February 17, 2015

Alexander Lara, owner of Miami-based home health care company Longcare Home Health Corporation, pleaded guilty in connection with a $13M Medicare fraud scheme involving kickbacks and bribes to Medicare beneficiaries, doctors’ offices, medical clinics and others in exchange for patient referrals and fraudulent prescriptions to support fraudulent billings to Medicare.  DOJ

February 13, 2015

Illinois physician Dr. Michael J. Reinstein pleaded guilty to the crime of receiving illegal kickbacks and benefits totaling nearly $600,000 from pharmaceutical manufacturer Teva Pharmaceuticals USA Inc. and its subsidiary IVAX LLC in exchange for regularly prescribing the anti-psychotic drug clozapine to his patients.  Reinstein also agreed to pay $3.79M to settle a parallel civil lawsuit alleging he violated the False Claims Act for causing the submission of false claims...

February 10, 2015

Orelvis Olivera, the owner of Miami home health care agency Acclaim Home Healthcare Inc., pleaded guilty for his role in a $6.9M Medicare fraud scheme.  Olivera admitted he and his co-conspirators billed Medicare for expensive physical therapy and home health care services not medically necessary and paid kickbacks and bribes to patient recruiters in exchange for patient referrals.  DOJ

February 6, 2015

A federal jury in Detroit convicted unlicensed Detroit physician Wilfred Griffith for his participation in a nearly $4.7M fraud scheme. According to evidence presented at trial, Griffith worked as an unlicensed physician at Phoenix Visiting Physicians in 2010 and 2011 where he treated Medicare beneficiaries and used prescription pads pre-signed by Dr. Dwight Smith to prescribe medicine. He also referred Medicare beneficiaries to Detroit-area home health company Cherish Home Health...

February 3, 2015

Ernesto Fernandez pleaded guilty and was sentenced to 10 years in prison in connection with a long-running $6.2M Medicare fraud scheme involving Miami-based home health care agency Professional Medical Home Health LLC. Fernandez was an owner and operator of Professional Home Heath and also the owner and operator of two other South Florida home health agencies where he caused patient documentation to be falsified, and planned, organized and oversaw the...

January 26, 2015

Ramon Regueira, the owner and operator of a Miami home health care agency Nation’s Best Care Home Health Corp. was sentenced to 106 months in prison and to pay $21M for his participation in a $30M Medicare fraud scheme. Regueira admitted he and his co-conspirators operated Nation’s Best for the purpose of billing the Medicare program for, among other things, expensive physical therapy and home health care services that were...

January 9, 2015

Felix Gonzalez, owner of Miami-based home health care company AA Advanced Care Inc. pleaded guilty in connection with a $32 million Medicare fraud scheme. Specifically, Gonzalez admitted he and his co-conspirators operated AA Advanced for the purpose of billing Medicare for, among other things, expensive physical therapy and home health care services not medically necessary or not provided at all. He also admitted he paid kickbacks and bribes to patient...

January 9, 2015

Global pharmaceutical company Daiichi Sankyo Inc. agreed to pay $39 million to resolve allegations it violated the False Claims Act by paying kickbacks to induce physicians to prescribe Daiichi drugs, including Azor, Benicar, Tribenzor and Welchol. According to the government, Daiichi paid physicians improper kickbacks in the form of speaker fees as part of Daiichi’s Physician Organization and Discussion programs which were often just lavish dinners with the speaking physicians’...

Whistleblower News From The Inside — January 22, 2016

By the C|C Whistleblower Lawyer Team CenterLight Healthcare pays $46.7m to settle Medicaid fraud claims -- CenterLight has admitted it improperly enrolled over 1,200 patients in its long term home health care program who attended or were referred by social adult day care centers and whose needs did not meet the billing criteria of the managed care plan.  SDNY DOJ CFTC launches whistleblower website -- The CFTC launched its Whistleblower...

December 17, 2014

Mark Morad and Dr. Divini Luccioni, both of Louisiana, pleaded guilty to their role in a $56M Medicare fraud scheme. According to court documents, Morad directed the scheme through multiple New Orleans-area companies he owned, including Interlink Health Care Services Inc.,Memorial Home Health Inc., Lakeland Health Care Services Inc., Lexmark Health Care LLC, and Med Rite Pharmacy Inc. Morad paid kickbacks to recruiters who canvassed New Orleans neighborhoods for Medicare...