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Medicaid

This archive displays posts tagged as relevant to Medicaid and fraud in the Medicaid program. You may also be interested in our pages:

Page 27 of 41

June 25, 2018

New York announced registered nurse Collins Anyanwu-Mueller has been sentenced to a year in prison for stealing over $390,000 from Medicaid. A MFCU investigation uncovered that Anyanwu-Mueller submitted false Medicaid claims for private duty nursing services that he never provided to two severely disabled Medicaid recipients. Both Medicaid recipients required around-the-clock care. Prior to sentencing, Anyanwu-Mueller paid the State of New York $25,000 and has agreed to pay the remaining $367,954 in restitution owed. NY

Tagged in: FCA State, Home Health and Hospice, Medicaid, Medical Billing Fraud,

May 29, 2018

Wal-Mart and Sam’s Club will collectively pay $825,000 to resolve federal and state False Claims Act allegations the company’s automatic prescription refills for Minnesota Medicaid patients violated Minnesota law and wasted taxpayer dollars on unnecessary and unused medications. USAO DMN

Tagged in: FCA Federal, FCA State, Lack of Medical Necessity, Medicaid, Pharma Fraud,

May 16, 2018

Stephanie L. Patterson was sentenced to five years of probation and ordered to pay more than $81,000 for falsely claiming payments from the State of Illinois Medicaid Home Services Program for hundreds of hours of home health services not performed. USAO SDIL

Tagged in: Home Health and Hospice, Medicaid, Medical Billing Fraud,

April 27, 2018

New Era Rehabilitation Center and its owners agreed to pay roughly $1.4 million to resolve allegations they violated the False Claims Act by improperly billing Medicaid for methadone maintenance counseling services and psychotherapy services for the same patients. DOJ (CT)

Tagged in: FCA Federal, Medicaid, Medical Billing Fraud, Provider Fraud,

April 25, 2018

Long Island-based pediatrics practice Freed, Kleinberg, Nussbaum, Festa & Kronberg M.D., LLP (dba Pediatrics and Adolescent Medicine), along with some of the practice’s current and former physicians, agreed to pay $750,000 to resolve allegations they violated the False Claims Act by billing Medicaid for services provided by physicians who were not enrolled in the program. The allegations originated in a whistleblower lawsuit filed under the qui tam provisions of the False Claims Act. DOJ (EDNY)

Tagged in: FCA Federal, Improper Medical Personnel, Medicaid, Provider Fraud, Whistleblower Case, Whistleblower Rewards,

March 28, 2018

CenterLight Healthcare, Inc. agreed to pay $10 million to settle claims of violating the False Claims Act for collecting monthly Medicaid payments for 186 adult home residents who frequently did not receive required services while enrolled in Centerlight’s managed long-term care plan. In connection with the filing of the lawsuit and settlement, the Government had previously joined and settled a private whistleblower lawsuit filed under the qui tam provisions of the False Claims Act. In that case, Centerlight agreed to pay $46.7 million to settle claims of violating the False Claims Act by using social adult day care centers to enroll ineligible members in Centerlight’s managed long-term care plan. DOJ (SDNY)

Tagged in: FCA Federal, Managed Care, Medicaid, Whistleblower Case, Whistleblower Rewards,

March 8, 2018

Kmart Corporation agreed to pay $525,000 to settle claims it violated the False Claims Act by submitting claims for reimbursement to California’s Medi‑Cal program that were not supported by applicable diagnosis and documentation requirements. The allegations originated in a whistleblower lawsuit filed under the qui tam provisions of the False Claims Act by a Kmart pharmacist. The whistleblower will receive a whistleblower award of roughly $96,500 from the proceeds of the government’s recovery. DOJ (EDCA)

Tagged in: FCA Federal, Medicaid, Medical Billing Fraud, Pharma Fraud, Whistleblower Case, Whistleblower Rewards,

January 31, 2018

Brooklyn-based home health care company Home Family Care, Inc. and its co-owner and president agreed to pay roughly $6.4 million to settle claims they violated the False Claims Act by billing Medicaid for home health care services the company did not provide to Medicaid recipients. The allegations originated in a whistleblower lawsuit filed under the qui tam provisions of the False Claims Act. DOJ (EDPA)

Tagged in: FCA Federal, Home Health and Hospice, Medicaid, Medical Billing Fraud, Whistleblower Case,

April 27, 2018

A behavioral health and substance abuse treatment provider with locations in Connecticut and its owners have agreed to pay $1,378,533 to resolve a joint state-federal investigation into allegations that they submitted false claims for payment to Connecticut’s Medicaid program. New Era Rehabilitation Center and its co-founders and owners – Dr. Ebenezer Kolade and Dr. Christina Kolade – are enrolled as providers in the Connecticut Medical Assistance Program (CMAP), which includes the state’s Medicaid program. As part of their practice, they provide methadone treatment services for patients dealing with opioid addiction. Most of their patients are CMAP beneficiaries. CT

Tagged in: Medicaid, Provider Fraud,

February 15, 2018

New York announced the arrest and indictment of, as well as a civil asset forfeiture action against, Arkady Goldin, 39, of Brooklyn, and Value Pharmacy, Inc. ("Value"), for allegedly defrauding the New York State Medicaid program out of millions of dollars. Goldin, an owner of Value, is charged with Grand Larceny in the First Degree and other crimes for having allegedly paid kickbacks to a hospital employee for the referral of prescriptions for costly cancer medications. Additionally, prosecutors allege that Value billed Medicaid for over a million dollars of prescription medication it did not have in stock to dispense. The Attorney General’s Medicaid Fraud Control Unit ("MFCU"), also filed an asset forfeiture and civil recovery action against Goldin, Value, and Goldin’s co-owners seeking over $8.7 million in damages and penalties, alleging that Value’s owners made millions from these schemes that they funneled through shell companies to purchase personal expenses such as travel, luxury cars, and a high-end country club membership. NY

Tagged in: Anti-Kickback and Stark, Healthcare Fraud, Medicaid, Pharma Fraud,

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