Medicaid

Advanced Urology Pays $14M to Settle False Claims Act Allegations of Billing Medicare for Medically Unnecessary Services

By the Constantine Cannon Whistleblower Team On April 2, the Department of Justice (DOJ) announced that Georgia-based Advanced Urology, Inc. and its founder Dr. Jitesh Patel will pay $14 million to settle allegations they violated the False Claims Act and Georgia False Medicaid Claims Act by billing for urology procedures that were medically unnecessary or not performed at all.[1]  Notably, DOJ highlighted that...

Physical Therapy Company to Pay Millions to Resolve False Claims Act Allegations

By the Constantine Cannon Whistleblower Team On March 25, Jerome F. Gorgon Jr., the U.S. Attorney for the Eastern District of Michigan, announced that Team Rehabilitation Services, LLC (“Team Rehab”), a company operating around 140 physical therapy clinics in various states, agreed to pay $4,969,494 to settle allegations it violated the False Claims Act by submitting false claims for payment to federal...

Two Plead Guilty to $68M Brooklyn Adult Day Care and Home Healthcare Fraud Scheme

By the Constantine Cannon Whistleblower Team On January 15, Elaine Antao and Manal Wasef pleaded guilty to conspiring to defraud Medicaid by offering kickbacks for services not rendered at two Brooklyn social adult day cares and a home healthcare company. The proceedings took place before United States District Judge Natasha C. Merle in federal court in Brooklyn. Each defendant faces up to 10 years in...

New York Goes After Owner and Office Manager of Medical Transport Company for Alleged Medicaid Fraud and Money Laundering

By the Constantine Cannon Whistleblower Team Two weeks ago (October 24), the New York State Comptroller announced it was charging the owner and office manager of Angel Medical Transportation  in connection with an alleged Medicaid fraud scheme.¹ The State charged Angel Medical owner Mohammad Chaudhry with stealing more than $1.8 million from Medicaid, and office manager Noah Shook with paying kickbacks to...

NJ Rehab Center Will Pay $19.75M to Resolve False Claims Act Allegations

On April 30, a New Jersey-based drug and alcohol rehabilitation facility, Summit BHC New Jersey, LLC, d/b/a Seabrook, agreed to pay $19.75 million to resolve allegations that it violated the False Claims Act by billing for services it was not authorized to provide. This case was initiated by a former Seabrook employee who filed suit under the whistleblower or qui tam provisions of the False Claims Act. According to...

Network that Offers Programs for Adults with Disabilities Agrees to Pay $5M to Settle False Claims Act Case

The government announced it settled a civil fraud lawsuit against Community Options, Inc., (“COI”) and Community Options New York, Inc., (“CONY,” and together with COI, the “Defendants” or “Community Options”) for fraudulently billing Medicaid for services without necessary and accurate documentation and failing to report and return overpayments to Medicaid. Defendants agreed to pay the United States...

California Clinics, Lab, and Their Owners Pay $10M to Resolve False Claims, Kickback, and Stark Law Allegations

On December 26, the DOJ announced that medical clinics, a lab, and the owners will pay $10 million to settle allegations that they submitted false claims to Medicare and California’s Medicaid program, Medi-Cal, in violation of the Anti-Kickback Statute (AKS) and Stark Law (Physician Self-Referral Law). The defendants include Southern California Medical Center (SCMC), R & B Medical Group Inc., doing business as...

Walgreens to Pay $106.8M to Settle Whistleblower Case Alleging it Billed the Government for Prescriptions it Did Not Dispense

Walgreens has agreed to pay $106.8 million to settle false claims allegations that between 2009 and 2020 it billed government healthcare programs, including Medicare and Medicaid, for prescriptions that it never dispensed because they were not picked up by patients. The government alleged that Walgreens received tens of millions of dollars to which it was not entitled for prescriptions that it never actually provided...

Opioid Exploitation: Doctor and Staff Charged with Conspiracy and Fraud

VNS Health: $1M Settlement for Failing To Provide Services to Hospice Patients

The U.S. Attorney's Office for the Southern District of New York announced a substantial settlement with Visiting Nurse Service of New York (formerly VNSNY, now VNS Health) and its related entities. This settlement addresses allegations of fraudulent billing practices that undermined the Medicaid program meant to support some of the most vulnerable patients like those in hospice.  VNS Health is one of the largest...