Archive

Healthcare Providers and Marketers Will Pay $1.1M to Settle Laboratory Kickback Allegations

Posted 01/10/25

In January 2025, the government announced that lab marketers, physicians and their associated entities have agreed to pay $1,137,914 to resolve False Claims Act allegations that they participated in laboratory kickback schemes in violation of the Anti-Kickback Statute. The parties involved include physicians Dr. Abbesalom Ghermay (from Plano, Texas); Dr. Daniel Theesfeld (from Longview, Texas) and his medical...

Tagged in: Anti-Kickback and Stark, False Claims Act, Healthcare Fraud,

California Clinics, Lab, and Their Owners Pay $10M to Resolve False Claims, Kickback, and Stark Law Allegations

Posted 12/30/24

On December 26, the DOJ announced that medical clinics, a lab, and the owners will pay $10 million to settle allegations that they submitted false claims to Medicare and California’s Medicaid program, Medi-Cal, in violation of the Anti-Kickback Statute (AKS) and Stark Law (Physician Self-Referral Law). The defendants include Southern California Medical Center (SCMC), R & B Medical Group Inc., doing business as...

Tagged in: Anti-Kickback and Stark, False Claims Act, Medicaid, Medicare, qui tam,

16 Cardiology Practices Across 12 States Pay $17.7M to Settle False Claims Act Allegations

Posted 12/27/24

On December 20, 2024, the government announced that 16 cardiology practices and physicians across 12 states will pay a total of $17,761,564 to settle claims that they overbilled Medicare for diagnostic radiopharmaceuticals and thereby violated the False Claims Act (FCA). Diagnostic radiopharmaceuticals are “radioactive drugs that healthcare providers use for special imaging tests and for treating certain types of...

Tagged in: False Claims Act, Medicare, qui tam,

Hold the Phone: Telemarketer Sent to Prison for $67M Health Care Fraud and Money Laundering Scheme

Posted 12/17/24

In December 2024, Jose Goyos, (38, from West Palm Beach, Florida) was sentenced to 15 years in prison for defrauding Medicare by falsely billing over $67 million for medically unnecessary genetic tests. Goyos and his co-conspirators worked at a telemarketing call center that roped thousands of unsuspecting Medicare beneficiaries and their doctors into their scheme. According to the government, Goyos managed the...

Tagged in: Healthcare Fraud, Medicare, Money Laundering,

Fraud alert! California Hospital Pays $10.25M to Resolve Whistleblower Suit Alleging Medically Unnecessary Inpatient Admissions and Kickbacks

Posted 12/16/24

On December 12, the DOJ announced that California’s Oroville Hospital will pay $10,250,000 to the United States and the State of California to resolve allegations that it submitted false claims to Medicare and Medicaid for medically unnecessary inpatient hospital admissions, a kickback and physician self-referral scheme, and the use of incorrect diagnosis codes to maximize reimbursements. Oroville Hospital will pay...

Tagged in: False Claims Act, Healthcare Fraud, qui tam,

Another Clinical Trial Fraud Success for Government Enforcement: Bring on the Clinical Trial Fraud Whistleblowers

Posted 12/11/24

On December 10, the Department of Justice (DOJ) announced the latest clinical trial fraud enforcement success with the conviction of two chief executives for lying to investors about the supposed promise of an investigational drug called leronlimab their companies were promoting to treat HIV and COVID-19. It follows two recent Securities and Exchange (SEC) actions against biopharma companies and their executives for...

Tagged in: Clinical Trial Fraud, Pharma Fraud, SEC Whistleblower Reward Program,

Hoodwink in Hartford: Home Health Care Company and Its Owners Settle Medicaid False Claims Act Allegations

Posted 12/10/24

stethoscope on top of hundred dollar bills scattered around

United States Attorney for the District of Connecticut, Vanessa Roberts Avery, and Connecticut Attorney General, William Tong announced that Home Care VNA LLC and its current and former owners, Shakira Lubega and Constant Ogutt, have agreed to pay $361,520 to resolve allegations that they submitted claims for home health care services that violated Medicaid regulations for plans of care. Home Care VNA is a home...

Tagged in: False Claims Act, Home Health and Hospice, Medicaid fraud,

Predatory Pharmacies Targeted Low-Income HIV Patients: Former Owner of New York Pharmacies Sentenced for Ongoing $11 Million Medicaid Fraud Scheme

Posted 12/4/24

dollars with a prescription signifying healthcare fraud

On November 20, 2024, New York Attorney General Letitia James announced that former pharmacy owner Aftab Hussain was sentenced to two to six years in prison for swindling over $11.5 million in a Medicaid fraud scheme that targeted low-income HIV patients who required life-saving medications. Hussain and his co-conspirators paid illegal kickbacks to patients to entice them as repeat customers at over 20...

Tagged in: Healthcare Fraud, Medicaid fraud,

SEC Announces Settled Charges Against Pharma Company and Executives for Misleading Investors about FDA Clinical Review of Drugs

Posted 12/3/24

Securities and Exchange Commission seal on building

The SEC continues to go after pharmaceutical companies for securities law violations in connection with misleading investors. The most recent example is the SEC’s settled charges against a publicly traded biotherapeutics company called Kiromic BioPharma, Inc. (KRBP), the company’s former CEO, and its former chief financial officer. In this case, Kiromic was working on developing two cancer fighting drugs...

Tagged in: FDA Fraud, SEC Whistleblower Reward Program, Securities Fraud,

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,

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Healthcare Providers and Marketers Will Pay $1.1M to Settle Laboratory Kickback Allegations

California Clinics, Lab, and Their Owners Pay $10M to Resolve False Claims, Kickback, and Stark Law Allegations

16 Cardiology Practices Across 12 States Pay $17.7M to Settle False Claims Act Allegations

Hold the Phone: Telemarketer Sent to Prison for $67M Health Care Fraud and Money Laundering Scheme

Fraud alert! California Hospital Pays $10.25M to Resolve Whistleblower Suit Alleging Medically Unnecessary Inpatient Admissions and Kickbacks

Another Clinical Trial Fraud Success for Government Enforcement: Bring on the Clinical Trial Fraud Whistleblowers

Hoodwink in Hartford: Home Health Care Company and Its Owners Settle Medicaid False Claims Act Allegations

Predatory Pharmacies Targeted Low-Income HIV Patients: Former Owner of New York Pharmacies Sentenced for Ongoing $11 Million Medicaid Fraud Scheme

SEC Announces Settled Charges Against Pharma Company and Executives for Misleading Investors about FDA Clinical Review of Drugs

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

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