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Page 31 of 158

March 5, 2021

A substance abuse treatment facility and two inpatient psychiatric hospitals in Ohio, along with their corporate parent, have agreed to pay $10.25 million to resolve claims under the Anti-Kickback Statute and False Claims Act.  According to DOJ, between 2013 and 2019, The Woods at Parkside, Cambridge Behavioral Hospital, and Ridgeview Behavioral Hospital—all owned by Florida-based Oglethorpe Inc.—allegedly provided improper inducements in the form of free long-distance transportation in order to entice patients to seek treatment at their facilities, and then submitted claims for services provided to those patients to Medicare.  The case was initiated by a former client advocate working at Cambridge, Darlene Baker.  DOJ; USAO SDOH

March 4, 2021

Alabama-based Heart Center Research, LLC has agreed to pay $1.1 million to settle allegations of receiving kickbacks from now-defunct Seattle-based medical testing company Natural Molecular Testing Corporation (NMTC) in exchange for referring patients for genetic testing.  In 2019, DOJ settled with three doctors and a medical practice also involved with the NMTC scheme, for $1.1 million.  USAO WDWA

March 3, 2021

The CEO of a group of medical providers in Michigan and Ohio has been sentenced to 15 years in prison and ordered to pay over $51 million in restitution to Medicare, as well as forfeit over $11.5 million in cash along with multiple properties and a Detroit Pistons season ticket membership, following a trial that found him guilty for his role in an extensive fraud scheme against Medicare.  Mashiyat Rashid, the CEO of Tri-County Wellness Group, allegedly instituted a corporate policy that forced patients—many of whom were addicted to opioids and recruited from homeless shelters and soup kitchens—to submit to medically unnecessary but highly reimbursed back injections in exchange for prescriptions to medically unnecessary opioids.  To implement the policy, Rashid made a point to hire physicians who were willing to put profit over patient care, further incentivizing them by offering to split reimbursements with them.  Yet according to trial testimony, many of the patients did not want, need, or benefit from the painful back injections, which left some of them suffering from adverse conditions, including open holes in their back.  Rashid is the second defendant to be sentenced in this case; twenty-one other defendants, including two physicians, have been convicted so far. DOJ

March 2, 2021

North Carolina durable medical equipment provider A Perfect Fit for You, Inc. and its owner Margaret Gibson have agreed to pay a total of $24.14 million to resolve civil claims that they falsely billed Medicaid for DME that had never been ordered or delivered, including by using the personally identifying information of Medicaid recipients who had been dead for years.  In addition, to resolve criminal charges of healthcare fraud, the company will pay an additional $2 million fine and $10.1 million in restitution to the North Carolina Medicaid program.  USAO ED NC

March 2, 2021

Medical practice Allergy and Asthma Associates Inc., in Roanoke, Virginia, will pay $2.1 million to resolve allegations that it fraudulently billed Medicare and Medicaid for asthma treatments.  AAA treated patients with Xolair, an asthma treatment sold in single-use vials, and billed government healthcare programs for the entire vial when, in fact, they were splitting vials between different patients.  USAO WDVA

February 25, 2021

Following a self-disclosure to the U.S. Department of Health and Human Services in 2018, Bioventus, LLC has agreed to pay more than $3.6 million to resolve allegations of violating the False Claims Act in connection with sales of its Exogen ultrasonic bone growth stimulator device.  According to Bioventus, it discovered that its sales representatives sometimes improperly completed sections of certificates of medical necessity (CMN) that Medicare rules require be completed by treating physicians or physician offices.  USAO MDNC

February 25, 2021

Texas Center for Orthopedic and Spinal Disorders and its owner, osteopath Mark Kuper, have agreed to a judgment of $11.2 million to resolve claims arising from their fraudulent billing of government healthcare programs.  Kuper also pleaded guilty to healthcare fraud, and was sentenced to 10 years in prison.  Defendants admitted that they submitted claims for services that were never rendered, including claims for one-on-one physical therapy pursuant to an individualized plan of care, when patients were actually attending group sessions with an athletic trainer, and claims for 60-minute psychotherapy sessions when patients actually spoke with unqualified individuals for just 15-20 minutes.  In addition, Kuper permitted his wife to use his credentials to issue prescriptions for controlled substances.  The civil investigation was initiated by a qui tam complaint filed by Richard Brown, who will receive 17% of the government’s recovery.  USAO ND TX

February 19, 2021

Antonio Olivera, a hospice administrator in Southern California, has been sentenced to 2.5 years in prison and ordered to pay nearly $2.2 million in restitution for his role in a multimillion dollar fraud scheme that ran from 2011 to 2018.  Together with three co-conspirators, Olivera paid illegal kickbacks to patient recruiters for referrals of Medicare beneficiaries to the hospice, Mhiramarc Management LLC.  When Mhiramarc staffers realized the referrals did not qualify for hospice, Olivera overruled them and caused the referrals to be put on hospice, ultimately causing Medicare to pay over $17 million in false claims.  DOJ

February 12, 2021

The operator of Georgia-based durable medical equipment company Wilmington Island Medical Inc. has been sentenced to two years in prison and ordered to pay about $550,000 in restitution for paying kickbacks to doctors and nurse practitioners in exchange for signed orders and then billing those orders to Medicare.  The judgment against Patrick Wolfe is part of an ongoing investigation by the Southern District of Georgia to crack down on more than $1.5 billion in losses to Medicare and Medicaid originating from the district.  So far a total of thirty-one individuals and companies have been charged.  USAO SDGA

February 9, 2021

India-based cancer drug manufacturer Fresenius Kabi Oncology Limited (FKOL) has agreed to pay $50 million in fines and forfeiture for failing to provide certain records to FDA investigators.  In violation of the Federal Food, Drug and Cosmetic Act, which helps ensure the purity and potency of drugs sold in the United States, FKOL actively obstructed a 2013 FDA inspection of one of its plants by removing and deleting manufacturing records.  As part of the settlement, FKOL has also agreed to implement a compliance and ethics program to prevent, detect, and correct any further violations of U.S. laws.  DOJ; USAO NV
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