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Fishy Business and Fraudulent Bills: New York Internist Pleads Guilty to $891K Healthcare Fraud Scheme

Posted 11/22/24

The Hippocratic Oath was apparently not an ethical pledge Dr. Kenneth Fishberger took to heart. On Thursday, November 14, 2024, New York internist Dr. Fishberger, 75, pleaded guilty in Boston federal court to one count of conspiracy to commit healthcare fraud. Fishberger, an internist from East Setauket, N.Y., received kickbacks for ordering medically unnecessary transcranial doppler (TCD) brain scans, tests used...

Tagged in: Anti-Kickback and Stark, Healthcare Fraud, Medical Billing Fraud,

Opioid Exploitation: Doctor and Staff Charged with Conspiracy and Fraud

Posted 07/8/24

In Saint Louis, Dr. David A. Parks along with his clinical manager and spouse, James M. Bilderback, and front desk staffer Michelle J. Scheer, face serious allegations of conspiracy and health care fraud. Indicted by the U.S. District Court, the three are accused of illegal prescription practices and fraudulent activities aimed to profit from controlled substances and fraudulent medical billing.

The...

Tagged in: Healthcare Fraud, Medicaid, Medical Billing Fraud, Provider Fraud,

VNS Health: $1M Settlement for Failing To Provide Services to Hospice Patients

Posted 07/3/24

The U.S. Attorney's Office for the Southern District of New York announced a substantial settlement with Visiting Nurse Service of New York (formerly VNSNY, now VNS Health) and its related entities. This settlement addresses allegations of fraudulent billing practices that undermined the Medicaid program meant to support some of the most vulnerable patients like those in hospice. VNS Health is one of the largest...

Tagged in: Healthcare Fraud, Home Health and Hospice, Medicaid, Medical Billing Fraud, Medicare,

New York Doctor Indicted for $20.7 Million in Medicare Fraud and Kickback Scheme

Posted 02/23/24

On February 21, 2024, a federal grand jury in New Jersey indicted Dr. Alexander Baldonado, of Queens, New York, for his alleged involvement in a complex health care fraud and illegal kickback scheme. According to the DOJ press release, this scheme involved the submission of over $20.7 million in false and fraudulent claims to Medicare, primarily for medically unnecessary genetic cancer screening and Covid-19...

Tagged in: FCA Federal, Government Programs Fraud, Healthcare Fraud, Laboratory and IDTF, Lack of Medical Necessity, Medical Billing Fraud, Medical Devices and DME, Medicare, Provider Fraud, Reporting to Government,

Catch of the Week: Lincare, Inc.

Posted 02/16/24

This week's Department of Justice (DOJ) Catch of the Week goes to Lincare, Inc., a durable medical equipment supplier with locations throughout the country. Yesterday (February 15), the company agreed to pay $25.5 million to settle DOJ charges of violating the False Claims Act by billing Medicare for the rental of non-invasive ventilators (NIVs) when patients no longer needed or used them. DOJ also charged Lincare...

Tagged in: Catch of the Week, FCA Federal, Healthcare Fraud, Lack of Medical Necessity, Medicaid, Medical Devices and DME, Medicare, Other Government Health Programs, Whistleblower Case,

Top Ten Healthcare False Claims Act Recoveries for 2023

Posted 01/30/24

Doctor Holding Stethoscope with Crossed Arms

This past year was another big year for DOJ enforcement under the False Claims Act, the government's primary fraud-fighting tool. And as we noted in our recent Top Ten listing of False Claims Act recoveries for 2023, all but 3 of the Top Ten recoveries were in the healthcare space involving various schemes to defraud Medicare and Medicaid. So here is our look at the Top Ten healthcare recoveries for...

Tagged in: Anti-Kickback and Stark, FCA Federal, Healthcare Fraud, Medicaid, Medical Billing Fraud, Medicare, Top 10, Whistleblower Case,

Catch of the Week: New York-Presbyterian Hospital

Posted 01/26/24

This week's Department of Justice (DOJ) Catch of the Week goes to New York-Presbyterian Hospital. Yesterday (January 25), the hospital agreed to pay $801,000 to settle charges it violated the False Claims Act by billing Medicare, Medicaid and TRICARE for medically unnecessary images for radiation therapy treatments provided to cancer patients. The settlement is notable not for the relatively small amount of money...

Tagged in: Catch of the Week, FCA Federal, Healthcare Fraud, Lack of Medical Necessity, Medicaid, Medicare, Other Government Health Programs, Whistleblower Case,

Testing Lab and Owner/CEO Settle False Claims Act Case for $13.25 Million

Posted 01/12/24

Laboratory Analysis. Scientist Measuring Sample

RDx Bioscience Inc. (“RDx”), a clinical laboratory that operated in New Jersey, and its owner and CEO agreed to pay $13.25 million to settle a False Claims Act case alleging kickbacks and unnecessary testing schemes, according to a recent DOJ press release. The press release also notes that RDx and its owner/CEO agreed to cooperate with the DOJ’s “investigations of, and litigation against, other participants...

Tagged in: Anti-Kickback and Stark, FCA Federal, Healthcare Fraud, Laboratory and IDTF, Lack of Medical Necessity,

Top Ten False Claims Act Recoveries in 2023

Posted 01/11/24

It was another big year for DOJ enforcement under the False Claims Act, the government's primary fraud-fighting tool. As usual, most of the recoveries were in the healthcare space with seven of the Top-10 involving various schemes to defraud Medicare and Medicaid. Several of these Top-10 recoveries involved enforcement actions targeting violations of the Anti-Kickback Statute and Stark Law, which prohibit medical...

Tagged in: Anti-Kickback and Stark, Electronic Health Records, FCA Federal, Government Programs Fraud, Healthcare Fraud, Medicaid, Medical Billing Fraud, Medicare, Top 10, Whistleblower Case,

Catch of the Week: Moffitt Cancer Center

Posted 01/5/24

This week's Department of Justice (DOJ) Catch of the Week goes to Tampa-based H. Lee Moffitt Cancer Center & Research Institute Hospital. Yesterday (January 4), the non-profit cancer treatment and research center agreed to pay roughly $19.6 million to settle DOJ charges of violating the False Claims Act by billing Medicare for patient care services provided during research studies not eligible for...

Tagged in: Catch of the Week, FCA Federal, Healthcare Fraud, Improper Medical Facility, Medical Billing Fraud, Medicare,

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Fishy Business and Fraudulent Bills: New York Internist Pleads Guilty to $891K Healthcare Fraud Scheme

Opioid Exploitation: Doctor and Staff Charged with Conspiracy and Fraud

VNS Health: $1M Settlement for Failing To Provide Services to Hospice Patients

New York Doctor Indicted for $20.7 Million in Medicare Fraud and Kickback Scheme

Catch of the Week: Lincare, Inc.

Top Ten Healthcare False Claims Act Recoveries for 2023

Catch of the Week: New York-Presbyterian Hospital

Testing Lab and Owner/CEO Settle False Claims Act Case for $13.25 Million

Top Ten False Claims Act Recoveries in 2023

Catch of the Week: Moffitt Cancer Center

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