Healthcare Fraud
This archive displays posts tagged as relevant to healthcare fraud.
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August 13, 2018
Nurse practitioner Sandra Haar, founder and chief executive officer of Horisons Unlimited, a non-profit provider of health and dental services in Merced, California, pleaded guilty to health care fraud and conspiracy to receive kickbacks. Haar's scheme billed for services that were not rendered or were medically unnecessary, even submitting bills for office visits with doctors when, in fact, patients were met in local parking lots and given Suboxone, an opioid medication, in plastic baggies. Haar also received thousands in kickbacks from a laboratory in exchange for sending Horisons patients to the lab. ED CA (later sentencing and civil settlement here)August 10, 2018
Trinity Medical Pharmacy, LLP and several members of its leadership have agreed to pay $2,244,270.14 to settle allegations that it violated the False Claims Act by giving illegal kickbacks to patients and providers, billing TRICARE and other government programs for medical reimbursement claims arising from those kickbacks, and failing to disclose information that would have barred it from becoming a provider for Express Scripts, which provides pharmaceutical services for TRICARE. USAO MDFLAstraZeneca Settles Seroquel False Claims Action -- Again
Posted 08/9/18
Catch of the Week -- Prime Healthcare
Posted 08/9/18
August 8, 2018
Dr. Donald Chamberlain and Karen Chamberlain, the owners of a Chattanooga gynecology practice, will pay $428,000 to settle False Claims Act allegations. According to the government, the Chamberlains used foreign-sourced, non-FDA approved, anticancer drugs, and billed Medicare and Tennessee’s Medicaid programs for similar, approved drugs. The drugs the Chamberlains used were cheaper than similar drugs that were approved by the FDA. USAO Eastern District of TennesseeAugust 6, 2018
Grenada Lake Medical Center will pay $1.1M to settle allegations that it violated the FCA by submitting claims for medically unnecessary psychotherapy services to the Medicare program. The alleged fraud lasted over eight years and was brought to light by a whistleblower, a former programs manager at the company, who will receive an award of $195k. USAO Eastern District of ArkansasAugust 3, 2018
Prime Healthcare Services and related entities, as well as its CEO Dr. Prem Reddy, will pay $65 million to settle two Medicare fraud allegations. First, Prime and Dr. Reddy allegedly engaged in a centralized scheme to boost inpatient admissions of patients who had no medical need to be admitted. Second, they allegedly falsely upcoded patients’ diagnoses in order to increase reimbursements. Whistleblower Karin Berntsen, who initiated the lawsuit, will receive over $17 million of the settlement. DOJ; CDCAAugust 3, 2018
Northwest ENT Associates, P.C. agreed to pay $1,195,361 to settle allegations under the federal False Claims Act that they re-used balloon catheters in medical procedures, even though they were intended only for a single use. By choosing to cut a corner for their own financial benefit, Northwest ENT put their patients’ health in jeopardy as well as impacting federal funds needed for other medical procedures. Northwest ENT has entered into a three-year Integrity Agreement with the Office of the Inspector General of the Department of Health and Human Services. DOJCatch of the Week -- William Beaumont Hospital
Posted 08/3/18
