Catch of the Week: Dozens of Fraudsters Sentenced in Multimillion Dollar Compounding Pharmacy Fraud

On Thursday, an Alabama District Court Judge sentenced dozens of defendants to prison for participating in a massive conspiracy to swindle insurers for medically unnecessary compound drugs. The defendants included company executives and managers, a prescriber, billers, and sales representatives associated with Northside Pharmacy, which was doing business as Global Compounding Pharmacy (Global). According to the DOJ press release, Global employees and their conspirators engaged in an extensive pharmaceutical fraud...

April 23, 2021

Bobby Rouse, a former executive with Continuum Healthcare LLC, which owned Houston hospital Westbury Community Hospital as well as area mental health centers, was sentenced to ten years in prison following his guilty plea on charges arising from an unlawful kickback scheme.  At the direction of Rouse and co-conspirators, Continuum paid kickbacks for the referral of patients to partial hospitalization programs at Continuum facilities, many of whom did not qualify...

Catch of the Week: Final Merida Hospice Fraudster Sentenced in $150 Million Scheme

Jose Garza, the former operations manager of Merida Group, a Texas-based hospice, and home health chain, just landed a 27-month prison sentence for his role in a $150 million hospice fraud scheme. Garza is the latest to receive a sentence in connection with the decade-long Merida Group scheme, which saw people with long-term illnesses falsely told they would die soon, while executives at the company pocketed millions in stolen Medicare...

Catch of the Week: Telemarketer Gets 10 Years in $3.3 Million Telemedicine and Genetic Testing Fraud Scheme

Ivan Andre Scott, a 36-year-old Florida man, just landed a 10-year prison sentence for organizing a $3.3 million Medicare fraud scheme involving two of the hottest healthcare trends – telemedicine and genetic testing to assess the likelihood of future cancer. The conspiracy targeted vulnerable Medicare beneficiaries for pricey cancer screening genetic tests, prosecutors said. Claims for these tests were falsely billed to Medicare even though they did not meet the...

April 14, 2021

The owner of a Florida-based telemarketing call center, Ivan Andre Scott, has been sentenced to 10 years in prison after being convicted of conspiracy to commit healthcare fraud in connection with a $3.3 million fraud scheme against Medicare.  According to evidence presented at trial, Scott made telemarketing calls to Medicare beneficiaries to persuade them to take expensive genetic tests, paid illegal kickbacks to telemedicine companies in exchange for doctor authorizations,...

Corruption in humanitarian relief and development programs: How to report USAID fraud

Late last week, the Department of Justice announced that the International Rescue Committee had agreed to pay $6.9 million to settle allegations that it had participated in a scheme to rig contract bids and then passed on inflated costs to the United States Agency for International Development (USAID).  IRC, a New York-based humanitarian relief organization, received funding from USAID to provide humanitarian assistance to people affected by the conflict in...

Top Ten Environmental Fraud Settlements for 2020

In many ways, the COVID-19 pandemic uprooted our routines and put life on pause in 2020. But environmental fraud continued unabated, and so did enforcement actions against the perpetrators. We saw two major enforcement actions relating to devices designed to evade emissions requirements, several enforcement actions relating to water contamination and the knowing sale of products containing harmful pollutants, and several more against companies who took advantage of environmental tax...

DOJ Previews False Claims Act Enforcement Priorities for 2021

The False Claims Act is the federal government's primary enforcement tool to combat fraud against the public.  Every year the government recovers billions of dollars under the statute, primarily with the help of whistleblowers.  Under the so-called qui tam provisions of the act, whistleblowers are authorized to act as private attorneys general and bring lawsuits on behalf of the government and recover a portion of the proceeds. Last year was...

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

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...