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$45.6 Million Settlement in False Claims Act Case Against Nursing Facility Defendants

Posted 11/17/23

Nurse Holding Clipboard in Front of Nursing Patient

The DOJ recently announced another settlement of a False Claims Act case against skilled nursing facilities (SNFs). This time, it was a $45.6 million settlement of a False Claims Act case that the government brought against six SNFs; a management company called Paksn Inc.; and Prema Thekkek, the owner. The six SNFs do business as (i) Bay Point Healthcare Center (Kayal Inc.); (ii) Gateway Care & Rehabilitation...

Tagged in: Anti-Kickback and Stark, FCA Federal, Healthcare Fraud, SNF, Whistleblower Case,

DOJ Issues Elder Justice Report To Congress

Posted 10/26/23

A key focus of the Justice Department is prosecuting and deterring elder fraud and abuse. In the words of Attorney General Merrick Garland, “Every year, millions of older adults experience some form of elder abuse, neglect, financial exploitation, or fraud. … Holding to account those individuals and organizations that engage in elder fraud or abuse is the cornerstone of the Department’s elder justice...

Tagged in: FCA Federal, Healthcare Fraud,

Genetic Testing Scheme Leads to Another Fraud Conviction

Posted 10/11/23

The DOJ recently announced another fraud conviction in connection with genetic testing. This conviction from a federal jury in Florida is the latest word in a string of fraud actions against companies and individuals offering to provide genetic testing services. According to the DOJ, Jose Goyos and others managed the “‘doctor chase’ division” of a call center, which “contacted the primary care physicians...

Tagged in: Healthcare Fraud, Laboratory and IDTF, Lack of Medical Necessity, Medicare, Provider Fraud,

Scoundrel Spotlight - COVID-19 Fraudster Lourdes Navarro

Posted 10/9/23

This week's Scoundrel in the Spotlight is Lourdes Navarro and her husband Imran Shams. The married pair ran the LA County medical lab Clinical Laboratory Inc. (also called Health Care Providers Laboratory). Their lab performed COVID-19 screening tests primarily for nursing homes and other facilities catering to the elderly population. Last Thursday (October 5), Navarro pleaded guilty to fraudulently billing the...

Tagged in: COVID-19, Healthcare Fraud, Lack of Medical Necessity, Medical Billing Fraud, Medicare, Risk Adjustment Fraud,

Scoundrel Spotlight - Medicare Fraudster Jesus Virlar-Cadena

Posted 10/2/23

This week’s Scoundrel in the Spotlight is Jesus Virlar-Cadena, a former medical director of a Texas-based healthcare provider called Merida Group, who was recently sentenced to over four years in prison in connection with a fraudulent scheme involving over $150 million in false Medicare claims, according to a DOJ press release. The Merida Group marketed hospice services to patients with long-term incurable...

Tagged in: Criminal Proceedings, Healthcare Fraud, Home Health and Hospice, Lack of Medical Necessity, Medicare, Provider Fraud,

Nurse Practitioner Convicted in $200 Million Medicare Fraud Scheme

Posted 09/28/23

In a landmark healthcare fraud case, a federal jury in Miami has convicted a nurse practitioner $200 million for her central role in a massive Medicare fraud scheme in which she conspired with telemarketing companies to submit false claims for unnecessary genetic testing and medical equipment. Evidence presented during trial outlined the scheme: telemarketers targeted Medicare beneficiaries, and pressured them to...

Tagged in: FCA Federal, Healthcare Fraud, Lack of Medical Necessity, Medical Devices and DME, Medicare,

Catch of the Week: Gramercy Cardiac Diagnostic Services

Posted 09/26/23

businessmen shaking hands and other placing money in others pocket

This week's Department of Justice (DOJ) Catch of the Week goes to Gramercy Cardiac Diagnostic Services and its owner Klaus Peter Rentrop. Gramercy provides cardiac diagnostic imaging services, previously operating out of four offices in New York City. On Monday (September 18), the DOJ announced Rentrop and Gramercy will pay $6.5 million for violating the False Claims Act and Anti-Kickback Statute through their...

Tagged in: Anti-Kickback and Stark, FCA Federal, Healthcare Fraud, Provider Fraud, Whistleblower Case,

Catch of the Week: Lincare Holdings

Posted 08/31/23

This week's Department of Justice (DOJ) Catch of the Week goes to Florida-based Lincare Holdings, Inc., a wholly-owned subsidiary of the German chemical corporation Linde plc. On Monday (August 28), the DOJ announced that the company agreed to pay $29 million to settle charges of violating the False Claims Act by overbilling Medicare and Medicare Advantage Plans for oxygen equipment. Lincare provides oxygen...

Tagged in: Catch of the Week, FCA Federal, Healthcare Fraud, Medicare, Whistleblower Case,

DOJ Smackdown of COVID-19 Fraud

Posted 08/25/23

On Wednesday (August 23), the Department of Justice (DOJ) announced significant progress in its ongoing effort to combat COVID-19 fraud. The agency reported a nationwide, coordinated three-month sweep resulting in more than 700 enforcement actions involving hundreds of defendants, covering more than $800 million in alleged COVID-19 fraud. According to the government, these actions largely involved going after...

Tagged in: Contract Non-Compliance, COVID-19, FCA Federal, Healthcare Fraud, Whistleblower Eligibility,

Scoundrel Spotlight - Medicare Fraudster Minal Patel

Posted 08/23/23

This week's Scoundrel in the Spotlight is Minal Patel who last week (August 18) was sentenced to 27 years in prison for defrauding Medicare of almost half a billion dollars for genetic testing patients did not need and were procured through bribes and kickbacks. In announcing the sentencing, the government trumpeted the matter as one of the largest genetic testing fraud cases ever tried to verdict. Here is how...

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

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$45.6 Million Settlement in False Claims Act Case Against Nursing Facility Defendants

DOJ Issues Elder Justice Report To Congress

Genetic Testing Scheme Leads to Another Fraud Conviction

Scoundrel Spotlight - COVID-19 Fraudster Lourdes Navarro

Scoundrel Spotlight - Medicare Fraudster Jesus Virlar-Cadena

Nurse Practitioner Convicted in $200 Million Medicare Fraud Scheme

Catch of the Week: Gramercy Cardiac Diagnostic Services

Catch of the Week: Lincare Holdings

DOJ Smackdown of COVID-19 Fraud

Scoundrel Spotlight - Medicare Fraudster Minal Patel

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