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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,

DOJ Charges Healthcare CEO with Criminal Securities and Healthcare Fraud

Posted 06/12/20

Hands in handcuffs behind back of white man in business suit

In 2008, Rahm Emanuel, then-President Obama’s chief of staff, famously said, “You never want a serious crisis to go to waste. I mean, it’s an opportunity to do things that you think you could not do before.” However poorly phrased, generations of political and business leaders have understood the kernel of truth in his admonition. So have scammers and rip-off artists. We have been following the...

Tagged in: Catch of the Week, COVID-19, Criminal Proceedings, Financial and Investment Fraud, Healthcare Fraud, Laboratory and IDTF, Lack of Medical Necessity, Market Manipulation and Trading Violations, Misrepresentations, Securities Fraud,

Charges Filed in Shameful COVID-19 and Genetic-Cancer-Screening Test Scam

Posted 04/3/20

Erik Santos of Braselton, Georgia had run a fraudulent genetic cancer-screening-test scheme for months, then spotted an opportunity capitalize on fear surrounding COVID-19. According to the criminal complaint, Santos targeted elderly persons to determine if they met certain eligibility requirements for testing under government health-care programs. He passed the information along to co-conspirator testing...

Tagged in: Anti-Kickback and Stark, CC Lawyers, COVID-19, FCA Federal, Healthcare Fraud, Importance of Whistleblowers, Laboratory and IDTF, Lack of Medical Necessity, Provider Fraud,

Treble Damages Awarded in Medicare Whistleblower Case

Posted 02/21/20

The Fifth Circuit upheld a 2018 lower court decision this week, finding defendant BestCare Laboratory Services, LLC and its owner Karim Maghareh liable for treble damages—to the tune of just over $30 million—under the False Claims Act. BestCare provided clinical testing services for nursing home residents, many of whom were Medicare beneficiaries. Rather than billing for a technician’s travel to and from the...

Tagged in: Court Decision, Defenses, FCA Federal, Importance of Whistleblowers, Laboratory and IDTF, Medical Billing Fraud, Medicare, Whistleblower Case,

Catch of the Week — Comprehensive Pain Specialists Targeted for Urine Drug Testing Fraud

Posted 07/26/19

Laboratory sample vial lying on procedure coding form

Our Catch of the Week goes to Comprehensive Pain Specialists (CPS), a now-shuttered pain-management chain that was once one of the largest in the nation, treating as many as 48,000 pain patients a month at about 60 clinics across 11 states. CPS shut down in 2018 with little warning to patients and employees. On Monday, July 22, the United States and the State of Tennessee announced their partial intervention in...

Tagged in: Anti-Kickback and Stark, Bundling and Unbundling, Catch of the Week, FCA Federal, Healthcare Fraud, Improper Medical Personnel, Laboratory and IDTF, Lack of Medical Necessity, Medical Billing Fraud, Whistleblower Case,

Catch of the Week – Inform Diagnostics

Posted 02/1/19

Technician in laboratory safety wear using eyedropper to fill vials of blood

Texas-based pathology laboratory company Inform Diagnostics, formerly known as Miraca Life Sciences Inc., agreed on January 30th to a $63.5 million settlement to resolve allegations it violated the False Claims Act (“FCA”), the Anti-Kickback Statute (“AKS”), and the Stark Law by providing subsidies to referring physicians for electronic health record (“EHR”) technology as well as free or discounted...

Tagged in: Anti-Kickback and Stark, Catch of the Week, Electronic Health Records, FCA Federal, Healthcare Fraud, Laboratory and IDTF, Multiple Whistleblowers and First-to-File, Whistleblower Case,

Genetic Testing Company Settles Whistleblower Suit for $11.4M

Posted 03/14/18

Silicon Valley-based Natera, Inc. agreed to pay over $11 million to resolve claims it improperly billed government healthcare programs for its non-invasive prenatal tests and screenings in violation of the False Claims Act by billing for the tests with an incorrect billing code. In resolution of the allegations, Natera will pay over $10.6 million to the federal government and $756,183 to a number of state Medicaid...

Tagged in: FCA Federal, Laboratory and IDTF, Medical Billing Fraud, Whistleblower Case, Whistleblower Rewards,

Family Medicine Centers Settles Whistleblower False Claims Act Charges

Posted 09/12/17

By the C|C Whistleblower Lawyer Team A South Carolina family medical practice chain, along with its owner and laboratory director, agreed to pay roughly $2 Million to settle charges of violating the False Claims Act and Stark Law which prohibits physician self-referrals. Specifically, Family Medicine Centers of South Carolina (FMC) agreed to pay $1.56 million, and FMC's principal owner Dr. Stephen F. Serbin and...

Tagged in: Anti-Kickback and Stark, FCA Federal, Laboratory and IDTF, Lack of Medical Necessity, Provider Fraud, Whistleblower Case, Whistleblower Rewards,

Poplar Healthcare to Pay Nearly $900k to Resolve Whistleblower’s False Claims Act Allegations

Posted 05/3/17

By the C|C Whistleblower Lawyer Team The Justice Department announced the settlement on Monday, which resolves allegations that Memphis’s Poplar Healthcare and its subsidiary GI Pathology promoted and billed the government for medically unnecessary diagnostic tests. Poplar allegedly marketed certain stain tests as capable of definitely diagnosing a condition called mast cell enterocolitis. But according to...

Tagged in: FCA Federal, Laboratory and IDTF, Lack of Medical Necessity, Whistleblower Case,

DOJ Secures $11.4 Million FCA Settlement

Posted 04/26/17

By the C|C Whistleblower Lawyer Team Yesterday, the Department of Justice announced that as Pacific Pulmonary Services will pay $11.4 million to settle a False Claims lawsuit. At issue in the case were allegedly false claims to Medicare and other federal healthcare programs for oxygen and related equipment supplied in violation of program rules, as well as claims for sleep therapy equipment tainted by a kickback...

Tagged in: Anti-Kickback and Stark, FCA Federal, Healthcare Fraud, Laboratory and IDTF, Medical Devices and DME, Whistleblower Case, Whistleblower Rewards,

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

DOJ Charges Healthcare CEO with Criminal Securities and Healthcare Fraud

Charges Filed in Shameful COVID-19 and Genetic-Cancer-Screening Test Scam

Treble Damages Awarded in Medicare Whistleblower Case

Catch of the Week — Comprehensive Pain Specialists Targeted for Urine Drug Testing Fraud

Catch of the Week – Inform Diagnostics

Genetic Testing Company Settles Whistleblower Suit for $11.4M

Family Medicine Centers Settles Whistleblower False Claims Act Charges

Poplar Healthcare to Pay Nearly $900k to Resolve Whistleblower’s False Claims Act Allegations

DOJ Secures $11.4 Million FCA Settlement

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