Catch of the Week: Telemedicine Company Owner Charged in $784 Million Kickback Scheme
Underscoring the fraud risks associated with the government’s continued expansion and loosening of restrictions on telehealth, the U.S. Department of Justice recently announced that a grand jury in New Jersey has returned a superseding indictment against the Florida owner of multiple telemedicine companies, referred to by DOJ prosecutors as the Video Doctor Network, for allegedly participating in a massive Medicare...
FDA’s Approval of Alzheimer’s Drug Highlights Need for Whistleblowers
The Food and Drug Administration (FDA) is supposed to protect American consumers from unscrupulous private actors—charlatans, snake-oil salesmen, and the like—seeking to profit by selling unproven medical “cures,” treatments, and devices to the public. Emerging during the era of the robber barons as part of Theodore Roosevelt’s efforts to “civilize capitalism,” the FDA has prevented untold harm to...
Catch of the Week: Dental Clinics to Pay $2.7M for Using Unsterilized Tools on Medicaid Patients
For over five years, Upper Allegheny Health Systems, a health care system operating several dental clinics in New York and Pennsylvania, allegedly performed dental services without sterilizing equipment between patients and falsely billed Medicaid for those services. After a former employee blew the whistle, the United States and the State of New York stepped in to investigate, and the defendant agreed to a $2.7...
DOJ Lowers The Boom On COVID-19 Healthcare Scams, Again
Hey, fraudsters, did you hear? There was a global pandemic, so the government pumped trillions of dollars into the economy. Probably a good time to get a piece of the cut, you ask? They’ll never find out, right? So many ways to grift!
Well, not so much. From the start, the cops on the beat, led by the United States Department of Justice, have screamed from the rooftops: “Don’t do it. We WILL...
Catch of the Week: Virginia OB/GYN Sentenced to 59 Years in Prison for Performing Medically Unnecessary Procedures for More Than Ten Years
Healthcare fraudsters are typically motivated by greed. But in satisfying that greed, some fraudsters perform reprehensible acts that permanently affect the victims of the fraud, making even the penalty they receive pale in comparison.
This week we focus on the conviction of Javaid Perwaiz, an OB/GYN in Hampton Roads, Virginia, who was sentenced to 59 years in prison for performing medically unnecessary surgeries...
Catch of the Week: University of Miami to Pay $22 Million to Resolve Allegations of Lab Test Fraud
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
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
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
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
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...