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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 48 of 48

DOJ Gives Major Shoutout To Whistleblowers In $450M DaVita False Claims Act Settlement

Posted  06/26/15
By Gordon Schnell On Wednesday, Denver-based provider of dialysis services DaVita Healthcare Partners, Inc. agreed to pay $450 million to resolve charges it violated the False Claims Act by purposely creating and then billing the government for unnecessary waste in administering the drugs Zemplar and Venofer to dialysis patients.  DaVita is the largest provider of dialysis services in the US with dialysis clinics...

Tagged in: Dosage Fraud, FCA Federal, Lack of Medical Necessity, Medical Billing Fraud, Medicare, Pharma Fraud, Whistleblower Case,

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DOJ Catch Of The Week -- PharMerica Corporation

Posted  05/15/15
By the C|C Whistleblower Lawyer Team This week's Department of Justice "catch of the week" goes to PharMerica Corporation, an organization of long-term care pharmacies that dispense medications to residents of nursing homes and skilled nursing facilities across the country.  Yesterday, PharMerica agreed to pay $31.5 million to settle charges it violated the Controlled Substances Act by dispensing Schedule II...

Tagged in: Catch of the Week, Lack of Medical Necessity, Pharma Fraud, SNF,

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DOJ Catch of the Week -- Health Management Associates

Posted  05/8/15
By the C|C Whistleblower Lawyer Team This week's Department of Justice "catch of the week" goes to Health Management Associates Inc.  Yesterday, the hospital chain and 14 hospitals it previously owned and operated, along with 2 other hospitals, agreed to collectively pay $15.69 million to settle whistleblower charges they violated the False Claims Act by seeking and receiving Medicare reimbursement for Intensive...

Tagged in: Catch of the Week, FCA Federal, Lack of Medical Necessity, Whistleblower Case,

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April 16, 2015

Georgia doctor Zheng Xiang Wang and the Wang Eye Clinic, P.C. agreed to pay $790,000 to settle allegations they billed Georgia Medicaid for medically unnecessary ophthalmology procedures. GA

Tagged in: Lack of Medical Necessity, Medicaid, Provider Fraud,

DOJ Catch Of The Week -- Institute For Cardiovascular Excellence

Posted  01/9/15
By the C|C Whistleblower Lawyer Team This week's Department of Justice "catch of the week" goes to Florida cardiologist, Dr. Asad Qamar, and his physician group, the Institute for Cardiovascular Excellence.  On Monday, the DOJ intervened in two whistleblower lawsuits alleging Qamar and his group billed Medicare for medically unnecessary peripheral artery interventions and paid kickbacks to patients by waiving...

Tagged in: Catch of the Week, FCA Federal, Lack of Medical Necessity, Provider Fraud, Whistleblower Case,

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Rose Cancer Center - Healthcare Fraud ($5.7 million)

Constantine Cannon represented a whistleblower in a False Claims Act case alleging Mississippi-based Rose Cancer Center used unqualified technicians performing bone marrow biopsies, diluted chemotherapy drugs, and falsified patient records to conceal the clinic’s fraudulent Medicare billings.  The physician who owned and ran the practice plead guilty to various Medicare fraud violations, forfeited $5.7 million, and was sentenced to 20 years in prison.  In August 2014, our client (along with three other whistleblowers) received a whistleblower award of $525,000 from the government's recovery.  Read more -- Clarion Ledger, CC.

Tagged in: FCA Federal, Healthcare Fraud, Improper Medical Personnel, Lack of Medical Necessity, Medicare, Provider Fraud, Whistleblower Rewards,

April 23, 2014

Amedisys home health companies agreed to pay $150M resolve allegations they violated the False Claims Act by allegedly billing Medicare for nursing and therapy services not medically necessary or provided to patients who were not homebound, and by otherwise misrepresenting patients’ conditions to increase its Medicare payments. The allegations were first raised in several qui tam lawsuit filed by former Amedisys employees under the whistleblower provisions of the False Claims Act. DOJ

Tagged in: FCA Federal, Home Health and Hospice, Lack of Medical Necessity, Whistleblower Case, Whistleblower Rewards,

January 5, 2014

New York Attorney General Eric T. Schneiderman announced that Apple Transportation of New York, Inc. will pay $300,000 to settle claims it overbilled Medicaid for transportation services. As part of a settlement agreement, Apple Transportation admitted that between January 1, 2004 and October 30, 2008, it frequently billed Medicaid for ambulette services even though no personal assistance was provided to Medicaid recipients. As a result, Apple was paid by Medicaid for ambulette services at rates that were higher than the applicable livery rates. NY

Tagged in: Lack of Medical Necessity, Medicaid, Provider Fraud,

August 19, 2013

Shands Teaching Hospital & Clinics agreed to pay $26M to settle allegations that six of its health care facilities submitted false claims to Medicare, Medicaid and other federal health care programs for inpatient procedures that should have been billed as outpatient services. The allegations were first raised in a qui tam lawsuit filed under the whistleblower provisions of the False Claims Act. DOJ

Tagged in: FCA Federal, Hospital Fraud, Lack of Medical Necessity, Medical Billing Fraud,

Scooter Store Caught Cheating the Government Out of Millions

Posted  01/24/13
By Marlene Koury It seems like such a wholesome company.  They have those nice commercials where elderly folks are scooting to and fro on their power-mobility devices.  It would seem that only an honest and trustworthy company would dedicate itself to caring for the needs of the elderly in this way.  But, according to an independent auditor, The Scooter Store – the purveyor of these fine commercials and the...

Tagged in: Lack of Medical Necessity, Provider Fraud,

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