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Catch of the Week: Florida Lab Owner Pleads Guilty to $73 Million Telemedicine Fraud Scheme

Posted  09/3/21
telemedicine doctor on computer with patient
Editor’s Note: For this week’s biggest story, the record $90 million settlement secured by a Constantine Cannon client against Sutter Health, read more here.
Healthcare fraudsters have a track record of exploiting health crises for personal gain. The COVID-19 pandemic created new telemedicine opportunities for patients to receive care without having to see doctors in person. As expected, fraudsters seized on...

Medically Unnecessary Procedures Harm Patients, Raise U.S. Healthcare Costs, Atlantic Feature Emphasizes

Posted  08/20/21
surgeons operating on patient under bright lights
Unnecessary procedures have long plagued the U.S. healthcare system, costing taxpayers billions and subjecting thousands of patients to invasive procedures that sometimes do more harm than good. For decades, various government actors have acknowledged the problem.

Why then is it so difficult to prevent unnecessary procedures in the U.S.?

Reporter Chris Outcalt recently pondered in a piece for The Atlantic. The...

Catch of the Week: Telemedicine Company Owner Charged in $784 Million Kickback Scheme

Posted  08/20/21
Doctor on computer with patient discussing medicine
Underscoring the fraud risks associated with the government’s continued expansion and loosening of restrictions on telehealth, the U.S. Department of Justice recently announced that a grand jury in New Jersey has returned a superseding indictment against the Florida owner of multiple telemedicine companies, referred to by DOJ prosecutors as the Video Doctor Network, for allegedly participating in a massive Medicare...

FDA’s Approval of Alzheimer’s Drug Highlights Need for Whistleblowers

Posted  07/9/21
stamping saying fda approved
The Food and Drug Administration (FDA) is supposed to protect American consumers from unscrupulous private actors—charlatans, snake-oil salesmen, and the like—seeking to profit by selling unproven medical “cures,” treatments, and devices to the public.  Emerging during the era of the robber barons as part of Theodore Roosevelt’s efforts to “civilize capitalism,” the FDA has prevented untold harm to...

Catch of the Week: Dental Clinics to Pay $2.7M for Using Unsterilized Tools on Medicaid Patients

Posted  05/28/21
Dental Chair and Equipment
For over five years, Upper Allegheny Health Systems, a health care system operating several dental clinics in New York and Pennsylvania, allegedly performed dental services without sterilizing equipment between patients and falsely billed Medicaid for those services. After a former employee blew the whistle, the United States and the State of New York stepped in to investigate, and the defendant agreed to a $2.7...

DOJ Lowers The Boom On COVID-19 Healthcare Scams, Again

Posted  05/28/21
COVID Virus Zoomed In
Hey, fraudsters, did you hear?  There was a global pandemic, so the government pumped trillions of dollars into the economy.  Probably a good time to get a piece of the cut, you ask?  They’ll never find out, right?  So many ways to grift! Well, not so much.  From the start, the cops on the beat, led by the United States Department of Justice, have screamed from the rooftops:  “Don’t do it.  We WILL...

Catch of the Week: Virginia OB/GYN Sentenced to 59 Years in Prison for Performing Medically Unnecessary Procedures for More Than Ten Years

Posted  05/21/21
OB/GYN looking at a sonogram on screen
Healthcare fraudsters are typically motivated by greed. But in satisfying that greed, some fraudsters perform reprehensible acts that permanently affect the victims of the fraud, making even the penalty they receive pale in comparison. This week we focus on the conviction of Javaid Perwaiz, an OB/GYN in Hampton Roads, Virginia, who was sentenced to 59 years in prison for performing medically unnecessary surgeries...

Catch of the Week: University of Miami to Pay $22 Million to Resolve Allegations of Lab Test Fraud

Posted  05/14/21
University of Miami logo
The University of Miami will pay $22 million to resolve three False Claims Act lawsuits, the first of which was filed in 2013.  The government alleged that UM, which operates a medical school out of Jackson Memorial Hospital and an extensive health system spanning four south Florida counties, fraudulently billed government health care programs to boost declining revenues.  Jackson Memorial will separately pay $1.1...

Catch of the Week: Dozens of Fraudsters Sentenced in Multimillion Dollar Compounding Pharmacy Fraud

Posted  04/30/21
compounding pharmacy drugs
On Thursday, an Alabama District Court Judge sentenced dozens of defendants to prison for participating in a massive conspiracy to swindle insurers for medically unnecessary compound drugs. The defendants included company executives and managers, a prescriber, billers, and sales representatives associated with Northside Pharmacy, which was doing business as Global Compounding Pharmacy (Global). According to the DOJ...

Catch of the Week: Telemarketer Gets 10 Years in $3.3 Million Telemedicine and Genetic Testing Fraud Scheme

Posted  04/16/21
female looking through a lab telescope
Ivan Andre Scott, a 36-year-old Florida man, just landed a 10-year prison sentence for organizing a $3.3 million Medicare fraud scheme involving two of the hottest healthcare trends – telemedicine and genetic testing to assess the likelihood of future cancer. The conspiracy targeted vulnerable Medicare beneficiaries for pricey cancer screening genetic tests, prosecutors said. Claims for these tests were falsely...
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