Archive

January 10, 2014

Two former executives of HealthEssentials Solutions agreed to pay more than $1 million to resolve False Claims Act allegations that they knowingly caused the company to submit false Medicare claims between 1999 and 2004 by billing for services that were inflated or not medically necessary and by pressuring employees to do the same. The allegations were first raised in a qui tam lawsuit filed under the whistleblower provisions of the False Claims Act. DOJ

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

December 19, 2013

Dr. Elie Korban will pay $1.2M to resolve False Claims Act allegations that he billed Medicare and Medicaid for medically unnecessary cardiac stent placements. The allegations were first raised in a qui tam lawsuit filed under the whistleblower provisions of the False Claims Act. DOJ

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

November 19, 2013

The Ensign Group agreed to pay $48M to resolve allegations that it knowingly submitted to Medicare false claims for medically unnecessary rehabilitation therapy services. The allegations were first raised in a qui tam lawsuit filed under the whistleblower provisions of the False Claims Act. DOJ

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

June 29, 2015

New York announced a settlement with pharmacy Trinity Homecare LLC that returns $2.5 million to the state’s Medicaid program. A whistleblower filed a lawsuit in 2009 alleging that Trinity pushed infusion drugs, which are prescribed to manage symptoms, to hemophilia patients and presented claims to Medicaid for unneeded or excessive quantity of these drugs. The whistleblower alleged improper billing for drug deliveries, including ones that patients refused to accept and excess shipments. In at least one instance, these expensive drugs were allegedly left outside a patient’s home without signature by the patient. NY

Tagged in: FCA State, Lack of Medical Necessity, Medicaid, Whistleblower Case,

April 16, 2015

Georgia doctor Zheng Xiang Wang and the Wang Eye Clinic, P.C. agreed to pay $790,000 to settle allegations they billed Georgia Medicaid for medically unnecessary ophthalmology procedures. GA

Tagged in: Lack of Medical Necessity, Medicaid, Provider Fraud,

April 23, 2014

Amedisys home health companies agreed to pay $150M resolve allegations they violated the False Claims Act by allegedly billing Medicare for nursing and therapy services not medically necessary or provided to patients who were not homebound, and by otherwise misrepresenting patients’ conditions to increase its Medicare payments. The allegations were first raised in several qui tam lawsuit filed by former Amedisys employees under the whistleblower provisions of the False Claims Act. DOJ

Tagged in: FCA Federal, Home Health and Hospice, Lack of Medical Necessity, Whistleblower Case, Whistleblower Rewards,

January 5, 2014

New York Attorney General Eric T. Schneiderman announced that Apple Transportation of New York, Inc. will pay $300,000 to settle claims it overbilled Medicaid for transportation services. As part of a settlement agreement, Apple Transportation admitted that between January 1, 2004 and October 30, 2008, it frequently billed Medicaid for ambulette services even though no personal assistance was provided to Medicaid recipients. As a result, Apple was paid by Medicaid for ambulette services at rates that were higher than the applicable livery rates. NY

Tagged in: Lack of Medical Necessity, Medicaid, Provider Fraud,

August 19, 2013

Shands Teaching Hospital & Clinics agreed to pay $26M to settle allegations that six of its health care facilities submitted false claims to Medicare, Medicaid and other federal health care programs for inpatient procedures that should have been billed as outpatient services. The allegations were first raised in a qui tam lawsuit filed under the whistleblower provisions of the False Claims Act. DOJ

Tagged in: FCA Federal, Hospital Fraud, Lack of Medical Necessity, Medical Billing Fraud,

Contact

Click here for a confidential contact or call: