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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

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...

Tagged in: Catch of the Week, Criminal Proceedings, Falsifying Invoices, Healthcare Fraud, Improper Medical Facility, Lack of Medical Necessity, Medicaid, Medical Billing Fraud,

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

Posted 05/14/21

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...

Tagged in: Bundling and Unbundling, Catch of the Week, FCA Federal, Healthcare Fraud, Hospital Fraud, Laboratory and IDTF, Lack of Medical Necessity, Medical Billing Fraud, Whistleblower Case, Whistleblower Rewards,

Catch of the Week: Another Pharma Company, Incyte, Settles FCA Claims For Kickbacks to a Charitable Foundation

Posted 05/7/21

The Department of Justice announced this week that Incyte Corporation, a Delaware pharmaceutical company, has agreed to pay $12.6 million to resolve allegations that it violated the False Claims Act by paying kickbacks to a charitable foundation to increase prescriptions for the drug Jakafi, which is used to treat myelofibrosis, a form of leukemia that causes extensive scarring in bone marrow and leads to severe...

Tagged in: Anti-Kickback and Stark, Catch of the Week, FCA Federal, Healthcare Fraud, Medicare, Pharma Fraud, Whistleblower Case, Whistleblower Rewards,

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

Posted 04/30/21

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...

Tagged in: Anti-Kickback and Stark, Catch of the Week, Compounding Pharmacy Fraud, FCA Federal, Healthcare Fraud, Lack of Medical Necessity, Medical Billing Fraud, Pharma Fraud, Whistleblower Case,

P-Stim Fraud: A New DOJ Enforcement Priority?

Posted 04/23/21

The Department of Justice regularly publicizes its fraud prevention and False Claims Act enforcement priorities. These announced priorities typically focus on broad issues that affect the lives of millions of Americans – COVID-19 fraud, the opioid crisis, and the rapid expansion of telehealth. In addition, we keep an eye on DOJ enforcement actions, and these can reveal emerging trends, often in narrow areas. One...

Tagged in: Chiropractic, FCA Federal, Healthcare Fraud, Medical Billing Fraud, Medical Devices and DME, Provider Fraud,

Catch of the Week: Final Merida Hospice Fraudster Sentenced in $150 Million Scheme

Posted 04/23/21

Hands in handcuffs behind back of white man in business suit

Jose Garza, the former operations manager of Merida Group, a Texas-based hospice, and home health chain, just landed a 27-month prison sentence for his role in a $150 million hospice fraud scheme. Garza is the latest to receive a sentence in connection with the decade-long Merida Group scheme, which saw people with long-term illnesses falsely told they would die soon, while executives at the company pocketed millions...

Tagged in: Catch of the Week, Criminal Proceedings, Healthcare Fraud, Home Health and Hospice,

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

Posted 04/16/21

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...

Tagged in: Anti-Kickback and Stark, Catch of the Week, FCA Federal, Healthcare Fraud, Laboratory and IDTF, Lack of Medical Necessity, Medicare,

Bristol-Myers Squibb Settlement Highlights a Common-Sense Law: The Medicaid Drug Rebate Program

Posted 04/2/21

Drug prices are out of control. They now account for roughly 10% of our healthcare spending and America’s per capita outlay has nearly doubled over the past two decades. For the least fortunate among us, many of these medications have become out of reach altogether. While new proposals are regularly made, one approach that often gets overlooked is simply enforcing the laws already on the books. That is just...

Tagged in: Catch of the Week, Drug and DME Pricing, FCA Federal, Healthcare Fraud, Medicaid, Pharma Fraud, Whistleblower Case,

March Madness: AstraZeneca Fudges the Clinical Trial Results for Its COVID-19 Vaccine

Posted 03/26/21

In case you haven’t been following the NCAA Men’s Basketball Tournament (or even if you have), you might be surprised to learn that the University of Hartford is poised to win it all this year—except for the fact that it lost in the first round of the tournament to Baylor University, 79-55, and has been eliminated from the competition. Likewise, in case you haven’t been following the results of COVID-19...

Tagged in: COVID-19, FDA Fraud, Financial and Investment Fraud, Government Programs Fraud, Grant and Research Fraud, Healthcare Fraud, Pharma Fraud,

Catch of the Week: Founders of Poop-Testing Startup uBiome Face Fraud Charges

Posted 03/24/21

San Francisco-based uBiome and its founders Jessica Richman and Zachary Apte claimed they were “inventing the microbiome industry” and “making products that improve people’s lives.” Once considered a Silicon Valley success story, today, uBiome is bankrupt and its founders face various federal securities fraud and related criminal conspiracy charges. The biotech startup sold home medical tests including...

Tagged in: Catch of the Week, Criminal Proceedings, Improper Medical Facility, Medical Billing Fraud, Securities Fraud,

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

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

Catch of the Week: Another Pharma Company, Incyte, Settles FCA Claims For Kickbacks to a Charitable Foundation

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

P-Stim Fraud: A New DOJ Enforcement Priority?

Catch of the Week: Final Merida Hospice Fraudster Sentenced in $150 Million Scheme

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

Bristol-Myers Squibb Settlement Highlights a Common-Sense Law: The Medicaid Drug Rebate Program

March Madness: AstraZeneca Fudges the Clinical Trial Results for Its COVID-19 Vaccine

Catch of the Week: Founders of Poop-Testing Startup uBiome Face Fraud Charges

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