Healthcare Fraud Archives - Page 116 of 128

July 24, 2015

Mohammed Sadiq was sentenced to 80 months in prison and to pay $14.1 million in restitution for his leading role in a $12.6 million Medicare and tax fraud scheme. Sadiq, who owned and directed operations at two home health care companies in Detroit, admitted billing Medicare for home health services not medically necessary or provided and paying kickbacks to patient recruiters to obtain Medicare beneficiary information used in his scheme. DOJ

Tagged in: Anti-Kickback and Stark, Healthcare Fraud, Lack of Medical Necessity,

July 10, 2015

Detroit area doctor Farid Fata was sentenced to 45 years in prison and to forfeit $17.6 million for his role in a health care fraud scheme that included administering medically unnecessary infusions or injections to 553 individual patients and submitting to Medicare and private insurance companies approximately $34 million in fraudulent claims. DOJ

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

July 8, 2015

New Jersey doctor Frank Santangelo was sentenced to 63 months in prison and to forfeit more than $1.8 million for accepting $1.8 million in bribes to refer millions of dollars in business to Biodiagnostic Laboratory Services LLC. Including Santangelo, 38 people, 26 of them doctors, have pleaded guilty in connection with the bribery scheme, which its organizers have admitted involved millions of dollars in bribes and resulted in more than $100 million in payments to BLS from Medicare and various private insurance companies. DOJ

Tagged in: Anti-Kickback and Stark, Healthcare Fraud, Laboratory and IDTF, Provider Fraud,

June 30, 2015

Sylvia Walter-Eze, the former owner of medical equipment supply company Ezcor Medical Supply, was sentenced to 97 months in prison for her role in a fraud scheme that resulted in $3.5 million in fraudulent claims to Medicare and Medi-Cal. She was also ordered to pay restitution in the amounts of $1,866,260 to Medicare and $73,268 to Medi-Cal. The evidence presented at trial showed that Walter-Eze fraudulently billed more than $3.5 million to Medicare and Medi-Cal for products not medically necessary and paid illegal kickbacks to patient recruiters in exchange for patient referrals. DOJ

Tagged in: Healthcare Fraud, Medical Devices and DME,

June 24, 2015

Juan Carlos Delgado and Nereyda Infante, husband and wife owners of an Orlando health care clinic pleaded guilty to engaging in a $2.5 million health care fraud scheme. They owned and operated several health care clinics under variations of the name Prestige Medical and from February 2012 to September 2014 they fraudulently billed Medicare on behalf of the Prestige clinics for services that never were administered. DOJ

Tagged in: Healthcare Fraud, Medical Billing Fraud,

May 22, 2015

Detroit-area neurosurgeon Aria O. Sabit, owner and operator of the Michigan Brain and Spine Physicians Group, pleaded guilty to causing serious bodily injury to his patients in an $11 million Medicare fraud scheme. According to court documents, Sabit admitted he derived significant profits by convincing patients to undergo spinal fusion surgeries with instrumentation (meaning specific medical devices designed to stabilize and strengthen the spine) which he never rendered. DOJ

Tagged in: Healthcare Fraud,

May 18, 2015

A federal jury in Chicago convicted Rick E. Brown, the president of the in-home visiting physicians group Home Care America Inc., and Mary C. Talaga, the group’s biller, for their participation in a $4.5 million health care fraud scheme that included billing Medicare for services rendered to patients who were dead and services rendered by medical professionals who worked over 24 hours in a day. DOJ

Tagged in: Healthcare Fraud,

May 13, 2015

Olufunke Ibiyemi Fadojutimi, a registered nurse and former owner of Lutemi Medical Supply, was sentenced to four years in prison and ordered to pay restitution in the amount of $4,372,466 for her role in an $8.3 million Medicare fraud scheme. The evidence at trial showed that Fadojutimi and her co-conspirators paid cash kickbacks to patient recruiters in exchange for patient referrals, and additional kickbacks to physicians for fraudulent prescriptions for medically unnecessary durable medical equipment, such as power wheelchairs. DOJ

Tagged in: Healthcare Fraud, Lack of Medical Necessity, Medical Devices and DME,

May 12, 2015

Alexander Lara, an owner of Miami home health care company Longcare Home Health Corporation was sentenced to 10 years in prison and ordered to pay $13,771,528.94 in restitution and to forfeit $13,771,528.94 for his leading role in a $13 million Medicare fraud scheme that involved paying kickbacks and bribes to patient recruiters, Medicare beneficiaries and others in South Florida doctors’ offices and medical clinics. Lara admitted his company fraudulently billed the Medicare program for expensive physical therapy and home health care services that were not medically necessary or not provided at all. DOJ

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

April 16, 2015

Felix Gonzalez, owner of Miami home health care company AA Advanced Care Inc. was ordered to pay $21,423,160 in restitution and sentenced to 113 months in prison in connection with a $32 million Medicare fraud scheme. Gonzalez admitted operating his company for the purpose of billing the Medicare program for expensive physical therapy and home health care services that were not medically necessary or provided at all. He further admitted he negotiated and paid kickbacks and bribes to patient recruiters in exchange for patient referrals, as well as prescriptions, plans of care (POCs) and certifications for medically unnecessary therapy and home health services. DOJ

Tagged in: Anti-Kickback and Stark, Healthcare Fraud, Home Health and Hospice, Lack of Medical Necessity, Medical Billing Fraud,

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