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

Posted  05/14/21
University of Miami logo
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...

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

Posted  04/30/21
compounding pharmacy drugs
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...

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

Posted  04/16/21
female looking through a lab telescope
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...

Catch of the Week: Unnecessary Blood Flow Tests Led to Unnecessary Flow of Healthcare Dollars

Posted  03/19/21
Doctor in handcuffs holding a stethoscope
Healthcare fraudsters routinely look for ways to extract money from federal health programs in ways that raise the least suspicion of their actions.  One of these methods is through unnecessary diagnostic testing, which can often be lucrative when conducted routinely on large groups of patients. This week we focus on a recent settlement with Dr. Dinesh Shah and Michigan Physicians Group, P.C. (“MPG”) for $2...

The False Claims Act: It Benefits More than Just the Government

Posted  03/5/21
statue of Abraham Lincoln
The False Claims Act, a Civil War-era law, encourages private individuals, such as whistleblowers, to come forward and file suit against unscrupulous government contractors, and share in the government's recovery. The passage of the law was inspired by contractors selling the Union Army bags of sand as flour, lame mules as cavalry horses, and glued-together rags as uniforms. The main purpose of the law is, of...

Catch of the Week: 345 Charged in $6 Billion National Health Care Fraud and Opioid Takedown

Posted  10/2/20
Paper Ripped Uncovering Medical Necessity Wording
In the largest health care fraud and opioid enforcement action in the Justice Department’s history, 345 defendants—including more than 100 doctors, nurses, and other medical professionals—face charges for submitting over $6 billion in false or fraudulent claims to federal and private insurers.  Defendants stand accused of submitting $4.5 billion in fraudulent claims linked to telemedicine, $845 million...

Visiting Nurse Service of New York Settles Whistleblower Case Brought by Constantine Cannon Client for $57 Million

Posted  06/26/20
hand holding hospice patients hand
Constantine Cannon is pleased to announce a $57 million settlement of the False Claims Act lawsuit its whistleblower client brought against the Visiting Nurse Service of New York (VNSNY).  VNSNY is the largest not-for-profit home health care agency in the country, serving roughly 150,000 patients a year in New York, most of whom are elderly and/or disabled. The whistleblower, Edward Lacey, was an executive at...

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...

Catch of the Week: Logan Laboratories and Tampa Pain Relief Centers for Urine Drug Testing Fraud

Posted  04/17/20
Doctor with Cash
This week's Catch of the Week goes to Logan Laboratories, Inc. (Logan Labs), a reference laboratory in Tampa, Florida. Tampa Pain Relief Centers, Inc. (Tampa Pain), a pain clinic also based in Tampa, Florida, and two of their former executives who have agreed to pay a total of $41 million to resolve alleged violations of the False Claims Act for billing various federal health care programs for medically unnecessary...

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

Posted  04/3/20
doctor-mask
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...
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