Archive

March 6, 2018

Iowa chiropractor Bradley Brown and his clinic Brown Chiropractic, P.C. agreed to pay roughly $80,000 to settle claims they violated the False Claims Act and Anti-Kickback Statute by billing Medicare and Medicaid for chiropractic adjustments after providing free electrical stimulation to beneficiaries to influence those beneficiaries to receive chiropractic adjustments from Brown. DOJ (NDIA)

February 28, 2018

Rafael Arias, the owner of numerous Miami-area home health agencies, was sentenced to 240 months in prison and pay $66.4 million in restitution for his role in a $66 million conspiracy to defraud the Medicare program. As part of his guilty plea, Arias admitted recruiting nominee owners to falsely and fraudulently represent themselves as the agencies’ owners to hide his identity and ownership interest. Arias and his co-conspirators paid illegal bribes and kickbacks to patient recruiters to refer patients to these agencies, and submitted false and fraudulent home health care claims to Medicare for beneficiaries who, in many cases, did not qualify or for whom the services were never provided. DOJ

February 22, 2018

Samuel Konell was sentenced to 60 months in prison and pay roughly $10 million for his role in a $63 million health care fraud scheme involving now-defunct Greater Miami Behavioral Healthcare Center Inc. which purported to provide partial hospitalization program (PHP) services to individuals suffering from mental illness. Konell admitted he received kickbacks and/or bribes in return for referring Medicare beneficiaries from the Miami-Dade state court system to Greater Miami to serve as patients. He admitted he coordinated with criminal defendants in the state court system to obtain court orders for mental health treatment in lieu of incarceration so that he could refer those individuals to Greater Miami to serve as patients in return for kickbacks and/or bribes. Konell further admitted that he did so knowing that certain of those individuals were not mentally ill or otherwise did not meet the criteria for PHP treatment. DOJ

February 13, 2018

Detroit-area doctor Mahmoud Rahim was sentenced to 72 months in prison and ordered to forfeit roughly $1.7 million for his role in a $10.4 million conspiracy to defraud the Medicare program. According to the evidence presented at trial, Rahim accepted kickbacks in exchange for referring Medicare patients for electromyogram tests, some of which were unnecessary, and physical therapy performed by unlicensed individuals. DOJ

January 25, 2018

Primex Clinical Laboratories, LLC agreed to pay $3.5 million to settle claims it violated the False Claims Act and Anti-Kickbacks Statue by paying kickbacks in exchange for laboratory referrals for patient pharmacogenetic testing. The allegations originated by a whistleblower lawsuit filed under the qui tam provisions of the False Claims Act by former sales reps Don Pyburn and David Choate. They will receive a whistleblower award of $754,000 from the proceeds of the government’s recovery. DOJ (NDTX)

January 23, 2018

Drs. Aytac Apaydin and Stephen Worsham, urologists based in Northern California who own Salinas Valley Urology Associates and formerly owned Advance Radiation Oncology Center, will pay roughly $1 million to settle claims they violated the False Claims Act by submitting claims to Medicare for image guided radiation therapy (IGRT) that was referred and billed in violation of the physician self-referral law (the “Stark Law”) and the Anti-Kickback Statute. DOJ

February 15, 2018

New York announced the arrest and indictment of, as well as a civil asset forfeiture action against, Arkady Goldin, 39, of Brooklyn, and Value Pharmacy, Inc. ("Value"), for allegedly defrauding the New York State Medicaid program out of millions of dollars. Goldin, an owner of Value, is charged with Grand Larceny in the First Degree and other crimes for having allegedly paid kickbacks to a hospital employee for the referral of prescriptions for costly cancer medications. Additionally, prosecutors allege that Value billed Medicaid for over a million dollars of prescription medication it did not have in stock to dispense. The Attorney General’s Medicaid Fraud Control Unit ("MFCU"), also filed an asset forfeiture and civil recovery action against Goldin, Value, and Goldin’s co-owners seeking over $8.7 million in damages and penalties, alleging that Value’s owners made millions from these schemes that they funneled through shell companies to purchase personal expenses such as travel, luxury cars, and a high-end country club membership. NY

January 4, 2018

Kim Ricard was sentenced to 51 months in prison and to pay roughly $2 million in restitution for her involvement in a $2 million home health kickback scheme carried out through a New Orleans area home health agency. DOJ

December 20, 2017

Maryland-based pharmaceutical company United Therapeutics Corporation agreed to pay $210 million to resolve claims it violated the False Claims Act and Anti-Kickback Statute by using a foundation as a conduit to pay the copays of Medicare patients taking the company's pulmonary arterial hypertension drugs. The government charged that covering the copays was prohibited remuneration used to induce Medicare patients to purchase the company’s products. DOJ

December 19, 2017

Two physician groups, EmCare Inc. and Physician’s Alliance Ltd, agreed to pay more than $33 million to settle charges of violating the False Claims Act and Anti-Kickback Statute for allegedly receiving kickbacks in exchange for patient referrals to hospitals owned by the now-defunct Health Management Associates. Dallas-based EmCare agreed to pay $29.6 million to resolve allegations it received remuneration from HMA to recommend patients be admitted to HMA hospitals on an inpatient basis when the patients should have been treated on an outpatient basis. In a separate settlement, Pennsylvania-based Physician's Alliance agreed to pay $4 million for allegedly accepting illegal remuneration from HMA to refer patients to two HMA hospitals, Lancaster Regional Medical Center and Heart of Lancaster Medical Center. The allegations originated in whistleblower lawsuits filed under the qui tam provisions of the False Claims Act.  Drs. Thomas Mason and Stephen Folstad brought the qui tam suit against EmCare and will receive a whistleblower award of roughly $6.2 million from the proceeds of the government's recovery. Former HMA hospital executives George E. Miller and Michael J. Metts brought the qui tam suit against Physician's Alliance and will receive a yet-to-be-determined award from the proceeds of the government's recovery. DOJ