Archive

February 1, 2017

Florida urologist Dr. Meir Daller agreed to pay $3.81 million to resolve allegations he violated the False Claims Act by causing claims to be submitted to federal health care programs for laboratory tests that were not medically necessary.  Dr. Meir practices as part of Gulfstream Urology, a division of 21st Century Oncology, LLC, which is a nationwide provider of integrated cancer care services.  The government previously entered into settlements relating to similar allegations with 21st Century Oncology for $19.75 million and urologists David Spellberg and Robert Scappa for $1,050,000 and $250,000, respectively.  The allegations originated in a whistleblower lawsuit filed under the qui tam provisions of the False Claims Act by Mariela Barnes, a former medical assistant for Dr. Spellberg at Naples Urology Associates, also a division of 21st Century Oncology.  She will receive a whistleblower award of $571,500 from the proceeds of the government's recovery in this settlement.  This is in addition to a $3,437,000 million award she already received from the prior settlements.  DOJ (MDFL)

January 27, 2017

Brooklyn residents Olga Proskurovsky, Yuriy Omelchenko and Isak Aharanov pleaded guilty in connection with a health care fraud scheme involving two Brooklyn clinics that caused approximately $55 million in false claims to Medicare and Medicaid.  They agreed to forfeiture money judgments in the amount of roughly $17 million.  Proskurovsky served as a medical biller and Omelchenko worked as a therapist manager at Prime Care on the Bay LLC and Bensonhurst Mega Medical Care P.C. where they assisted in a scheme to defraud the Medicare and Medicaid programs in which patients subjected themselves to medically unnecessary health services, including physical and occupational therapy, provided by unlicensed staff.  DOJ

January 19, 2017

The University of Pennsylvania Health System agreed to pay $845,000 to settle charges of violating the False Claims Act by improperly billing Medicare for stent procedures two interventional cardiologists performed at Pennsylvania Hospital.  DOJ (EDPA)

January 13, 2017

Massachusetts-based ambulance company Medstar Ambulance Inc., including four subsidiary companies and its two owners, Nicholas and Gregory Melehov, agreed to pay $12.7 million to resolve allegations that they violated the False Claims Act by submitting false claims to Medicare for ambulance transport services. According to the government, Medstar routinely billed for services that did not qualify for reimbursement because the transports were not medically reasonable and necessary, billed for higher levels of services than were required by patients’ conditions, and billed for higher levels of services than were actually provided. The allegations originated in a whistleblower lawsuit filed under the qui tam provisions of the False Claims Act by Dale Meehan, a former employee in Medstar’s billing office. Mr. Meehan will receive a whistleblower award of roughly $3.5 million. DOJ

January 12, 2017

Idia Oriakhi, the administrator of five Houston-area home health agencies, pleaded guilty to conspiring to defraud the State of Texas’ Medicaid-funded Home and Community-Based Service and the Primary Home Care Programs of more than $7.8 million. Oriakhi’s parents owned and operated Aabraham Blessings, LLC; Baptist Home Care Providers, Inc.; Community Wide Home Health, Inc.; Four Seasons Home Healthcare, Inc. and Kis Med Concepts, Inc. and admitted that she, her father Godwin Oriakhi and others obtained patients for her family’s home health agencies by paying illegal kickback payments to patient recruiters and physicians for referring and certifying Medicaid patients for services not medically necessary and often not provided. DOJ

January 12, 2017

Connecticut home healthcare provider Family Care Visiting Nurse and Home Care Agency, LLC and its owners David A. Krett and Rita C. Krett agreed to pay roughly $5.25 million to resolve allegations they violated the False Claims Act by billing for services which under Medicaid required a registered nurse when in fact a registered nurse did not provide the services. The government further alleged the company submitted claims to Medicaid for patients who were or may have been dually eligible for Medicare and Medicaid without first following required procedures for submitting claims to Medicare. DOJ (DCT)

January 12, 2017

The Confederated Tribes of the Colville Reservation (CGT) agreed to pay roughly $246,000 to settle charges it violated the False Claims Act by submitting false claims to Medicaid seeking the reimbursement of mental health counseling services either not provided or not medically indicated or necessary. The CCT is a federally recognized, sovereign Indian tribe, with tribal offices located at Nespelem, Washington, on the Tribes’ reservation. DOJ (EDWA)

January 9, 2017

Detroit-area neurosurgeon Aria O. Sabit was sentenced to 235 months in prison for his role in a $2.8 million health care fraud scheme in which he caused serious bodily harm to patients by performing unnecessary invasive spinal surgeries. Sabit owned and operated the Michigan Brain and Spine Physicians Group. He admitted deriving significant profits by convincing patients to undergo spinal fusion surgeries with “instrumentation” (medical devices designed to stabilize and strengthen the spine) that he never performed and billed public and private healthcare benefit programs for those fraudulent services. Whistleblower Insider

January 5, 2017

Ultimate Nursing Services of Iowa, Inc. and its president Steven Tucker Anderson agreed to pay $1 million to settle charges they violated the False Claims Act by submitting cost reports for non-reimbursable travel and entertainment expenses and for non-reimbursable costs associated with services provided to Ultimate Nursing by other entities owned by Anderson or a family member. DOJ (NDIA)

January 12, 2017

Texas announced a settlement with MB2 Dental Solutions (MB2) and 21 affiliated pediatric dental practices. MB2 agreed to pay the United States and the State of Texas $8.45 million for alleged violations of the federal False Claims Act (FCA) and the Texas Medicaid Fraud Prevention Act (TMFPA). Three lawsuits were resolved with this settlement alleging that MB2 knowingly submitted claims for children’s dental services which were either not performed or were provided after false identification was used. The claims also involved illegal kickbacks to Medicaid beneficiaries and their families, marketers and marketing entities. The allegations were brought to the attention of the U.S. and Texas authorities by whistleblowers who filed one lawsuit under the FCA and two under the TMFPA. TX