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:
May 6, 2014
The owners of Alpha Ambulance Inc. , a now-defunct Los Angeles-area ambulance transportation company, were sentenced for committing Medicare fraud by providing non-emergency ambulance transportation to Medicare beneficiaries whose medical condition at that time did not require ambulance transportation and then altering required documentation to conceal the scheme. DOJFebruary 25, 2014
Diagnostic Imaging Group agreed to pay $15.5M to resolve allegations that its diagnostic testing facility falsely billed federal and state health care programs for tests that were not performed or not medically necessary and by paying kickbacks to physicians. The allegations were first raised in three qui tam lawsuits filed under the whistleblower provisions of the False Claims Act. DOJFebruary 10, 2014
SelfRefind, a chain of addiction treatment clinics in Kentucky, and related entities and individuals, agreed to pay $15.75M to resolve allegations they violated the False Claims Act by submitting claims to Medicare and Kentucky’s Medicaid program for tests that were medically unnecessary, more expensive than those performed or billed in violation of the Stark Law. DOJJanuary 29, 2014
Saint Joseph Health System agreed to pay $16.5 million to resolve allegations that Saint Joseph Hospital violated the False Claims Act by submitting false claims to the Medicare and Kentucky Medicaid programs for a variety of medically unnecessary cardiac procedures. The allegations were first raised in a qui tam lawsuit filed under the whistleblower provisions of the False Claims Act. DOJJanuary 10, 2014
Two former executives of HealthEssentials Solutions agreed to pay more than $1 million to resolve False Claims Act allegations that they knowingly caused the company to submit false Medicare claims between 1999 and 2004 by billing for services that were inflated or not medically necessary and by pressuring employees to do the same. The allegations were first raised in a qui tam lawsuit filed under the whistleblower provisions of the False Claims Act. DOJDecember 19, 2013
Dr. Elie Korban will pay $1.2M to resolve False Claims Act allegations that he billed Medicare and Medicaid for medically unnecessary cardiac stent placements. The allegations were first raised in a qui tam lawsuit filed under the whistleblower provisions of the False Claims Act. DOJNovember 19, 2013
The Ensign Group agreed to pay $48M to resolve allegations that it knowingly submitted to Medicare false claims for medically unnecessary rehabilitation therapy services. The allegations were first raised in a qui tam lawsuit filed under the whistleblower provisions of the False Claims Act. DOJDOJ Catch Of The Week -- Kindred Healthcare
Posted 01/15/16
By the C|C Whistleblower Lawyer Team
This week's Department of Justice "Catch of the Week" goes to Kentucky-based healthcare provider Kindred Healthcare, Inc. On Tuesday, the company and its two RehabCare Group subsidiaries agreed to pay $125 million to resolve allegations of violating the False Claims Act by knowingly causing skilled nursing facilities to submit false claims to Medicare for rehabilitation...