Nurse Practitioner Convicted in $200 Million Medicare Fraud Scheme
Posted 09/28/23
In a landmark healthcare fraud case, a federal jury in Miami has convicted a nurse practitioner $200 million for her central role in a massive Medicare fraud scheme in which she conspired with telemarketing companies to submit false claims for unnecessary genetic testing and medical equipment.
Evidence presented during trial outlined the scheme: telemarketers targeted Medicare beneficiaries, and pressured them to...
This week's Scoundrel in the Spotlight is Minal Patel who last week (August 18) was sentenced to 27 years in prison for defrauding Medicare of almost half a billion dollars for genetic testing patients did not need and were procured through bribes and kickbacks. In announcing the sentencing, the government trumpeted the matter as one of the largest genetic testing fraud cases ever tried to verdict.
Here is how...
Catch of the Week: National Health Care Fraud Sweep
Posted 06/30/23
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...
This week's Department of Justice (DOJ) Catch of the Week goes to Florida-based compounding pharmacies Smart Pharmacy, Inc. and SP2, and their owner Gregory Balotin. Yesterday, they agreed to pay at least $7.4 million to settle charges they violated the False Claims Act by adding an antipsychotic drug to topical pain creams solely to boost Medicare reimbursement. Not because of any medical purpose the drug...
Catch of the Week: Vascular Surgeon Pays Over $60 Million for Defrauding Health Care Programs
Posted 05/26/23
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...
As Whistleblowers and Quality Care Advocates, Hospitalists are the Conscience of Healthcare
Posted 02/28/22
Thursday, March 3, 2022 is National Hospitalist Day, a day we recognize the contributions of the specialist care doctors and other professionals who provide quality care to sick and vulnerable patients in a hospital. As the fastest growing specialty in modern medicine, hospitalists are a critical part of the nation’s health care service delivery system.
Less noted but no less important, hospitalists also play a...
Catch of the Week: Texas Hospice CEO Gets 13 Year Sentence in $60 Million Fraud Scheme
Posted 01/28/22
A federal judge in Texas sentenced Bradley Harris, former head of Novus Health Services, Inc. hospice company in Frisco, to more than thirteen years in prison and ordered him to pay $27.6 million in restitution. The sentence, announced in a DOJ press release, follows his guilty plea on charges of conspiracy and fraud on Medicare and Medicaid.
Harris is the latest to be sentenced in a fraud scheme spanning...
Top Ten Financial and Healthcare Fraud Prison Sentences of 2021
Posted 01/28/22
Individuals involved in financial and healthcare fraud schemes face not just civil liability, but also criminal penalties – including prison time. In 2021, the Department of Justice obtained substantial prison sentences in a myriad of cases involving healthcare and financial frauds, many of which involved convictions of the type of fraudulent schemes that whistleblowers report. Whistleblowers play an essential role...
Catch of the Week: 13 Conspirators Busted in $100 Million No-Fault Insurance Fraud
Posted 01/14/22
The U.S. Attorney this week announced the arrest of doctors, businesspeople, an attorney, a New York police officer, and several others in one of the largest no-fault automobile insurance fraud takedowns in history.
The investigation leading to their arrest was conducted by the U.S. Attorney’s Office for the Southern District of New York, the FBI, and the Westchester County District Attorney’s Office. The...
Consistent with the trend in prior years, the bulk of the Justice Department’s fraud and false claims recoveries in 2021 stemmed from healthcare fraud matters. Most of the funds recovered arose from cases originated by whistleblowers under the qui tam provisions of the False Claims Act.
The majority of the recoveries on this list involve allegations of violations of the Anti-Kickback Statute, a federal law that...