Archive

November 3, 2022

Titan Medical Compliance, LLC, and its chiropractor owner Timothy Warren, have been ordered to pay over $15 million to resolve claims that they falsely marketed auricular electro-acupuncture devices as FDA-approved and Medicare-reimbursable, when in fact they are not. The judgment against Warren and Titan is the latest in a federal investigation into the improper billing of these non-surgical devices. USAO EDPA

Tagged in: FCA Federal, Healthcare Fraud, Medical Devices and DME, Medicare, Provider Fraud,

November 1, 2022

Electronic health record technology vendor Modernizing Medicine, Inc. (“ModMed”) has agreed to pay $45 million to resolve allegations, including by its former VP of Product Management, that it both received and provided illegal kickbacks in exchange for referrals. According to the government and whistleblower Amanda Long, ModMed engaged in schemes with Miraca Life Sciences, Inc. (now known as Inform Diagnostics) to receive kickbacks in exchange for recommending its users for Miraca’s lab services, and to provide its EHR technology free to healthcare providers to entice them to direct lab orders to Miraca and add to ModMed’s user base. Long will receive about $9 million of the settlement with ModMed. DOJ

Tagged in: Anti-Kickback and Stark, Electronic Health Records, FCA Federal, Healthcare Fraud, Laboratory and IDTF, Whistleblower Case, Whistleblower Rewards,

October 31, 2022

Felix Amos of Houston, TX will serve 30 months in federal prison and will pay over $21 million in restitution for his role in a Medicare fraud scheme carried out with two other co-defendants. From 2010 to 2015, Amos owned and operated home health companies Dayton Health Bridges, Access Practical Solutions, Advanced Holistic, GetUpandWalk Inc., and Guaranty Home Health Agency. Amos and his co-conspirators submitted false claims to Medicare for patients that did not need or receive services, including deceased or incarcerated persons, and for services not ordered by a physician. USAO SDTX

Tagged in: FCA Federal, Healthcare Fraud, Lack of Medical Necessity, Medical Billing Fraud, Medicare, Provider Fraud,

October 26, 2022

Honeywell International Inc. has agreed to pay $3.35 million to settle a False Claims Act case involving the sale of defective bullet proof vests to the government. Honeywell allegedly sold its patented Z Shield material to a bullet proof vest manufacturer, even though it knew the material was not cut out for ballistic use. The vests were ultimately sold to multiple agencies through a GSA contract, as well as various state, local, and tribal law enforcement authorities through a DOJ program. Their failures launched a 10-year investigation and litigation into the issue that ended with this settlement. In total, the government recovered over $133 million from 17 entities and individuals. DOJ

Tagged in: FCA Federal, Government Procurement Fraud,

October 18, 2022

Carter Healthcare LLC, affiliates CHC Holdings and Carter-Florida, president Stanley Carter, and Chief Operations Officer Bradley Carter have agreed to pay $23 million and $7.2 million to settle two whistleblower cases alleging violations of the False Claims Act. The first case, filed in the Western District of Oklahoma, alleged that the Oklahoma-based home health company paid illegal kickbacks to physicians under the guise of medical directorships in order to induce referrals. The second case, filed in the Southern District of Florida by former therapists Sharon Mahaffey and Mark Brimer, alleged that Carter Healthcare billed Medicare for medically unnecessary therapy and upcoded patient diagnoses for higher reimbursements. As part of the settlements, defendants Stanley and Bradley Carter have agreed to be excluded from participating in government healthcare programs for 5 years, and whistleblowers Mahaffey and Brimer will split a $1.3 million relator’s share. USAO WDOK; USAO SDFL

Tagged in: FCA Federal, Healthcare Fraud, Medicare, Other Government Health Programs, Whistleblower Case, Whistleblower Rewards,

October 17, 2022

Sutter Health has agreed to pay more than $13 million to settle claims of billing Medicare, Medicaid, TRICARE, and the Federal Employees Health Benefits Program for quantitative urine testing that were in fact performed by third-party labs. The company has already paid more than $6.5 million and is due to pay the remaining $6.5 million in the next 30 days. USAO NDCA

Tagged in: FCA Federal, Healthcare Fraud, Laboratory and IDTF, Medicaid, Medicare, Other Government Health Programs,

October 12, 2022

Four pharmacies have agreed to pay over $6.8 million to settle a qui tam suit that alleged they defrauded TRICARE and the Federal Employees Health Benefits Program, in violation of the False Claims Act. According to a former accountant for one of the pharmacies, DermaTran Health Solutions, LLC; Pharmacy Insurance Administrators, LLC; Legends Pharmacy; TriadRx; and Lake Side Pharmacy created a program to waive mandatory copays for beneficiaries of federal health insurers, overcharged the government for compounded pain creams, and traded out-of-network prescriptions with other pharmacies, which constituted a kickback. USAO NDGA

Tagged in: Anti-Kickback and Stark, Compounding Pharmacy Fraud, FCA Federal, Healthcare Fraud, Other Government Health Programs, Pharma Fraud,

October 6, 2022

A man in Missouri who was convicted of committing healthcare fraud through various durable medical equipment companies has been sentenced to 3 years in prison and ordered to repay $7.5 million. Jamie McCoy, who owned or operated AE Wellness LLC, Summit Medical Supply, Patriot Medical Supply, and DME Device Co., had worked in conjunction with marketing firms and a telemedicine doctor to cause fraudulent claims derived from illegal kickbacks to be submitted to Medicare and TRICARE. After the scheme was discovered and McCoy and AE Wellness were suspended from further participation, two of McCoy’s associates opened the other companies to continue the fraud, while concealing McCoy’s role in the operation. USAO EDMO

Tagged in: Anti-Kickback and Stark, FCA Federal, Healthcare Fraud, Medical Devices and DME, Medicare, Other Government Health Programs,

September 30, 2022

The owners and operators of three home health care companies in Illinois, Patricia and Felix Omorogbe, have been sentenced to a combined 3.5 years in prison and ordered to pay a combined $8 million in restitution for paying illegal kickbacks to patient marketers in exchange for referrals of Medicare beneficiaries. According to the DOJ, in addition to the kickbacks, Patricia Omorogbe, a registered nurse, also falsely certified that she performed assessments on patients, causing false claims to be submitted to Medicare. DOJ

Tagged in: Anti-Kickback and Stark, FCA Federal, Healthcare Fraud, Home Health and Hospice, Medicare, Provider Fraud,

September 27, 2022

Following a whistleblower complaint that alleged Massachusetts-based Public Consulting Group LLC (PCG) overbilled Medicaid, in violation of the False Claims Act, the company has agreed to pay $2.5 million. According to whistleblower Shane Shackford, PCG caused local school districts to submit false claims to Medicaid while under contract with the State of New Jersey to administer its Special Education Medicaid Initiative (SEMI) program—which provides federal funding to the state and local school districts for providing certain medical services to eligible students. For his role in the case, Shackford will received a 21% share of the settlement. USAO NJ

Tagged in: FCA Federal, Healthcare Fraud, Medicaid, Medical Billing Fraud, Whistleblower Case, Whistleblower Rewards,

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