investors. It marks the symbolic end to the SPAC bubble that Palihapitiya is credited with instigating.

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  • Markets: Investors pre-gamed the Fed’s big interest rate decision coming this afternoon by sending stocks lower and Treasury yields higher; they’re sweating what’s expected to be the central bank’s third 75-basis-point hike in a row to tamp down inflation. Speaking of inflation, Ford’s stock had its worst day in 11 years after warning of $1 billion in extra supplier costs.

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Finally, the Justice Department charged 47 people for allegedly carrying out the single largest Covid relief fraud scheme to date. Feds say that by exploiting a program meant to feed needy Minnesota children, the defendants stole $250 million. Prosecutors say the fraud was committed by a network of individuals connected to the nonprofit Feeding Our Future and was overseen by the nonprofit’s founder, Aimee Bock. Feeding Our Future was one of a handful of organizations Minnesota trusted to oversee the distribution of meals to children in low-income families during the pandemic. Instead, prosecutors allege, the organization operated a “pay-to-play scheme” in which individuals submitted fake meal sites and children’s names, raking in government money with fraudulent invoices.

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TELE-MEDICINE Fraud, Abuse and New Barriers!

Posted on January 18, 2022 by Dr. David Edward Marcinko MBA MEd CMP™

Telemedicine: Fraud and Abuse During the COVID Pandemic

By Susan Walberg

The COVID-19 pandemic has brought with it huge challenges for people all over the world; not only the obvious health-related concerns but also shutdowns, unemployment, financial difficulties, and a variety of lifestyle changes as a result.

When the COVID pandemic struck, CMS quickly recognized that access to care would be an issue, with healthcare resources strained and many providers or suppliers shutting down their offices or drastically limiting availability. Patients who needed routine care or follow-up visits were at risk for not receiving services during a time when healthcare providers were scrambling to enhance infection control measures and implement other new safety standards to protect patients and healthcare workers.

The Centers for Medicare and Medicaid Services (CMS) has responded by easing restrictions and regulatory burdens in order to allow patients to receive the healthcare services they need without undue access challenges. One key area that has changed is the restrictions related to telehealth services, which were previously only paid by Medicare under certain circumstances, such as patients living in remote areas.

Among the changes and waivers CMS has offered, telemedicine reimbursement is among the more significant. Telemedicine services, which includes office visits and ‘check ins’ are now allowed and reimbursed by Medicare. In addition to reimbursement changes, CMS has also relaxed the HIPAA privacy and information security enforcement standards, paving the way for providers to adopt a new model of providing services electronically.

TELE-HEALTH BARRIERS: https://www.statnews.com/2021/07/13/telehealth-provisions-emergency-patients/

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MORE:  https://medicalexecutivepost.com/2021/05/18/fraud-schemes-of-few-medical-providers/

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What Exactly is a PONZI SCHEME; etc?

Posted on September 22, 2021 by Dr. David Edward Marcinko MBA MEd CMP™

AND OTHER INVESTING SCAMS!

By Dr. David E. Marcinko MBA CMP®

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A Ponzi scheme (/ˈpɒnzi/, Italian: [ˈpontsi]) is a form of fraud that lures investors and pays profits to earlier investors with funds from more recent investors. Recall Bernie Madoff.

More: https://medicalexecutivepost.com/2010/06/04/the-madoff-circle/

The scheme leads victims to believe that profits are coming from legitimate business activity (e.g., product sales or successful investments), and they remain unaware that other investors are the source of funds. A Ponzi scheme can maintain the illusion of a sustainable business as long as new investors contribute new funds, and as long as most of the investors do not demand full repayment and still believe in the non-existent assets they are purported to own.

Link: https://en.wikipedia.org/wiki/Ponzi_scheme

A pyramid scheme is a business model that recruits members via a promise of payments or services for enrolling others into the scheme, rather than supplying investments or sale of products. As recruiting multiplies, recruiting becomes quickly impossible, and most members are unable to profit; as such, pyramid schemes are unsustainable and often illegal.

CITE: https://www.r2library.com/Resource/Title/0826102549

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How to Spot and Protect Yourself From Investment Fraud

Pyramid schemes have existed for at least a century in different guises. Some multi-level marketing plans have been classified as pyramid schemes.

And, there are MANY other schemes in the financial services sector.

MORE: https://www.msn.com/en-us/money/other/are-you-about-to-be-the-victim-of-a-ponzi-scheme/ar-BB1cqabu?li=BBnb7Kz

Front Running: https://medicalexecutivepost.com/2018/02/06/what-is-front-running/

Churning: https://medicalexecutivepost.com/2021/07/23/churning-front-running-and-pumping-dumping/

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IRS Cracking Down on Tax Identity Fraud

Posted on November 2, 2012 by Dr. David Edward Marcinko MBA MEd CMP™

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About Stolen Identity Refund Fraud [SIRF]

[By Children’s Home Society of Florida Foundation]

The IRS, the Justice Department and Congress all recognize that stolen identity refund fraud (SIRF) is a major and growing problem. With the increase in electronic filing, individuals are obtaining the Social Security numbers and names of other persons and filing to claim their tax refunds. The Justice Department estimates that there could be up to $26 billion in fraudulent refunds over the next five years.

Assistant Attorney General Kathryn Keneally of the Tax Division of the Justice Department conducted a briefing on September 27 in Washington. She acknowledged, “The stolen identity refund fraud cases present a different kind of crime than we usually see.” Keneally continued and explained the depth of the problem. Treasury officials understand that greater efforts are needed by the IRS, Department of Justice and U.S. Attorney’s Office to confront the problem.

How Identity Thieves Work

How do most identity thieves operate? The essential information for an identity thief is a name and a Social Security number. There are at least three ways that identity thieves are collecting this information and receiving tax refunds.

  1. First, some have persuaded a postal employee to intercept multiple refunds to an address.
  2. A second strategy might involve the use of a doorman to direct refund checks to the identity thief.
  3. Third, bank tellers have been bribed to collect the personal information necessary for the identity thief to file and obtain a fraudulent refund.

Geographic Dispersion

Two areas of the country are particularly affected. Southern District of Florida U.S. Attorney Wilfredo Ferrer acknowledged the problem there. He stated, “This is the fastest growing and most insidious fraud in this district right now. It’s sort of like the crime du jour.” He is regularly finding victims “from all walks of life” who had their identities stolen so the thief could collect a “bogus tax refund.” Ferrer disclosed that there are even victims who work in the office of the U.S. Attorney.

Another area with a significant problem is the Southern District of New York. Deputy U.S. Attorney Richard Zabel pointed out that many New York thieves are involved in tax fraud. He stated, “It’s like Willy Sutton – Why do you rob banks? Because … that’s where the money is!

Well, if you’re doing identity theft, the big money is in the Federal Government’s bank account.”

e-Filing Challenges

The IRS recognizes the challenge with eFiling. On the one hand, the IRS has greatly improved the speed of refunds for lawful taxpayers who eFile. In addition, the eFiling of tens of millions of tax returns saves a huge amount of time and cost for the government in processing tax returns.

However, the challenge with eFiling is that the thieves are able to obtain information and file before the legitimate taxpayer. By the time the actual taxpayer files, the thief has received the refund. In some cases, thieves have promptly transferred the funds outside of the United States.

Large Scale Networks

Some thieves are operating on a fairly large scale. Attorney Zabel referred to one case in New York in 2009. Two individuals filed 7,000 false returns and requested a total of $72 million in refunds. Because the refunds were sent to the same address, the fraud was discovered.

Congressional Legislation

Congress has several bills under consideration that would address the problem. Keneally noted that there are also several regional tax task forces that are moving forward to find and prosecute identity thieves. The Department of Treasury, Department of Justice and the U.S. Attorney’s offices are all cooperating.

Assessment

In addition, the IRS is updating its computer software. If there are multiple refunds to one address or indications that the refund may not be appropriate, the software will “flag” the return for greater review.

Conclusion

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