Contact

Click here for a confidential contact or call:

1-212-350-2774

Archive

Page 1 of 70

September 13, 2023

Texas-based Oliver Street Dermatology Management LLC, which manages dermatology practices, surgical centers, and pathology labs across the country, has agreed to pay $8.9 million to resolve self-reported violations of the Anti-Kickback Statute, Stark Law, and False Claims Act.  The company revealed in 2021 that some of its former senior managers had fraudulently increased the purchase price of 11 dermatology practices acquired between 2013 and 2018 in exchange for referrals.  Claims arising from those referrals were found to have been submitted to Medicare.  USAO NDTX

Tagged in: Anti-Kickback and Stark, FCA Federal, Healthcare Fraud, Medicare, Reporting to Government,

August 31, 2023

Watermark Retirement Communities LLC, which manages 79 retirement homes across the country, has agreed to pay $4.25 million to settle claims of violating the Anti-Kickback Statute and False Claims Act.  According to a lawsuit launched by David Freeman, the former director of strategic growth for a nationwide home health agency (HHA), between 2014 and 2020, Watermark solicited and received kickbacks from the HHA in exchange for referrals of Medicare beneficiaries from 8 of its retirement facilities in 5 states, including Arizona, Connecticut, Delaware, Florida, and Pennsylvania.  Watermark then caused false claims to be submitted in connection with those referrals.  DOJ

Tagged in: Anti-Kickback and Stark, FCA Federal, Healthcare Fraud, Home Health and Hospice, Medicare, Whistleblower Case, Whistleblower Rewards,

August 30, 2023

Lompoc Valley Medical Center (LVMC) has agreed to pay $5 million to resolve allegations of causing false claims to be submitted to California’s Medicaid program.  Under the Patient Protection and Affordable Care Act (ACA), Medi-Cal received federal funds to expand coverage to previously uninsured adults.  However, LVMC knowingly claimed and received payments from the government for services that were duplicative, not reimbursable, or not priced at fair market value.  CA AG

Tagged in: FCA Federal, FCA State, Healthcare Fraud, Medicaid, Medical Billing Fraud,

August 18, 2023

A doctor who defrauded California’s Medicaid program of over $20 million has been sentenced to 5 years in jail, ordered to pay $2.3 million in restitution, and forced to surrender his medical license.  Mohamed Waddah El-Nachef had pleaded guilty to prescribing medically unnecessary anti-psychotics, HIV medications, and opioids to over a thousand Medi-Cal beneficiaries, many of whom then sold the drugs for cash.  CA AG

Tagged in: Healthcare Fraud, Lack of Medical Necessity, Medicaid, Provider Fraud,

August 18, 2023

The owner and operator of Georgia-based LabSolutions LLC has been sentenced to 27 years in prison for submitting over $463 million in medically unnecessary genetic and other laboratory tests derived from illegal kickbacks.  Minal Patel allegedly paid kickbacks to telemarketing companies to talk Medicare beneficiaries into getting the tests, then paid kickbacks to telemedicine doctors who signed orders for the tests without ever speaking to beneficiaries to determine need.  As a result of these fraudulent actions, Medicare paid over $187 million in reimbursement, with Patel receiving over $21 million personally, between 2016 and 2019.  DOJ

Tagged in: Anti-Kickback and Stark, Criminal Proceedings, Healthcare Fraud, Laboratory and IDTF, Lack of Medical Necessity, Medicare,

August 8, 2023

Pharmaceutical drug manufacturers Shire PLC, Baxter International Inc., Baxalta Inc., Viropharma Inc., Takeda Pharmaceuticals U.S.A., Inc., and Takeda Pharmaceuticals America have agreed to pay more than $42 million to settle a qui tam suit alleging violations of the Texas Medicaid Fraud Prevention Act.  According to an unnamed whistleblower, the companies allegedly directly or indirectly provided payments or nursing services to Medicaid providers in exchange for referrals or recommendations of a particular drug.  TX AG

Tagged in: FCA State, Healthcare Fraud, Medicaid, Pharma Fraud, Whistleblower Case,

August 4, 2023

Aspirar Medical Lab LLC and owner Pick Chay have agreed to pay almost $2 million to resolve allegations of defrauding the North Carolina Medicaid program.  The company allegedly paid two other companies for referring medically unnecessary urine drug tests to it, then submitted claims stemming from these illegal kickbacks to Medicaid.  NC AG

Tagged in: FCA State, Healthcare Fraud, Laboratory and IDTF, Lack of Medical Necessity, Medicaid,

August 1, 2023

A now defunct clinical laboratory in Texas, BestCare Laboratory Services LLC, and its owner, Karim Maghareh, have agreed to pay another $5.7 million on top of nearly $800,000 already paid to the government to resolve an outstanding obligation under a 2018 judgment for violating the False Claims Act.  The underlying lawsuit, filed in 2008 by whistleblower Richard Drummond, alleged that BestCare billed Medicare for travel by lab technicians that did not reflect the actual mileage traveled.  DOJ

Tagged in: FCA Federal, Healthcare Fraud, Laboratory and IDTF, Medicare, Whistleblower Case, Whistleblower Rewards,

July 31, 2023

Martin’s Point Health Care Inc. in Maine has agreed to pay almost $22.5 million to resolve a lawsuit by a former manager in its Risk Adjustment Operations group, which alleged the health plan administrator defrauded Medicare over a three year period.  The former manager, Alicia Wilbur, alleged that Martin’s Point reviewed charts for their Medicare Advantage beneficiaries to identify additional diagnosis codes, then submitted those codes in claims to Medicare in order to increase reimbursements even though they were not properly supported by patient medical records.  For blowing the whistle on this misconduct, Wilbur will receive a $3.8 million award.  DOJ

Tagged in: FCA Federal, Healthcare Fraud, Medical Billing Fraud, Medicare, Provider Fraud, Whistleblower Case, Whistleblower Rewards,

July 11, 2023

The owner of one of California’s largest chains of pain management clinics has agreed to pay nearly $11.4 million to the federal government and the states of California and Oregon to settle allegations of defrauding Medicare and state Medicaid programs of millions of dollars.  A nearly four-year investigation by government data analysts found that Dr. Francis Lagattuta and his business, Lags Medical Clinics—which operates more than 20 facilities in California and Oregon—billed the healthcare programs for medically unnecessary tests and procedures that were provided to every patient as part of clinic protocols.  The investigation also found that patients who did not consent to such procedures had their pain medication reduced.  Furthermore, a respiratory therapist who was the spouse of an executive was recruited to interpret certain test results despite having no formal medical training.  In addition to the monetary penalty, Dr. Lagattuta is also barred from serving Medi-Cal beneficiaries for the next five years.  CA AG

Tagged in: FCA Federal, FCA State, Healthcare Fraud, Improper Medical Personnel, Lack of Medical Necessity, Medicaid, Medicare, Provider Fraud,

1 2 3 4 … 70

Newsletter

Subscribe to receive email updates from the Constantine Cannon blogs

Sign up for: