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Healthcare Fraud

This archive displays posts tagged as relevant to healthcare fraud.

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Page 53 of 126

Charges Filed in Shameful COVID-19 and Genetic-Cancer-Screening Test Scam

Posted  04/3/20
doctor-mask
Erik Santos of Braselton, Georgia had run a fraudulent genetic cancer-screening-test scheme for months, then spotted an opportunity capitalize on fear surrounding COVID-19.  According to the criminal complaint, Santos targeted elderly persons to determine if they met certain eligibility requirements for testing under government health-care programs.  He passed the information along to co-conspirator testing...

The Missing Ventilator Stockpile Was Not Inevitable

Posted  04/3/20
Hospital Building Sign
The coronavirus crisis has been a crash course for the general public in how lifesaving ventilators work.  But the federal government has long known how crucial they are and how important it is to be able to stockpile sufficient numbers.  Five years ago, the government tried to plan ahead by commissioning the design and production of a low-cost ventilator to build up public and private stores in case an...

Tracking Medicaid Fraud: HHS OIG Releases MFCU Annual Report

Posted  04/2/20
Human Health Services Office of Inspector General Logo
The HHS OIG recently released the Medicaid Fraud Control Units (MFCUs) Fiscal Year 2019 Annual Report, providing a consolidated accounting of the program’s success. MFCUs investigate and prosecute Medicaid fraud and patient abuse or neglect. MFCUs receive referrals from other agencies, the public, or via data mining with OIG approval. The referral is reviewed, an investigation is conducted, and the decision is...

April 2, 2020

FPR Specialty Pharmacy LLC and Mead Square Pharmacy, Inc., along with owners Christopher Casey and William Rue, have agreed to pay $426,000 to settle a whistleblower-brought case alleging violations of the Anti-Kickback Statute and False Claims Act in connection with a compounded prescription analgesic cream called Focused Pain Relief.  As part of the settlement, the defendants admitted that from 2011 to 2015, they sold prescription drugs to patients in states they were not licensed to sell in, failed to charge mandatory co-pays to beneficiaries of various federal healthcare programs, and paid sales agents to solicit physicians to prescribe the cream.  USAO SDNY

April 1, 2020

A physician’s assistant in Louisiana, Stephen Honeycutt, has agreed to pay $620,500 for accepting illegal kickbacks from OK Compounding, LLC, which has been involved in multiple enforcement actions of a similar nature across the country.  Over a period of about six months in 2013, Honeycutt prescribed expensive compounded pain creams to patients, many of whom were Medicare and TRICARE beneficiaries, in exchange for kickbacks disguised as medical director fees.  USAO NDOK

Loosening the Rules on Telehealth to Fight Coronavirus May Also Result in New Medicare Fraud Schemes

Posted  03/27/20
doctor-on-phone
In response to the coronavirus pandemic, the U.S. government is loosening rules on telehealth to make it easier—and safer—for patients to speak to their healthcare providers.  These steps are an important, and necessary, step to curtail the spread of the virus and to facilitate the treatment of infected patients.  But it may also open the door to new telehealth fraud schemes by unscrupulous individuals and...

March 20, 2020

A doctor in Florida has paid the United States $850,000 to settle claims of violating the Anti-Kickback and False Claims Acts.  In exchange for prescribing a powerful but highly addictive fentanyl spray, Subsys, to her patients, Dr. Parveen Khanna allegedly took illegal kickbacks from manufacturer Insys Pharmaceuticals, Inc that were disguised as speaker fees, then submitted claims for reimbursement to Medicare and TRICARE in violation of program rules prohibiting payment for kickback-induced services.  USAO MDFL

Data Analysts: a New Kind of Whistleblower to “Catch a Rogue,” write Gordon Schnell and Max Voldman in Stat News

Posted  03/20/20
data-analyst-on-laptop
On March 16, 2019, STAT published an article by Constantine Cannon whistleblower lawyers Gordon Schnell and Max Voldman about a new kind of whistleblower emerging: the data-driven whistleblower. The article, Data analysts: a new kind of whistleblower to ‘catch a rogue’?, discusses different courts’ reaction to False Claims Act cases brought by Integra Med Analytics, a “forensic analysis firm that studies...

The COVID-19 Crisis, Whistleblowers, and the Constantine Cannon Whistleblower Team

Posted  03/19/20
Soapy hands under running water faucet
As Constantine Cannon announced earlier this week, in response to the coronavirus (COVID-19) crisis, we have implemented contingency plans to work remotely.  While our work locations have changed, we remain dedicated to our whistleblower clients, and our team continues to provide whistleblowers with support and legal guidance. With offices in New York, D.C., San Francisco, and London, the Constantine Cannon...

March 13, 2020

Dr. Thi Thien Nguyen Tran and Village Dermatology and Cosmetic Surgery, LLC, have agreed to pay $1.74 million to settle claims of submitting false and inflated claims to Medicare.  From 2011 to 2016, defendants billed and caused Medicare to pay for lower-level wound repairs as if they were more complex adjacent tissue transfers.  The misconduct was eventually exposed by whistleblowers Dr. Robert Green and Emily Kennedy, who will share in a $305,000 award.  USAO MDFL
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