Archive

March 20, 2015

Florida Attorney General Pam Bondi’s Medicaid Fraud Control Unit announced the arrests of four individuals for allegedly recruiting the homeless to defraud Medicaid. According to the investigation, Christina Benson, owner of Tranquility Healthcare Solutions, billed Medicaid for services not provided or warranted for homeless men and women who were recruited by her associates to pose as patients. In less than a year and a half, Tranquility fraudulently billed Medicaid approximately $3.2 million. FL

March 19, 2015

Dr. Michael Montejo, a radiation oncologist and former employee of Florida Oncology Network P.A, will receive a whistleblower award of $1,082,500 from the $5,412,502 settlement resolving allegations Adventist Health System Sunbelt Healthcare Corporation violated the False Claims Act by providing radiation oncology services to Medicare and TRICARE beneficiaries that were not directly supervised by radiation oncologists or similarly qualified persons.  DOJ

March 16, 2015

New York Attorney General Eric T. Schneiderman announced that New York along with 49 other states and the District of Columbia have reached a settlement with global pharmaceutical company Daiichi Sankyo, Inc. to resolves allegations that Daiichi violated the False Claims Act by using lavish meals and speaker programs to improperly induce physicians to prescribe the drugs Azor, Benicar, Tribenzor and Welchol. Under the agreement, Daiichi agreed to pay the US and state Medicaid programs $39 million. The allegations originated in a whistleblower lawsuit filed by former Daiichi sales representative Kathy Fragoules under the qui tam provisions of the federal and New York State False Claims Acts. She will receive $6.1 million of the federal recovery and an undisclosed portion of the state recoveries. NY

March 12, 2015

Florida Attorney General Pam Bondi announced the plea of a Gadsden County Home Health Care Provider, Melissa Simmons, for defrauding the Florida Medicaid program out of more than $13,000. The charges originated from the receipt of an anonymous tip through the Florida Medicaid Fraud Hotline. FL

March 11, 2015

Olufemi Afuape and Oluyemisi Afuape, owners of Zion Rehab Services, were ordered to pay $1,407,325.50 in restitution to the Georgia Department of Community Health for billing the Georgia Medicaid program for physical, occupational and speech therapy without regard to whether the services were medically necessary and without regard to whether the services were actually delivered. GA

March 9, 2015

New York Attorney General Eric T. Schneiderman announced that Mental Health Association of Rockland County, Inc. agreed to pay $304,000 to resolve claims its managers and employees altered records in advance of a Medicaid audit so that the records would appear to support claims that were submitted by MHA Rockland to New York State’s Medicaid program. The allegations originated in a whistleblower lawsuit filed by two former MHA Rockland employees under the qui tam provisions of the New York False Claims Act, who will receive an undisclosed portion of the settlement. NY

March 9, 2015

Two former employees of the Mental Health Association of Rockland County, Inc. will receive an undisclosed whistleblower award from the $304,000 settlement resolving allegations MHAR violated the New York False Claims Act through its managers and employees altering records in advance of a Medicaid audit so the records would appear to support claims MHAR submitted to New York State's Medicaid program.   NY

March 6, 2015

Florida Attorney General Pam Bondi announced the arrest of three men for their alleged involvement in an $11 million multi-state drug diversion ring which involved the purchase of millions of dollars of medications on the black market, primarily from Medicaid recipients in Miami and Newark, and their resale to pharmacies in the Northeast, including North Philly Pharmacy in Philadelphia and Lu Puja Pharmacy in Chicago. FL

March 3, 2015

Florida Attorney General Pam Bondi’s Medicaid Fraud Control Unit arrested Christopher A. Days, owner of Better Days of North Central Florida, LLC., for more than $65,000 in Medicaid fraud for billing for services not rendered and failing to properly document for services rendered. FL

February 26, 2015

Florida Attorney General Pam Bondi’s Medicaid Fraud Control Unit and the U.S. Department of Health and Human Services Office of Inspector General announced the arrest of Dr. Daniel Ronchetta, Chiropractic Physician Assistant John Crowe and patient recruiter Frank Barrios for allegedly defrauding Medicaid and Medicare by paying and receiving kickbacks in return for providing false home health prescriptions and plans of care to patient recruiters. FL