DOJ Catch of the Week — Beaver Medical Group
Posted 08/9/19
Healthcare Fraud
This archive displays posts tagged as relevant to healthcare fraud.
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August 8, 2019
California-based Beaver Medical Group LP and one of its physicians, Dr. Sherif Khalil, have agreed to pay $5 million to resolve allegations of violating the False Claims Act. According to another physician formerly employed at Beaver, the defendants allegedly submitted false diagnoses to Medicare Advantage Organizations (MAOs) for the Medicare beneficiaries under its care, which caused Medicare to pay a needlessly inflated rate of reimbursement. The whistleblower, Dr. David Nutter, will receive a relator’s share of $850,000 from the settlement proceeds. DOJThis Week in Whistleblower History: National Whistleblower Day and the Creation of the Medicare and Medicaid Programs
Posted 08/2/19
August 2, 2019
A Georgia man accused of masterminding a fraud scheme against TRICARE has been sentenced to 8 years in prison and ordered to pay a combined $8 million in restitution and forfeiture. Coordinated by Michael Burton, the scheme ran from 2014 to 2015 and involved multiple co-defendants and a Florida-based pharmacy. Together, their cumulative actions caused TRICARE to spent millions of dollars on medically unnecessary compounded prescription drugs, and earned Burton over $1.4 million in commissions. USAO NDFLAugust 1, 2019
Tennessee-based telemarketer Scott Roix and his companies have agreed to pay $2.5 million to settle two whistleblowers’ False Claims suit alleging the submission of false claims to Medicare, TRICARE, and other federal health benefit programs. Roix and his companies allegedly procured fraudulent insurance information from patients around the country in order to arrange prescriptions for medically unnecessary pain creams; they then sold these prescriptions to pharmacies, labeling proceeds as earned through marketing services. The whistleblowers in this case, Jennifer Silva and Jessica Robertson, will receive $287,500 for revealing the fraudulent scheme. USAO MDFLCatch of the Week — Comprehensive Pain Specialists Targeted for Urine Drug Testing Fraud
Posted 07/26/19
July 24, 2019
Pennsylvania-based Eagleville Hospital has agreed to pay $2.85 million to settle allegations of defrauding Medicare, Medicaid, and the Federal Employees Health Benefits Program. According to an anonymous relator, Eagleville violated the False Claims Act between 2011 and 2018 by submitting claims for substance abuse patients improperly admitted for high paying, hospital-level detoxification treatments. The whistleblower will receive $500,000 of the recovery. USAO EDPAQuestion of the Week — Will Healthcare Settlements Continue to Dominate False Claims Act Recoveries?
Posted 07/24/19
July 23, 2019
The owners of Pennsylvania-based E-Z Pharmacy II, Darshan Bapa Inc. and Natverbhai Patel, have agreed to pay $400,000 to resolve their liability under the False Claims Act. E-Z Pharmacy allegedly billing Medicare for prescription drugs that were never dispensed. USAO EDPAGovernment Documents Dangerous Failures in Hospice-Care Facilities
Posted 07/19/19
