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Improper Medical Facility

This archive displays posts tagged as relevant to healthcare billings for unlicensed, unauthorized, or otherwise improper facilities. You may also be interested in our pages:

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Catch of the Week: Texas Hospice CEO Gets 13 Year Sentence in $60 Million Fraud Scheme

Posted  01/28/22
doctor touching hospice patient
A federal judge in Texas sentenced Bradley Harris, former head of Novus Health Services, Inc. hospice company in Frisco, to more than thirteen years in prison and ordered him to pay $27.6 million in restitution. The sentence, announced in a DOJ press release, follows his guilty plea on charges of conspiracy and fraud on Medicare and Medicaid. Harris is the latest to be sentenced in a fraud scheme spanning...

Catch of the Week: Fraudulent Sleep Tests in Fresno

Posted  10/29/21
bed with pillow and sheets scattered
Fraud permeates through all aspects of America’s healthcare system- from hospitals to big pharma to chiropractors. This week’s catch of the week focuses on another part of the system, sleep clinics. As increasing numbers of troubled sleepers are seeking diagnosis and treatment of chronic sleep disorders, the significant growth in sleep medicine over recent years brings increasing opportunities for the unscrupulous...

Catch of the Week: Florida Lab Owner Pleads Guilty to $73 Million Telemedicine Fraud Scheme

Posted  09/3/21
telemedicine doctor on computer with patient
Editor’s Note: For this week’s biggest story, the record $90 million settlement secured by a Constantine Cannon client against Sutter Health, read more here.
Healthcare fraudsters have a track record of exploiting health crises for personal gain. The COVID-19 pandemic created new telemedicine opportunities for patients to receive care without having to see doctors in person. As expected, fraudsters seized on...

Catch of the Week: Virginia OB/GYN Sentenced to 59 Years in Prison for Performing Medically Unnecessary Procedures for More Than Ten Years

Posted  05/21/21
OB/GYN looking at a sonogram on screen
Healthcare fraudsters are typically motivated by greed. But in satisfying that greed, some fraudsters perform reprehensible acts that permanently affect the victims of the fraud, making even the penalty they receive pale in comparison. This week we focus on the conviction of Javaid Perwaiz, an OB/GYN in Hampton Roads, Virginia, who was sentenced to 59 years in prison for performing medically unnecessary surgeries...

Catch of the Week: Founders of Poop-Testing Startup uBiome Face Fraud Charges

Posted  03/24/21
specimen jar
San Francisco-based uBiome and its founders Jessica Richman and Zachary Apte claimed they were “inventing the microbiome industry” and “making products that improve people’s lives.” Once considered a Silicon Valley success story, today, uBiome is bankrupt and its founders face various federal securities fraud and related criminal conspiracy charges. The biotech startup sold home medical tests including...

2020 Whistleblower of the Year Candidate – Dawn Wooten

Posted  01/5/21
barbed wired fence
Privately run immigration detention facilities have been a stain on our nation’s reputation for years now.  The refugees and other immigrants who are detained within their walls suffer family separation, inadequate medical care, lack of basic necessities, inedible food, psychological torture, and even death from easily treatable diseases due to flimsy infection controls.  The current pandemic crisis only amplifies...

Catch of the Week: Guardian Elder Care

Posted  02/21/20
person holding elder's hand
This week's DOJ Catch of the Week goes to Guardian Elder Care.  On Wednesday, the operator of more than 50 nursing homes in Pennsylvania, Ohio and West Virginia agreed to pay roughly $15.5 million to resolve allegations it violated the False Claims Act by billing the government -- Medicare and the Federal Employees Health Benefits Program -- for medically unnecessary rehabilitation therapy services.  According to...

March 17, 2017

Two individuals have been ordered to pay $13.5 million for the deceptive marketing of medications and services relating to the treatment of erectile dysfunction at an unlicensed medical clinic in Framingham, Attorney General Maura Healey announced. The judgment also orders preventive measures to ensure future compliance with the law. Pursuant to the Suffolk Superior Court judgment, Kevin Hornsby, M.D., was ordered to pay $11 million in civil penalties and his wife, Heidi Hornsby, was ordered to pay $2.5 million. According to the AG’s complaint, Florida Men’s Medical Clinic, LLC (FMMC), Men’s Medical Clinic, LLC (MMC), Kevin Hornsby, MD and Heidi Hornsby, were responsible for the deceptive marketing of medications and services relating to the treatment of erectile dysfunction at an unlicensed medical clinic in Framingham that went by the names Massachusetts Men’s Medical Clinic, Massachusetts Men’s Medical and Men’s Medical Clinic. The defendants used various deceptive practices in widespread TV, print and radio advertising to market the erectile dysfunction services and treatments sold at their Framingham facility. According to the complaint links to PDF file, more than 4,000 consumers went to the unlicensed facility for care. MA

$2.6 Million Whistleblower Settlement With Bay Sleep Clinic

The clinic will settle whistleblower allegations of using unlicensed technicians and unapproved locations and of doctor kickback referrals. Constantine Cannon LLP is pleased to announce a $2.6 million settlement on behalf of its client for whistleblower allegations against Bay Sleep Clinic. The settlement was announced by the United States government on December 28, 2016, against Bay Sleep Clinic, which currently operates 20 locations throughout northern California; its related Qualium Corporation and Amerimed Corporation businesses; and owners and operators Anooshiravan Mostowfipour and Tara Nader. The “qui tam,” or whistleblower, lawsuit alleged that the defendants fraudulently billed Medicare for sleep studies conducted by unlicensed individuals in unapproved locations; improperly dispensed durable medical equipment from unapproved locations using unlicensed technicians; and paid doctors for referrals in violation of the federal Anti-Kickback Statute. The defendants neither admitted nor denied liability. The whistleblower, Elma F. Dresser, is a former Bay Sleep Clinic employee who worked as a sleep technician and marketer for eight years. Through her various roles at the company, Ms. Dresser became familiar with the defendants’ alleged scheme to bilk money from Medicare. She filed her suit in 2012, leading the government to investigate the claims and join the case. Ms. Dresser was represented by Eric R. Havian, partner and attorney, Jessica T. Moore, partner and attorney, Anne Hayes Hartman, partner and attorney, Hallie Noecker, attorney, and Sarah Poppy Alexander, attorney of Constantine Cannon’s whistleblower practice in San Francisco, along with co-counsel from the Law Office of William C. Dresser. “It’s rewarding to see the alleged fraudsters held responsible. Because of the close cooperation and work between the whistleblower and the government, we were able to recover significant funds for the government,” said Anne Hayes Hartman, co-lead counsel on the case. “It is gratifying to represent people like Elma Dresser, who bravely stepped forward with knowledge of her employer’s wrongdoing. Many do not appreciate the risks whistleblowers face to hold alleged wrongdoers accountable.” “Sleep studies are a quickly expanding medical field,” said Jessica T. Moore, who served as co- lead counsel on the case. “Ensuring the safety of these procedures should be a top priority of the government for all patients, Medicare and otherwise.” The federal False Claims Act allows whistleblowers to sue companies that are defrauding the government and receive a reward if the government recovers any funds as a result. The government may choose to intervene in the lawsuit, as it has done in this case. The False Claims Act is one of the government’s most effective weapons in combatting fraud, waste, and abuse by those who contract with the government. Healthcare fraud alone is estimated to cost the U.S. billions of dollars. Such fraud can be difficult to discern without access to inside information; well-placed whistleblowers are necessary to provide the information the government might otherwise lack to help stop these practices.
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