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Brace Yourself: Jury Finds Co-Conspirator Guilty in $1.4B Medicare DME Fraud Scheme

Posted 06/10/25

By the Constantine Cannon Whistleblower Team The first week of June is Medicare Fraud Prevention Week, geared toward raising awareness and safeguarding the integrity of a crucial healthcare system on which many Americans rely. While this initiative and this case do not expressly call out to whistleblowers, we are! This recent government enforcement action concerning a Medicare fraud scheme serves as a reminder...

Tagged in: Medical Devices and DME, Medicare,

NJ Rehab Center Will Pay $19.75M to Resolve False Claims Act Allegations

Posted 05/2/25

On April 30, a New Jersey-based drug and alcohol rehabilitation facility, Summit BHC New Jersey, LLC, d/b/a Seabrook, agreed to pay $19.75 million to resolve allegations that it violated the False Claims Act by billing for services it was not authorized to provide. This case was initiated by a former Seabrook employee who filed suit under the whistleblower or qui tam provisions of the False Claims Act. According to...

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

$127M Health Care Fraud and Kickback Scheme: Business Operators Sentenced, Settle False Claim Act Allegations

Posted 04/29/25

By the Constantine Cannon Whistleblower Team The government continues to prioritize healthcare fraud enforcement. As we detailed in our round-up of top healthcare-related False Claims Act recoveries from 2024, more than $1.67 billion (58% of all FCA recoveries that year) came from healthcare fraud cases alone. With several settlements already announced this year, 2025 is shaping up to be another active year in...

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

Government Files False Claims Act Complaint Against Vohra Wound Physicians Management and Its Owner

Posted 04/9/25

On April 4, the government announced it filed a complaint under the False Claims Act against Vohra Wound Physicians Management LLC (Vohra), its entities, and its founder Dr. Ameet Vohra. Among other violations, the government alleged the company submitted false claims to Medicare for upcoded and medically unnecessary wound care services. Vohra, one of the country’s largest wound care providers, has contracts...

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

Network that Offers Programs for Adults with Disabilities Agrees to Pay $5M to Settle False Claims Act Case

Posted 04/7/25

The government announced it settled a civil fraud lawsuit against Community Options, Inc., (“COI”) and Community Options New York, Inc., (“CONY,” and together with COI, the “Defendants” or “Community Options”) for fraudulently billing Medicaid for services without necessary and accurate documentation and failing to report and return overpayments to Medicaid. Defendants agreed to pay the United States...

Tagged in: False Claims Act, Medicaid, Medicaid fraud, qui tam,

A “Saad” Case of Medicare Fraud: Saad Healthcare Pays $3M to Settle False Claims Act Allegations

Posted 02/25/25

On February 21, the government announced that Saad Enterprises Inc. (DBA Saad Healthcare) will pay $3 million to settle allegations that it violated the False Claims Act from 2013-2020 by submitting false claims for the care of 21 Alabama-based Medicare ineligible hospice patients who were not terminally ill. Hospice is end-of-life palliative care for terminally ill patients who move away from traditional curative...

Tagged in: False Claims Act, Medicare,

$1B Medicare Scam: Kansas Resident Pleaded Guilty to Illegal Kickback Fraud Scheme

Posted 02/25/25

On February 20, the DOJ announced that Johnson County, Kansas resident Gregory Schreck (50) pleaded guilty to operating DMERx, a web-based platform that created phony doctors’ orders to defraud Medicare and other federal health care benefit programs of over $1 billion. He will receive a maximum penalty of 10 years in prison. Schreck admitted that he and his accomplices targeted 100,000+ Medicare beneficiaries to...

Tagged in: Anti-Kickback and Stark, Medicare,

A $5.4M Health Care Fraud Scheme: Louisiana Doctor Sentenced for Illegally Distributing Over 1.8M Opioid Doses

Posted 02/13/25

On February 6, 2025, the government announced that Louisiana physician, Adrian Dexter Talbot M.D., 59, was sentenced to 87 months in prison for conspiring to illegally distribute 1.8+ million doses of Schedule II controlled substances (including oxycodone, hydrocodone, and morphine), and for defrauding health care benefit programs of over $5.4 million. Talbot owned and operated Medex Clinical Consultants (Medex),...

Tagged in: Healthcare Fraud, Medicare,

A $1.2B+ Health Care Graft Grift! Arizona Couple Pleads Guilty to Fraud

Posted 02/4/25

On January 31, 2025, the government announced an update in a case involving a Phoenix, Arizona couple pleading guilty to causing the submission of over $1.2 billion of fraudulent claims to Medicare and other health insurance programs. The couple submitted claims for costly, medically unnecessary wound grafts applied to elderly and terminally ill patients. Alexandra Gehrke, 39, and her husband, Jeffrey King, 46,...

Tagged in: Healthcare Fraud, Medicare,

California Woman Sentenced in $369M Fraud Scheme Involving Billing for Medically Unnecessary Respiratory Tests

Posted 02/3/25

On January 28, the government announced that California resident Lourdes Navarro, 66, was sentenced to nine years in prison for her involvement in submitting fraudulent claims to both government and private insurance companies during the COVID-19 pandemic. Navarro and her co-conspirator, Imran Shams, illegally bundled COVID-19 screening tests with expensive and medically unnecessary respiratory pathogen panel (RPP)...

Tagged in: Healthcare Fraud, Medicare,

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Brace Yourself: Jury Finds Co-Conspirator Guilty in $1.4B Medicare DME Fraud Scheme

NJ Rehab Center Will Pay $19.75M to Resolve False Claims Act Allegations

$127M Health Care Fraud and Kickback Scheme: Business Operators Sentenced, Settle False Claim Act Allegations

Government Files False Claims Act Complaint Against Vohra Wound Physicians Management and Its Owner

Network that Offers Programs for Adults with Disabilities Agrees to Pay $5M to Settle False Claims Act Case

A “Saad” Case of Medicare Fraud: Saad Healthcare Pays $3M to Settle False Claims Act Allegations

$1B Medicare Scam: Kansas Resident Pleaded Guilty to Illegal Kickback Fraud Scheme

A $5.4M Health Care Fraud Scheme: Louisiana Doctor Sentenced for Illegally Distributing Over 1.8M Opioid Doses

A $1.2B+ Health Care Graft Grift! Arizona Couple Pleads Guilty to Fraud

California Woman Sentenced in $369M Fraud Scheme Involving Billing for Medically Unnecessary Respiratory Tests

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