Archive

Florida Nursing Assistant Convicted in $11.4M Medicare Fraud Scheme

By the Constantine Cannon Whistleblower Team On January 22, a federal jury convicted Florida-based nursing assistant and durable medical equipment (DME) supplier owner Christian “Chris” Cruz for his role in an $11.4 million healthcare fraud and wire fraud conspiracy.[1]

What Was the Alleged Scheme?

According to prosecutors, Cruz  submitted false claims for hundreds of Medicare beneficiaries and they were...

Two Plead Guilty to $68M Brooklyn Adult Day Care and Home Healthcare Fraud Scheme

By the Constantine Cannon Whistleblower Team On January 15, Elaine Antao and Manal Wasef pleaded guilty to conspiring to defraud Medicaid by offering kickbacks for services not rendered at two Brooklyn social adult day cares and a home healthcare company. The proceedings took place before United States District Judge Natasha C. Merle in federal court in Brooklyn. Each defendant faces up to 10 years in...

Whistleblower-Initiated Case: DOJ Files FCA Complaint Against Priority Hospital Group and Three LTCHs

By the Constantine Cannon Whistleblower Team On January 16, the government filed a False Claims Act complaint against Priority Hospital Group LLC (PHG), a Louisiana-based hospital management company, three PHG-managed long term care hospitals, and a doctor alleging they submitted false claims for medically unnecessary care and engaged in improper patient referrals in violation of the Anti-Kickback and Stark Law.

Traditions Health Pays $34M to Settle False Claims Act Charges of Medically Unnecessary Home Health Services

By the Constantine Cannon Whistleblower Team Last Thursday (January 22), the Department of Justice (DOJ) announced that Tennessee-based Traditions Health agreed to pay $34 million to settle allegations it violated the False Claims Act and Anti-Kickback Statute and Stark Law by billing Medicare for medically unnecessary home health services and paying kickbacks to physicians in exchange for referrals.[1] ...

Florida Ophthalmology Practices Agree to Pay Nearly $6M in Whistleblower Case Involving Transcranial Doppler Ultrasounds

By the Constantine Cannon Whistleblower Team Five Florida ophthalmology practices, Clay Eye Holdings LLC, Retina Macula Specialists of Miami LLC, Florida Eye Institute P.A., Miami Eye LLC, and Kendall Eye Institute Inc., agreed to pay roughly $6 million to settle allegations that they submitted fraudulent claims to Medicare and Medicaid in violation of the False Claims Act. [1] According to the government, the...

Healthcare Employees Sentenced to Prison for Multimillion Dollar Adult Daycare Fraud Scheme

By the Constantine Cannon Whistleblower Team A Texas physician and a clinic employee have been sentenced to prison for their roles in a multimillion dollar healthcare fraud and kickback scheme involving unnecessary lab tests and prescriptions. Dr. Osama Nahas, owner and physician at Crosspoint Medical Clinic, and medical assistant Isabel Pruneda were convicted on March 1, 2024 by a federal jury of conspiracy to...

South Carolina Lab Pleads Guilty and Will Pay At Least $6.8M to Resolve Kickback Allegations Involving Doctors

By the Constantine Cannon Whistleblower Team Clinical laboratory LTD Holding LLC (previously Labtech Diagnostics LLC) based in Anderson, South Carolina, and its founder and CEO Joseph Labash, agreed to pay roughly $6.8 million to settle False Claims Act allegations that they paid illegal kickbacks to doctors from August 2018 to November 2021. This settlement brings the DOJ’s total civil False Claims Act...

Recent Enforcement Actions Target Two Healthcare Fraud Schemes Totaling Over $180M

By the Constantine Cannon Whistleblower Team The government is committed to cracking down on healthcare fraud schemes as evident in two recent sentencing announcements involving more than $180 million in losses.

Missouri Resident Sentenced to Prison for $174M Healthcare Fraud Conspiracy

A court sentenced Missouri resident Jamie P. McNamara to 10-years in prison on October 23 for orchestrating a scheme to defraud...

New York Doctor Receives Seven-Year Prison Sentence for $24M Medicare Fraud

By the Constantine Cannon Whistleblower Team The government remains persistent in its efforts to combat healthcare fraud, actively pursuing and prosecuting those who exploit the system. This ongoing commitment is evident in its recent enforcement actions, including the case we are analyzing in this post. New York doctor Alexander Baldonado, M.D., 69, received a seven-year prison sentence for submitting more than...

Owners of Wound Graft Companies Pay Big for False Claims Act and Kickback Violations -- DOJ Reinforces Zero Tolerance for Healthcare Fraud

By the Constantine Cannon Whistleblower Team Last Friday (December 12), the Department of Justice (DOJ) announced the major sentencing, forfeitures, and penalties imposed on the owners of several Arizona wound graft companies for a $1.2 billion healthcare fraud scheme.[1]  DOJ described the action -- against Alexandra Gehrke and her husband Jeffrey King -- as “the first prosecution of its kind.”

What Was the...