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Healthcare Fraud

This archive displays posts tagged as relevant to healthcare fraud.

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Page 67 of 126

June 27, 2019

Massachusetts-based Clinical Science Laboratory, Inc. (CSL), and its owners, Stanley Elfbaum and Louis Amoruso, have agreed to pay $1.5 million to settle allegations under the False Claims Act that it charged Connecticut Medicaid 19 times what it charged other customers for urine drug screens.  According to the DOJ, from 2016 to 2017, CSL charged Connecticut $38 per test while charging substance abuse treatment centers only $2 per test.  USAO CT

Tagged in: FCA Federal, Healthcare Fraud, Laboratory and IDTF, Medicaid,

June 27, 2019

Anne Arundel Medical Center (AAMC) has settled with the United States for alleged submissions of false claims to Medicare, TRICARE, and the Federal Employees Health Benefits Program.  In a whistleblower suit by former AAMC employee Barbara McHenry, the Maryland-based hospital was accused of billing for medically unnecessary Evaluation and Management (E/M) services from 2010 to 2013, and doubled billing for E/M services from 2014 to 2017 despite a 2014 update from CMS.  As part of the settlement, AAMC will pay $3 million and comply with a five-year Corporate Integrity Agreement, and McHenry will receive $473,100.  USAO MD

Tagged in: FCA Federal, Healthcare Fraud, Hospital Fraud, Medical Billing Fraud, Medicare, Other Government Health Programs, Whistleblower Case, Whistleblower Rewards,

June 26, 2019

A patient recruiter in Michigan has been sentenced to 5 years in prison and ordered to pay $1.5 million in restitution for taking part in a three-year scheme to defraud Medicare. Defendant Sophia Eggleston had allegedly solicited and received kickbacks in exchange for her referrals, causing Medicare to pay $1.5 million to a home health agency connected to the fraud scheme.  DOJ

Tagged in: Anti-Kickback and Stark, Criminal Proceedings, Healthcare Fraud, Medicare,

June 26, 2019

The Trustees of the University of Pennsylvania Health System have agreed to pay $275,000 to settle allegations of submitting false claims to Medicaid in violation of the False Claims Act.  During a seven month period in 2017, the health system’s Lancaster General Hospital allegedly billed Medicaid for interpretations of obstetric ultrasounds despite its physicians failing to complete those reports in a timely manner.  In about 10% of the cases, the reports were not completed until more than 90 days after the ultrasound was performed, rendering them useless.  USAO EDPA

Tagged in: FCA Federal, Healthcare Fraud, Hospital Fraud, Medicaid, Medical Billing Fraud,

New York Introduces Bills to Expand Whistleblower Protections

Posted  06/21/19
statute of liberty New York symbol
Under current law, whistleblowers who reported fraudulent activity in the government or other settings in the State of New York are typically barred from bringing other legal actions. Maybe not anymore. Last week, both the New York State Senate and Assembly signed off on a series of amendments aimed at providing greater protection for employees who notice and report illegal activity, and expanding the definition of a...

Tagged in: FCA State, Healthcare Fraud, Importance of Whistleblowers, Pharma Fraud, Retaliation, Whistleblower Eligibility, Whistleblower Protection Laws,

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June 20, 2019

Hart to Heart Ambulance Services, d/b/a Hart to Heart Transportation Services, has agreed to pay $1.25 million to settle allegations that it defrauded Medicare by submitting claims for medically unnecessary services, violating the False Claims Act.  Allegations were first brought to the government’s attention by former employee, Bryan Arvey, who alleged that from 2010 to 2017, Hart to Heart management pressured employees to falsify claims for non-emergency ambulance transports, such as hospital discharges.  For aiding in the recovery of public funds, Arvey will receive a share of $251,000.  USAO MD

Tagged in: Ambulance, FCA Federal, Healthcare Fraud, Lack of Medical Necessity, Medical Billing Fraud, Medicare, Whistleblower Case, Whistleblower Rewards,

June 18, 2019

Nevada Heart & Vascular Center has agreed to pay $2.5 million to settle allegations that it accepted kickbacks from genetic testing companies, Natural Molecular Testing Corp. and Iverson Genetic Diagnostics, Inc., in exchange for referrals of Medicare patients.  The alleged violations of the Anti-Kickback Statute and False Claims Act occurred for nearly a year in 2012.  USAO NV

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

Mid Dakota Clinic - Healthcare Fraud/Kickbacks ($5.45 million)

Constantine Cannon represented a whistleblower in a False Claim Act alleging Mid Dakota Clinic engaged in a kickback scheme with its wholly owned ambulatory surgery center to elicit improper patient referrals.  In November 2019, the medical clinic agreed to pay $4.15 million to settle the matter.  Our client received a whistleblower award of 25% of the government's recovery.  Read more -- AP, Becker's, CC.

Tagged in: Anti-Kickback and Stark, FCA Federal, Healthcare Fraud, Medicare, Provider Fraud, Whistleblower Rewards,

June 12, 2019

In connection with the development of the Lakeway Regional Medical Center in Texas, a number of individuals and entities have agreed to pay $1.1 million to resolve claims that they made false claims in obtaining a loan insured by the Federal Housing Administration under a HUD program that insures loans to build hospitals in underserved areas.  Pacific Medical Buildings LLC, PMB Lakeway LLC, RD Development Partners LLC, Lakeway Management LLC, J&L Rush Family Partnership LP, Jeff Rush, and Brad Daniel, were alleged to have delayed refunds to investors who had cancelled their investments in order to make it appear as if the project satisfied mortgage covenants regarding the cash on hand required to close the loan. The settlement also resolves allegations that the settling parties received impermissible distributions of project funds. DOJ

Tagged in: FCA Federal, Government Loan Programs, Healthcare Fraud, Housing and Mortgage Fraud,

June 12, 2019

Lake Country Pharmacy and Compounding Center in Georgia, along with two of its principals, Chris and Carey Vaughan, have settled allegations filed by a whistleblower under the federal False Claims Act and Georgia False Medicaid Claims Act.  According to former pharmacist Chris Coleman, Lake Country submitted bills to Medicare, Medicaid, and TRICARE for compounded medications that were made from non-reimbursable bulk powders but billed as if they were made from reimbursable tablets.  Without admitting or denying these charges, Lake Country agreed to pay $365,000 and enter into an Integrity Agreement with the Department of Health and Human Services.  USAO MDGA

Tagged in: Compounding Pharmacy Fraud, FCA Federal, FCA State, Healthcare Fraud, Medicaid, Medicare,

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