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DOJ Charges Healthcare CEO with Criminal Securities and Healthcare Fraud

Posted  06/12/20
Hands in handcuffs behind back of white man in business suit
In 2008, Rahm Emanuel, then-President Obama’s chief of staff, famously said, “You never want a serious crisis to go to waste.  I mean, it’s an opportunity to do things that you think you could not do before.”  However poorly phrased, generations of political and business leaders have understood the kernel of truth in his admonition. So have scammers and rip-off artists. We have been following the...

Charges Filed in Shameful COVID-19 and Genetic-Cancer-Screening Test Scam

Posted  04/3/20
Erik Santos of Braselton, Georgia had run a fraudulent genetic cancer-screening-test scheme for months, then spotted an opportunity capitalize on fear surrounding COVID-19.  According to the criminal complaint, Santos targeted elderly persons to determine if they met certain eligibility requirements for testing under government health-care programs.  He passed the information along to co-conspirator testing...

Treble Damages Awarded in Medicare Whistleblower Case

Posted  02/21/20
specimen jar
The Fifth Circuit upheld a 2018 lower court decision this week, finding defendant BestCare Laboratory Services, LLC and its owner Karim Maghareh liable for treble damages—to the tune of just over $30 million—under the False Claims Act. BestCare provided clinical testing services for nursing home residents, many of whom were Medicare beneficiaries. Rather than billing for a technician’s travel to and from the...

Catch of the Week — Comprehensive Pain Specialists Targeted for Urine Drug Testing Fraud

Posted  07/26/19
Laboratory sample vial lying on procedure coding form
Our Catch of the Week goes to Comprehensive Pain Specialists (CPS), a now-shuttered pain-management chain that was once one of the largest in the nation, treating as many as 48,000 pain patients a month at about 60 clinics across 11 states.  CPS shut down in 2018 with little warning to patients and employees. On Monday, July 22, the United States and the State of Tennessee announced their partial intervention in...

Catch of the Week – Inform Diagnostics

Posted  02/1/19
Technician in laboratory safety wear using eyedropper to fill vials of blood
Texas-based pathology laboratory company Inform Diagnostics, formerly known as Miraca Life Sciences Inc., agreed on January 30th to a $63.5 million settlement to resolve allegations it violated the False Claims Act (“FCA”), the Anti-Kickback Statute (“AKS”), and the Stark Law by providing subsidies to referring physicians for electronic health record (“EHR”) technology as well as free or discounted...

Genetic Testing Company Settles Whistleblower Suit for $11.4M

Posted  03/14/18
Silicon Valley-based Natera, Inc. agreed to pay over $11 million to resolve claims it improperly billed government healthcare programs for its non-invasive prenatal tests and screenings in violation of the False Claims Act by billing for the tests with an incorrect billing code. In resolution of the allegations, Natera will pay over $10.6 million to the federal government and $756,183 to a number of state Medicaid...

Family Medicine Centers Settles Whistleblower False Claims Act Charges

Posted  09/12/17
By the C|C Whistleblower Lawyer Team A South Carolina family medical practice chain, along with its owner and laboratory director, agreed to pay roughly $2 Million to settle charges of violating the False Claims Act and Stark Law which prohibits physician self-referrals. Specifically, Family Medicine Centers of South Carolina (FMC) agreed to pay $1.56 million, and FMC's principal owner Dr. Stephen F. Serbin and...

Poplar Healthcare to Pay Nearly $900k to Resolve Whistleblower’s False Claims Act Allegations

Posted  05/3/17
By the C|C Whistleblower Lawyer Team The Justice Department announced the settlement on Monday, which resolves allegations that Memphis’s Poplar Healthcare and its subsidiary GI Pathology promoted and billed the government for medically unnecessary diagnostic tests. Poplar allegedly marketed certain stain tests as capable of definitely diagnosing a condition called mast cell enterocolitis. But according to...

DOJ Secures $11.4 Million FCA Settlement

Posted  04/26/17
By the C|C Whistleblower Lawyer Team Yesterday, the Department of Justice announced that as Pacific Pulmonary Services will pay $11.4 million to settle a False Claims lawsuit.  At issue in the case were allegedly false claims to Medicare and other federal healthcare programs for oxygen and related equipment supplied in violation of program rules, as well as claims for sleep therapy equipment tainted by a kickback...

Sleep Disorder Fraud: With the uptick in sleep disorder services and government spending comes the discovery of schemes and scams.

Posted  01/26/16
By Jessica Moore, published in ADVANCE Healthcare Network  Increasing numbers of troubled sleepers are seeking diagnosis and treatment of chronic sleep disorders that affect more than fifty million Americans.  The significant growth in sleep medicine over recent years brings increasing opportunities for the unscrupulous to engage in fraudulent services and billing of federal and state heath care programs that...
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