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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...

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

Posted  02/23/24
doctor with dollars

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...

Genetic Testing Scheme Leads to Another Fraud Conviction

Posted  10/11/23
Scientist Testing a Specimen
The DOJ recently announced another fraud conviction in connection with genetic testing. This conviction from a federal jury in Florida is the latest word in a string of fraud actions against companies and individuals offering to provide genetic testing services. According to the DOJ, Jose Goyos and others managed the “‘doctor chase’ division” of a call center, which “contacted the primary care physicians...

Scoundrel Spotlight - Medicare Fraudster Jesus Virlar-Cadena

Posted  10/2/23
hand holding hospice patients hand
This week’s Scoundrel in the Spotlight is Jesus Virlar-Cadena, a former medical director of a Texas-based healthcare provider called Merida Group, who was recently sentenced to over four years in prison in connection with a fraudulent scheme involving over $150 million in false Medicare claims, according to a DOJ press release. The Merida Group marketed hospice services to patients with long-term incurable...

Catch of the Week: Gramercy Cardiac Diagnostic Services

Posted  09/26/23
businessmen shaking hands and other placing money in others pocket
This week's Department of Justice (DOJ) Catch of the Week goes to Gramercy Cardiac Diagnostic Services and its owner Klaus Peter Rentrop.  Gramercy provides cardiac diagnostic imaging services, previously operating out of four offices in New York City.  On Monday (September 18), the DOJ announced Rentrop and Gramercy will pay $6.5 million for violating the False Claims Act and Anti-Kickback Statute through their...

Catch of the Week: National Health Care Fraud Sweep

Posted  06/30/23
Person Having Doctor Consultation
This week's Department of Justice (DOJ) Catch of the Week goes to the 78 individuals criminally charged with participating in health care fraud and opioid abuse schemes across the country.  On Wednesday, DOJ announced the "strategically coordinated, two-week nationwide law enforcement action" it brought with federal and state law enforcement partners, which targeted misconduct resulting in over $2.5 billion in...

Catch of the Week: Vascular Surgeon Pays Over $60 Million for Defrauding Health Care Programs

Posted  05/26/23
Surgeons on Operating Table
This week's Department of Justice (DOJ) "Catch of the Week" goes to Michigan vascular surgeon Vasso Godiali.  Yesterday, DOJ announced he was sentenced to 80 months in prison "for orchestrating a multimillion-dollar scheme to defraud health care programs by submitting claims for the placement of vascular stents and for thrombectomies that he did not perform." In addition to the jail time, Dr. Godiali also has to...

Top Ten Healthcare Fraud Recoveries of 2022

Posted  01/6/23
Healthcare fraud image showing stethoscope with gavel
Consistent with the trend in prior years, 2022 saw government enforcement agencies taking aim at fraud and false claims in healthcare.  As the cost of healthcare rises along with its share of the U.S. economy, the enforcement focus on healthcare fraud is likely to accelerate. And, as always, the role of whistleblowers will be critical, as demonstrated by the dominance of cases originated by whistleblowers under the...

Telehealth Boomed During the Pandemic - and so Did Telehealth Fraud

Posted  08/24/22
Doctor with stethoscope on computer screen
Prior to the pandemic, telehealth was basically nonexistent, with one study clocking the percentage of “virtual” doctors’ visits before Covid-19 at zero percent. At the time, America’s largest insurer, Medicare, only covered telemedicine in limited circumstances that usually still involved a visit to a healthcare facility. Medicare’s coverage limitations demonstrated the Department of Health and Human...

DOJ Ramps Up Enforcement Against COVID-19 Fraud

Posted  04/25/22
COVID-19-Fraud-Whistleblower-Lawyers
Even as mask restrictions are being relaxed in most parts of the country, the U.S. Department of Justice is ramping up its oversight of federal funds spent to fight the COVID-19 pandemic.  Just last week, DOJ announced criminal charges against 21 defendants in nine federal districts for their alleged participation in COVID-19 fraud schemes that resulted in over $149 million in false billings to federal programs. 
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