Contact

Click here for a confidential contact or call:

1-212-350-2774

Lack of Medical Necessity

This archive displays posts tagged as relevant to fraud arising from medically unnecessary healthcare services. You may also be interested in our pages:

Page 31 of 48

Family Medicine Centers Settles Whistleblower False Claims Act Charges

Posted  09/12/17
By the C|C Whistleblower Lawyer Team A South Carolina family medical practice chain, along with its owner and laboratory director, agreed to pay roughly $2 Million to settle charges of violating the False Claims Act and Stark Law which prohibits physician self-referrals. Specifically, Family Medicine Centers of South Carolina (FMC) agreed to pay $1.56 million, and FMC's principal owner Dr. Stephen F. Serbin and...

July 17, 2017

Ohio-based nursing home operators Foundations Health Solutions Inc., Olympia Therapy Inc. and Tridia Hospice Care Inc., and their executives Brian Colleran and Daniel Parker, agreed to pay roughly $19.5 million to resolve allegations they violated the False Claims Act by submitting to Medicare claims for medically unnecessary rehabilitation therapy services and for hospice services to patients not eligible for the Medicare benefit, and by soliciting and receiving kickbacks to refer patients from their skilled nursing facilities to home health care provider Amber Home Care LLC.  The allegations originated in two whistleblower lawsuits filed under the qui tam provisions of the False Claims Act by former Olympia employee Vladimir Trakhter and former Tridia employees Paula Bourne and La’Tasha Goodwin.  Mr. Trahkter will receive a whistleblower award of roughly $2.9 million and Ms. Bourne and Ms. Goodwin collectively will receive an award of roughly $740,000, all from the proceeds of the government’s recovery.  Whistleblower Insider

July 14, 2017

Rodney Hesson and Gertrude Parker, owners of Nursing Home Psychological Services and Psychological Care Services, were respectively sentenced to 180 months and 84 months in prison and to respectively pay $13.8 million and $7.3 million in restitution for their involvement in a $25.2 million Medicare fraud scheme involving billing Medicare for psychological testing services that nursing home residents did not need or in some instances did not receive.  DOJ

July 6, 2017

Pennsylvania hospice company Compassionate Care of Gwynedd Inc., and a subsidiary of New Jersey-based Compassionate Care Hospice Group Inc., agreed to pay $2 million to resolve allegations it violated the False Claims Act by providing unnecessary hospice services.  The government alleged the company admitted patients by using a diagnosis of “debility” that was not medically justified.  The allegations originated in a whistleblower lawsuit filed under the qui tam provisions of the False Claims Act.  The whistleblowers will receive an award of more than $350,000 from the proceeds of the government's recovery.  DOJ (DNJ)

July 5, 2017

Reliant Care Group, Reliant Care Management Company, Reliant Care Rehabilitative Services, and a number of Reliant affiliated skilled nursing facilities agreed to pay roughly $8.4 million to settle charges they violated the False Claims Act by billing Medicare for unnecessary physical, speech, and occupational therapy to nursing home residents.  DOJ (EDMO)

June 26, 2017

Dr. Miguel Burgos, the medical director of four Florida infusion clinics, and Yosbel Marimon, the owner of the clinics, were sentenced respectively to 64 months and 90 months in prison for their roles in a $13.7 million Medicare fraud conspiracy that involved submitting claims for expensive infusion-therapy drugs that were never purchased, never provided and not medically necessary.  DOJ

August 4, 2017

Georgia announced a civil settlement with The Medical Center of Central Georgia, Inc., more commonly known as The Medical Center, Navicent Health (Navicent). Navicent agreed to pay to the United States and the State of Georgia $2,549,742 to resolve allegations that it violated the False Claims Act and the Georgia False Medicaid Claims Act by submitting bills for ambulance transports that were either inflated or medically unnecessary. Additionally, Navicent’s current Corporate Integrity Agreement (CIA) will be heightened and extended to cover the newly resolved conduct. A CIA is an agreement between a private provider of services and the United States whereby the provider, at its own expense, institutes and maintains a program, overseen by the OIG with reviews by an independent review organization, to insure compliance with the laws and regulations regarding participation in federally funded programs. GA

DOJ Catch of The Week -- Foundations Health Solutions

Posted  07/21/17
By the C|C Whistleblower Lawyer Team This week's Department of Justice "Catch of the Week" goes to Foundations Health Solutions Inc., Olympia Therapy Inc. and Tridia Hospice Care Inc.  On Monday, these Ohio-based companies, comprising one of the largest nursing home operations in the state, and their executives Brian Colleran and Daniel Parker, agreed to pay roughly $19.5 million to resolve allegations that they...

July 17, 2017

Former Olympia Therapy Inc. employee Vladimir Trakhter and former Tridia Hospice Care Inc. employees Paula Bourne and La’Tasha Goodwin will collectively receive a whistleblower award of more than $3.6 million from the roughly $19.5 million Olympia, Tridia and Foundations Health Solutions Inc. agreed to pay to resolve allegations they violated the False Claims Act by submitting to Medicare claims for medically unnecessary rehabilitation therapy services and for hospice services to patients not eligible for the Medicare benefit, and by soliciting and receiving kickbacks to refer patients from their skilled nursing facilities to home health care provider Amber Home Care LLC.

Fraudster of the Week -- Alabama Pain Doctor Rassan M. Tarabein

Posted  07/7/17
By the C|C Whistleblower Lawyer Team Last week, federal authorities announced that Dr. Rassan M. Tarabein, a neurologist who operates the Eastern Shore Neurology and Pain Center in Daphne, Alabama, had been arrested on myriad federal and state charges relating to health care fraud.  A federal grand jury recently returned a 22-count superseding indictment against Tarabein, charging him with health care fraud,...
1 29 30 31 32 33 48