Healthcare Fraud
This archive displays posts tagged as relevant to healthcare fraud.
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May 31, 2018
New York doctor Thomas Savino was sentenced to four years in prison, fined $100,000, and ordered to forfeit $27,500 for violating the AKS and other laws by accepting at least $25,000 in cash brides from Biodiagnostic Laboratory Services LLC in exchange for referring patient blood samples to the lab. USAO DNJMay 18, 2018
New York podiatrist Perrin Edwards pled guilty to billing Medicare and private insurance companies for medical services he had not performed and for upcoding normal nail trimming, which is not reimbursable, to nail debridement, a covered service. Edwards will pay a $5,000 fine, serve one year of probation, and perform 50 hours of community service. USAO NDNYMay 17, 2018
Five New Jersey salesmen were sentenced to prison terms ranging from 21 to 41 months for their role in violating the AKS and other laws by bribing doctors-with cash, sham consulting fees, and other means of payment-for patient blood specimen referrals. USAO DNJMay 17, 2018
New Orleans physician Jobie Crear was sentenced to 8 months in prison and ordered to pay more than $810,000 to Medicare for his role in an illegal kickback conspiracy in which he paid recruiters to bring Medicare patients to a nursing and home health services company he operated. USAO EDLAUS Obtains $114M FCA Judgement in Kickbacks Case
Posted 05/31/18
On May 23, the US District Court in South Carolina issued judgment for the US for roughly $114M against three individuals, LaTonya Mallory, Floyd Dent III, and Robert Johnson, for violating the FCA by paying kickbacks to doctors in exchange for patient referrals. The defendants also caused two labs to bill Medicare, TRICARE, and Medicaid for medically unnecessary tests. The judgment follows a January jury verdict that...
Pfizer Agrees to Pay $23.85 Million to Resolve False Claims Act Liability for Paying Kickbacks
Posted 05/24/18
The Department of Justice today announced that Pfizer agreed to pay $23.85 million to resolve allegations that it used a foundation as a conduit to pay the copays of Medicare patients taking three Pfizer drugs. Medicare Part B or D beneficiaries typically make a partial payment when obtaining prescription drugs in the form of a copay, coinsurance, or deductible. Under the Anti-Kickback Statute, pharmaceutical...
Michigan Home Health Agency Owner Pleads Guilty to Health Care Fraud Charges
Posted 05/18/18
The owner of a Michigan home health agency pleaded guilty to fraud charges for his role in a scheme involving approximately $8 million in fraudulent Medicare claims for home health services that were procured through the payment of illegal kickbacks. Zahir Shah, 48, of West Bloomfield, Michigan, pleaded guilty to one count of conspiracy to commit health care fraud and wire fraud and one count of conspiracy to pay and...
Medicare Fraudsters Beware; DOJ May Be Reviewing Your Billing Data
Posted 05/15/18
By the C|C Whistleblower Lawyer Team
Maryland physician Sureshkumar Muttath agreed to pay more than $1.5 million to settle claims he violated the False Claims Act by submitting claims to Medicare for medically unnecessary autonomic nervous function tests and neurobehavioral status exams. The settlement originated under DOJ’s new initiative of tracking irregularities in Medicare billing data. See DOJ Press...