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Healthcare Fraud

This archive displays posts tagged as relevant to healthcare fraud.

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Page 87 of 126

Hundreds of Medical Professionals Charged in Largest Healthcare Fraud Takedown in American History

Posted  07/19/18
RAC Monitor publishes article by partner Mary Inman and associate Max Voldman  (July 19, 2018). Click here to read the article.

Tagged in: Healthcare Fraud,

July 17, 2018

County Ambulance, Inc. has paid $16.7K to settle allegations that it violated the FCA by using money it received from Medicare and Mainecare to pay the salary of an employee who had previously been excluded from those programs. USAO Maine

Tagged in: Ambulance, FCA Federal, Healthcare Fraud,

July 16, 2018

Healthquest, Inc. and its owners have settled FCA allegations for $1.5M. According to the government, the home health care company, paid kickbacks to marketers to induce patient referrals. The company has also entered into a 5 year corporate integrity arrangement. The allegations were first brought by a whistleblower, a former marketer, who will receive $300K. USAO Southern District of Florida

Tagged in: Anti-Kickback and Stark, FCA Federal, Healthcare Fraud, Home Health and Hospice, Whistleblower Case, Whistleblower Rewards,

July 13, 2018

Orthopedic specialists in Oklahoma have agreed to pay $670,000 to settle allegations in a False Claims Act qui tam that they falsely billed Medicare, Medicaid, and Tricare for unnecessary ultrasonic guidance procedures and for services that were not performed.  The settlement resolved two claims in the whistleblower action, brought by a former employee, in which the government had intervened prior to settlement; other claims continue to be litigated.  USAO WDOK

Tagged in: Healthcare Fraud, Lack of Medical Necessity, Medical Billing Fraud, Provider Fraud, Whistleblower Case, Whistleblower Rewards,

July 10, 2018

Liberty Ambulance agreed to pay $1.2 million to settle an FCA qui tam alleging that, from 2005 to 2016, Liberty had fraudulently upcoded life support services and unnecessarily transported patients.  The case was filed by whistleblower Shawn Pelletier, who will receive $264,000 from the settlement, on top of $1.2 million he had received from prior settlements with other defendants.  USAO MDFL

Tagged in: Ambulance, FCA Federal, Healthcare Fraud, Upcoding, Whistleblower Case, Whistleblower Rewards,

July 10, 2018

The New Mexico U.S. Attorney’s Office announced the sentencing of a cardiologist to 51 months in prison for healthcare fraud and obstruction of justice.  Roy Heilbron had been indicted for regularly performing unnecessary diagnostic tests on his patients and falsifying medical records to cover the fraudulent billing; he also had billed for procedures that were never performed.  USAO NM

Tagged in: Healthcare Fraud, Lack of Medical Necessity, Medical Billing Fraud, Provider Fraud,

July 9, 2018

NY-based Health Quest Systems, Inc. (Health Quest), and its subsidiary hospital Putnam Health Center (Putnam) entered a $14.7 million settlement with DOJ and a $895,427 settlement with New York based on their submission of inflated and otherwise impermissible claims for payment to Medicare and Medicaid.  Specifically, the defendants billed Medicare for undocumented E&M services, billed for home-health services without supporting medical records, and billed for orthopedic surgeons who referred patients in violation of the Physician Self-Referral Law, also known as the Stark Law.  Three former Health Quest employees, who filed suit under the qui tam provisions of the False Claims Act, will receive a share of the recovery, including a reward of nearly $2 million to one of the relators.  DOJ; USAO NDNY

Tagged in: Anti-Kickback and Stark, FCA Federal, FCA State, Healthcare Fraud, Hospital Fraud, Medical Billing Fraud, Whistleblower Case, Whistleblower Rewards,

July 2, 2018

Virginia in-home healthcare provider Hope In-Home Care, LLC, will pay $3.3 million to resolve allegations that it fraudulently billed Medicaid for a series of false statements and billing related to the provision of personal care services.  Specifically, the USAO and Virginia Attorney General alleged that Hope In-Home Care billed for services that it did not perform and for services provided by uncertified personal care aides, and it falsified records to conceal these frauds.  USAO EDVA

Tagged in: Healthcare Fraud, Home Health and Hospice, Improper Medical Personnel, Medical Billing Fraud,

Catch of the Week -- Health Quest Systems and Putnam Hospital Center

Posted  07/13/18
This week, DOJ announced a $14.7 million settlement with NY-based Health Quest Systems, Inc. (Health Quest), and its subsidiary hospital Putnam Health Center (Putnam) based on their submission of inflated and otherwise impermissible claims for payment to Medicare and Medicaid, making Health Quest and Putnam our Catch of the Week. The settlement resolves allegations stemming from three separate lawsuits bought by...

Tagged in: Anti-Kickback and Stark, Catch of the Week, Healthcare Fraud, Home Health and Hospice, Hospital Fraud, Medicaid, Medical Billing Fraud, Medicare, Multiple Whistleblowers and First-to-File, Upcoding, Whistleblower Case, Whistleblower Rewards,

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July 2, 2018

FWC Urogynecology, LLC agreed to pay $1.7 million to settle allegations under the False Claims Act. FWC allegedly misused Medicare billing codes by billing modifier 25 for services that were not billable or that it did not provide. The alleged conduct occurred between 2012 and 2017. USAO MDFL

Tagged in: FCA Federal, Healthcare Fraud, Medical Billing Fraud, Provider Fraud,

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