Archive

Scoundrel Spotlight - COVID-19 Fraudster Lourdes Navarro

Posted 10/9/23

This week's Scoundrel in the Spotlight is Lourdes Navarro and her husband Imran Shams. The married pair ran the LA County medical lab Clinical Laboratory Inc. (also called Health Care Providers Laboratory). Their lab performed COVID-19 screening tests primarily for nursing homes and other facilities catering to the elderly population. Last Thursday (October 5), Navarro pleaded guilty to fraudulently billing the...

Tagged in: COVID-19, Healthcare Fraud, Lack of Medical Necessity, Medical Billing Fraud, Medicare, Risk Adjustment Fraud,

Scoundrel Spotlight - Medicare Fraudster Jesus Virlar-Cadena

Posted 10/2/23

This week’s Scoundrel in the Spotlight is Jesus Virlar-Cadena, a former medical director of a Texas-based healthcare provider called Merida Group, who was recently sentenced to over four years in prison in connection with a fraudulent scheme involving over $150 million in false Medicare claims, according to a DOJ press release. The Merida Group marketed hospice services to patients with long-term incurable...

Tagged in: Criminal Proceedings, Healthcare Fraud, Home Health and Hospice, Lack of Medical Necessity, Medicare, Provider Fraud,

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...

Tagged in: FCA Federal, Healthcare Fraud, Lack of Medical Necessity, Medical Devices and DME, Medicare,

Catch of the Week: Gramercy Cardiac Diagnostic Services

Posted 09/26/23

businessmen shaking hands and other placing money in others pocket

This week's Department of Justice (DOJ) Catch of the Week goes to Gramercy Cardiac Diagnostic Services and its owner Klaus Peter Rentrop. Gramercy provides cardiac diagnostic imaging services, previously operating out of four offices in New York City. On Monday (September 18), the DOJ announced Rentrop and Gramercy will pay $6.5 million for violating the False Claims Act and Anti-Kickback Statute through their...

Tagged in: Anti-Kickback and Stark, FCA Federal, Healthcare Fraud, Provider Fraud, Whistleblower Case,

Catch of the Week: Lincare Holdings

Posted 08/31/23

This week's Department of Justice (DOJ) Catch of the Week goes to Florida-based Lincare Holdings, Inc., a wholly-owned subsidiary of the German chemical corporation Linde plc. On Monday (August 28), the DOJ announced that the company agreed to pay $29 million to settle charges of violating the False Claims Act by overbilling Medicare and Medicare Advantage Plans for oxygen equipment. Lincare provides oxygen...

Tagged in: Catch of the Week, FCA Federal, Healthcare Fraud, Medicare, Whistleblower Case,

DOJ Smackdown of COVID-19 Fraud

Posted 08/25/23

On Wednesday (August 23), the Department of Justice (DOJ) announced significant progress in its ongoing effort to combat COVID-19 fraud. The agency reported a nationwide, coordinated three-month sweep resulting in more than 700 enforcement actions involving hundreds of defendants, covering more than $800 million in alleged COVID-19 fraud. According to the government, these actions largely involved going after...

Tagged in: Contract Non-Compliance, COVID-19, FCA Federal, Healthcare Fraud, Whistleblower Eligibility,

Scoundrel Spotlight - Medicare Fraudster Minal Patel

Posted 08/23/23

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...

Tagged in: Anti-Kickback and Stark, Criminal Proceedings, Healthcare Fraud, Laboratory and IDTF, Lack of Medical Necessity, Medicare,

District Court Rules that Broad Measure of Damages Applies in False Claims Act Case, Greatly Increasing Defendants’ Exposure

Posted 07/21/23

Several aspects of the federal False Claims Act incentivize the government and relators to bring fraud claims to recover damages to the government. In addition to awarding relators typically between 15% and 30% of the proceeds of the action or settlement; awarding reasonable attorneys’ fees, expenses, and costs; and applying statutory penalties for each false claim submitted; the act also provides for treble...

Tagged in: Anti-Kickback and Stark, Court Decision, FCA Federal, Healthcare Fraud,

Catch of the Week: NextGen Healthcare

Posted 07/14/23

This week's Department of Justice (DOJ) Catch of the Week goes to electronic health record (EHR) technology vendor NextGen Healthcare Inc. Today, DOJ announced the company has agreed to pay $31 million to settle charges it violated the False Claims Act by misrepresenting to the government the capabilities of its EHR software and providing kickbacks to its users to induce them to recommend NextGen’s software. The...

Tagged in: Anti-Kickback and Stark, Catch of the Week, Electronic Health Records, FCA Federal, Healthcare Fraud, Whistleblower Case,

Beware of Salty Snacks and Candy Containing THC

Posted 07/7/23

Stack of Multicolored Gummy Bears with One Standing

On Wednesday (July 5), the FTC and FDA jointly issued cease and desist letters to several companies selling various food products containing THC, the key psychoactive ingredient in marijuana. In announcing the enforcement action, the government made it clear the problem is not the sale of these products. It is how they are selling them, which according to the agencies is in almost identical packaging to many...

Tagged in: FDA Fraud, Off-Label and Unapproved Use,

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Scoundrel Spotlight - COVID-19 Fraudster Lourdes Navarro

Scoundrel Spotlight - Medicare Fraudster Jesus Virlar-Cadena

Nurse Practitioner Convicted in $200 Million Medicare Fraud Scheme

Catch of the Week: Gramercy Cardiac Diagnostic Services

Catch of the Week: Lincare Holdings

DOJ Smackdown of COVID-19 Fraud

Scoundrel Spotlight - Medicare Fraudster Minal Patel

District Court Rules that Broad Measure of Damages Applies in False Claims Act Case, Greatly Increasing Defendants’ Exposure

Catch of the Week: NextGen Healthcare

Beware of Salty Snacks and Candy Containing THC

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