Healthcare Fraud
This archive displays posts tagged as relevant to healthcare fraud.
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August 1, 2018
Gena Randolph, a speech therapist in Mount Pleasant, South Carolina who owned and controlled Palmetto Speech and Language Associates and Per Diem Healthcare Services, was convicted after committing a health care fraud scheme amounting to a total of $2 million by, among other things, submitting claims for services provided by others or not provided at all. Ms. Randolph faces over ten years in federal prison. DOJJuly 31, 2018
Compassionate Home Care Services, Inc., its owner Carol Anders, and her son Ryan Santiago will pay a $3 million judgment for violating the federal and North Carolina False Claims Acts by filing reimbursement claims for services not rendered or rendered by unlicensed aides and family members. Anders and Santiago were also found to have falsified documents to conceal evidence of fraud upon being investigated by the government. USAO EDNCJuly 30, 2018
South Korean citizen Young Yi was convicted of conspiracy to commit health care and wire fraud, among other charges, for directing employees at her sleep clinics, 1st Class Sleep Diagnostic Center, to solicit patients for additional, medically unnecessary studies, which she then billed to Medicare and private insurance. To hide the fraud, Yi concealed study results, lied about patient co-pays, and shifted bills across various entities she controlled. In all, Yi acquired more than $83 million from the scheme. DOJ; EDVACatch of the Week – 3M Company
Posted 07/27/18
On July 26, 2018, DOJ announced that Saint Paul, Minnesota-based 3M Company would pay $9.1 million to settle allegations that it knowingly sold defective dual-ended “Combat Arms” earplugs to the United States military without disclosing defects that made the devices ineffective and may have caused thousands of soldiers to suffer significant hearing loss and tinnitus (or ringing in the ears). Caught for its...
July 26, 2018
New York announced guilty pleas by transportation company 716 Transportation, Inc., its president, and one of its drivers, in connection with a $1.2 million Medicaid fraud scheme. The company and its president admitted to billing Medicaid for transportation services that were either never provided or that violated Medicaid rules and regulations. NY AGConstantine Cannon Partner Jessica Moore on Court’s Decision in Medicare Advantage Case
Posted 07/23/18
Becker’s Hospital Review published Four Key Takeaways From 9th Circuit’s Resurrection of the Silingo Medicare Advantage Case, written by Constantine Cannon partner Jessica T. Moore. In the article, Ms. Moore analyzes the Ninth Circuit’s July, 2018, ruling in U.S. ex rel. Silingo v. WellPoint, Inc., a case brought by a whistleblower under the False Claims Act alleging risk adjustment fraud in Medicare’s Part C...
Catch of the Week -- AngioDynamics
Posted 07/20/18
This week's Department of Justice "Catch of the Week" goes to New York-based medical device maker AngioDynamics, Inc. On Wednesday, the company agreed to pay $12.5 million to resolve allegations it violated the False Claims Act by making false and misleading promotional claims about the LC Bead and Perforator Vein Ablation Kit (PVAK) medical devices. Angio served as the U.S. distributor for Biocompatibles plc, the...
10th Circuit Finds that Doctor’s Judgment is Not Automatically Reasonable and Necessary
Posted 07/20/18
By Poppy Alexander
Top-level heart surgeons work in a rarified world, where few may question their medical judgment. Yet that judgment is not infallible-and its presence is not in itself a protection against False Claims Act liability. The Tenth Circuit recently held as much in United States ex rel. Polukoff v. St. Mark’s Hospital et al., finding that a doctor may be exercising medical judgment while still...