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August 28, 2017

Oklahoma physician Dr. Gordon P. Laird agreed to pay $580,000 to settle allegations he violated the False Claims Act by submitting false claims to Medicare for services he did not provide or properly supervise.  He is a former owner and employee of the companies Blackwell Feet Plus, LLC, and Feet Plus, LLC, which later did business as Prevention Plus. DOJ (WDOK)

Tagged in: FCA Federal, Medical Billing Fraud, Provider Fraud,

August 24, 2017

Nashville-based transportation service provider Employment & Assessment Solutions, Inc. and its principal Chris Manus agreed to pay $550,000 to settle allegations they violated the False Claims Act by submitting false claims to TennCare for transportation services which were never provided, including claims for patients who were actually incarcerated or hospitalized at the time of the purported transport. DOJ (MDTN)

Tagged in: FCA Federal, Medical Billing Fraud, Provider Fraud,

August 3, 2017

The Medical Center of Central Georgia, Inc. (d/b/a The Medical Center, Navicent Health) agreed to pay roughly $2.6 million to resolve allegations it violated the False Claims Act by submitting bills for ambulance transports that were either inflated or medically unnecessary.  The allegations originated in a whistleblower lawsuit filed under the qui tam provisions of the False Claims Act by former Navicent paramedic Andre Valentine.  He will receive a yet-to-be-determined whistleblower award from the proceeds of the government's recovery.  DOJ (MDGA)

Tagged in: FCA Federal, Lack of Medical Necessity, Provider Fraud, Whistleblower Case, Whistleblower Rewards,

October 16, 2017

Louisiana announced the arrests of three New Orleans women as a result of an investigation exposing over $2 million in Medicaid Fraud. Lanice Stamps, 44 of New Orleans and owner of A New Direction Support Services, was arrested on 10 counts of Medicaid fraud for allegedly providing false and fraudulent claims for behavioral health services not rendered. Many recipients were fraudulently diagnosed as moderately mentally retarded or severely autistic so that the claims submitted could be billed at a higher level and they had never received counseling services. LA

Tagged in: Healthcare Fraud, Medicaid, Medical Billing Fraud, Provider Fraud,

September 7, 2017

The Hartford Dispensary will pay $627,000 through a federal-state settlement to resolve allegations that it violated the False Claims Act by falsely certifying to federal and state officials that it had a current medical director that was performing his duties in accordance with federal and state law. In 2014, the Office of the Attorney General commenced an investigation after a whistleblower complaint about the Hartford Dispensary, a private nonprofit behavioral health organization; the investigation was followed by a qui tam lawsuit alleging various violations of the state and federal False Claims Act. The state’s investigation focused on services that Hartford Dispensary provides as an opioid treatment program – primarily methadone and detoxification services.

Tagged in: Certifications, FCA Federal, Provider Fraud, Whistleblower Case,

August 2, 2017

Atlanta-based pain management clinic Atlanta Medical Clinic and its owner Dr. Timothy Dembowski agreed to pay $250,000 to resolve charges they violated the False Claims Act by billing for services performed by a physician suspended from the Medicare program and administering foreign, non-FDA approved drugs, which are not eligible for reimbursement under the Medicare program.  DOJ (NDGA)

Tagged in: FCA Federal, Medicare, Provider Fraud,

July 24, 2017

Dr. James Norman, the owner and operator of Norman Parathyroid Center, agreed to pay $4 million to resolve allegations he violated the False Claims Act by billing Medicare for pre-operative examination services for which he had already received payment from the government.  These extra fees ranged from $150 to $750 for Florida residents, to $1,750 or more for patients who lived out-of-state, adding up to hundreds of thousands of dollars in illicit billing.  The allegations originated in a whistleblower lawsuit filed under the qui tam provisions of the False Claims Act by a former patient of Dr. Norman, Myra Gross, and her husband, Dr. David Gross.  They will receive a whistleblower award of roughly $600,000 from the proceeds of the government's recovery.  DOJ (MDFL)

Tagged in: FCA Federal, Medicare, Provider Fraud, Whistleblower Case, Whistleblower Rewards,

July 24, 2017

Tennessee-based Pain Management Group P.C. agreed to pay $312,000 to settle charges it violated the False Claims Act by billing for medically unnecessary urine drug tests and non-FDA approved pharmaceuticals Botox, Supartz, and Eufflexa, which the company purchased from foreign-based suppliers.  DOJ (MDTN)

Tagged in: Healthcare Fraud, Medicare, Provider Fraud,

July 14, 2017

Narco Freedom, Inc., a former operator of outpatient chemical dependency clinics, Joining Hands Management Inc., an operator of short-term residences known as “three-quarter houses,” and Joining Hands co-owner Devorah Haigler, settled claims of violating the False Claims Act.  The government will receive a $50.5 million allowed claim in the Narco Freedom bankruptcy proceeding, and Joining Hands and Haigler will pay $300,000.  The government alleged the defendants engaged in a kickback scheme whereby Narco made monthly cash payments to Joining Hands in exchange for Haigler and others referring residents of Joining Hands three-quarter houses to NARCO outpatient programs.  The allegations originated in a whistleblower lawsuit under the qui tam provisions of the False Claims Act.  An unidentified whistleblower will receive an undisclosed whistleblower award from the proceeds of the government's recovery.  DOJ (SDNY)

Tagged in: FCA Federal, Healthcare Fraud, Medicare, Provider Fraud, Whistleblower Case, Whistleblower Rewards,

July 13, 2017

New York podiatrist Perrin D. Edwards pled guilty to health care fraud for illegally charging Medicare and private insurance companies for podiatry services he never provided and agreed to pay $410,000 to resolve charges of violating the False Claims Act.  DOJ (NDNY)

Tagged in: Medical Billing Fraud, Medicare, Provider Fraud,

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