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Healthcare Fraud

This archive displays posts tagged as relevant to healthcare fraud.

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Page 92 of 126

March 28, 2018

New Orleans resident Sandra Parkman was sentenced to 32 months in prison for her involvement in a $3.2 million Medicare fraud and kickback scheme. According to the evidence presented at trial, Parkman and others engaged in a scheme to defraud Medicare by supplying medically unnecessary durable medical equipment, including power wheelchairs, to Medicare beneficiaries in and around New Orleans. DOJ

March 28, 2018

Medical Transport LLC, a Virginia Beach-based provider of ambulance services, agreed to pay $9 million to resolve allegations it violated the False Claims Act by submitting claims for ambulance transports not medically necessary, that did not qualify as Specialty Care Transports, and that were billed improperly to the federal health care programs when they should have been billed to other payers. DOJ

March 27, 2018

Iowa acute care hospital Genesis Medical Center agreed to pay $1.88 million to settle claims it violated the False Claims Act by improperly retaining Medicare overpayments for hospital inpatient admission claims when those claims should have been billed at the lower reimbursement rate for either outpatient or observation services. DOJ (SDIA)

March 13, 2018

Marshfield Medical, Inc. (formerly known as Bromedicon, Inc.) agreed to pay $550,000 to settle claims it violated the False Claims Act for submitting claims to Medicare and other federal health care programs without providing a qualified interpreting physician to monitor each surgery for which it purportedly provided remote Intraoperative Neurophysiological Monitoring. According to the government, in some of those cases, no one monitored the data stream from the surgeries and in others, Bromedicon’s medical director, a foreign medical school graduate with no license to practice medicine in the United States, was the only monitor. The allegations originated in a whistleblower lawsuit filed under the qui tam provisions of the False Claims Act.  DOJ (EDPA)

March 8, 2018

Genetic testing company Natera, Inc. agreed to pay roughly $11.4 million to settle claims it violated the False Claims Act by improperly billing federal healthcare programs for Natera’s non-invasive prenatal test known as Panorama. The allegations originated in a whistleblower lawsuit filed under the qui tam provisions of the False Claims Act by Sallie McAdoo and Steven Aldridge. They will receive a yet-to-be-determined whistleblower award from the proceeds of the government’s recovery. DOJ (WDKY)

March 7, 2018

Florida dermatologist and owner of Treasure Coast Dermatology agreed to pay $2.5 million to settle claims he violated the False Claims Act by billing Medicare and TRICARE for procedures he did not perform.  The allegations originated in a whistleblower lawsuit filed under the qui tam provisions of the False Claims Act by Patricia Cleary, a former patient of Dr. Ioannides. She will receive a whistleblower award of $475,000 from the proceeds of the government’s recovery. DOJ (SDFL)

March 6, 2018

Iowa chiropractor Bradley Brown and his clinic Brown Chiropractic, P.C. agreed to pay roughly $80,000 to settle claims they violated the False Claims Act and Anti-Kickback Statute by billing Medicare and Medicaid for chiropractic adjustments after providing free electrical stimulation to beneficiaries to influence those beneficiaries to receive chiropractic adjustments from Brown. DOJ (NDIA)

February 28, 2018

Rafael Arias, the owner of numerous Miami-area home health agencies, was sentenced to 240 months in prison and pay $66.4 million in restitution for his role in a $66 million conspiracy to defraud the Medicare program. As part of his guilty plea, Arias admitted recruiting nominee owners to falsely and fraudulently represent themselves as the agencies’ owners to hide his identity and ownership interest. Arias and his co-conspirators paid illegal bribes and kickbacks to patient recruiters to refer patients to these agencies, and submitted false and fraudulent home health care claims to Medicare for beneficiaries who, in many cases, did not qualify or for whom the services were never provided. DOJ

February 7, 2018

New York surgeon Syed Imran Ahmed was sentenced to 156 months in prison -- and ordered to pay roughly $7 million in restitution, forfeit roughly $7 million and pay a $20,000 fine -- for his role in a scheme that involved the submission of millions of dollars in false and fraudulent claims to Medicare. According to evidence presented at trial, Ahmed, who practiced at Kingsbrook Jewish Medical Center and Wyckoff Heights Medical Center in Brooklyn, Franklin Hospital in Valley Stream, and Mercy Medical Center in Rockville Centre, New York, billed the Medicare program for incision-and-drainage and wound debridement procedures that he did not perform. DOJ
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