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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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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.

December 28, 2016

Bay Sleep Clinic, its related businesses -- Qualium Corporation and Amerimed Corporation -- and their owners and operators, Anooshiravan Mostowfipour and Tara Nader, agreed to pay $2.6 million to settle allegations they fraudulently charged Medicare for diagnostic sleep tests and medical devices in violation of Medicare payment rules. The allegations originated in a whistleblower lawsuit filed by Elma F. Dresser under the qui tam provisions of the False Claims Act. She will receive a whistleblower award of approximately $545,000 from the proceeds of the government's recovery. DOJ (NDCA)

Bay Sleep Clinic – Medicare Fraud/Unapproved Facilities, Unlicensed Technicians, and Physician Kickbacks ($2.6M).

Constantine Cannon represented whistleblower Elma Dresser, a sleep technician and former Bay Sleep employee. Ms. Dresser alleged that Bay Sleep Clinic and associated businesses, a network of sleep clinics in the San Francisco Bay Area, fraudulently billed Medicare for sleep studies conducted by unlicensed technicians 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 government joined a portion of the case, and in 2016, defendants agreed to pay $2.6 million to settle the matter. For her significant contributions, the relator’s share award was almost 21% of the government’s recovery. See DOJ for more.

August 22, 2016

Two Florida companies have been ordered to pay $17 million for deceptively marketing and billing for medications and services relating to the treatment of erectile dysfunction at an unlicensed medical clinic in Framingham, Massachusetts announced. The judgment, ordered by the Suffolk Superior Court, permanently prohibits Florida Men’s Medical Clinic, LLC (FMMC) and Men’s Medical Clinic, LLC (MMC) from operating unlicensed medical clinics in Massachusetts or deceptively marketing any medication or medical service relating to the treatment of erectile dysfunction in the state. Under the judgment, the two companies are also ordered to pay, between them, in excess of $17 million, with $6.3 million for restitution to Massachusetts consumers and the remainder in payments to the Commonwealth, including civil penalties. The companies have represented that they have ceased operations, and recovery of the amounts they are ordered to pay is uncertain. MA

July 27, 2016

Connecticut psychiatrist Dr. Anton Fry and his company CPC Associates agreed to pay $36,704 to resolve allegations they violated the False Claims Act by submitting improper claims to Medicare for psychiatric services that were provided over the phone instead of by meeting with the beneficiaries in the office and treating them in person.  The allegations originated in a whistleblower lawsuit filed under the qui tam provisions of the False Claims Act by Jodi Cohen, a former patient of Dr. Fry, and Medical Bill Consultants, LLC, a billing company.  They will receive a whistleblower award of $6,239 from the proceeds of the government's recovery.  DOJ (DCT)

March 9, 2016

Florida arrested a couple for defrauding the Medicaid program out of more than $180,000 in fraudulent claims. Oscar Alzate, 48, and Alba Garcia, 48, owners of Digital Radiology Center, Inc. and Medisound, Inc., allegedly operated a clinic without the appropriate licensure or proper oversight by a physician as required by Florida law. The investigation revealed that Alzate and his partner Garcia, neither who are physicians, billed the Medicaid program for services never rendered. The clinic owners also allegedly forged physicians’ signatures on medical reports and provided defective mammography services. FL

Constantine Cannon And Department of Justice Continue Joint Pursuit Against California Sleep-Clinic Chain

Posted  09/4/15
By Jessica T. Moore Constantine Cannon LLP has filed an amended complaint on behalf of a whistleblower alleging multi-faceted fraud on the part of Bay Sleep Clinic and its owners and operators, and billing company Access Medical Consultants.  The filing in United States ex rel. Dresser v. Qualium Corp., et al, Civil Action No. 12-1745 in the Northern District of California, comes on the same day the United States reported that it...
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