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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 39 of 41

April 23, 2015

Grady Health System agreed to pay $2,950,000 to settle claims it inaccurately coded claims for neo-natal intensive care unit patients, resulting in alleged damages to the Georgia Medicaid program. GA

Tagged in: FCA State, Healthcare Fraud, Medicaid, Medical Billing Fraud,

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,

April 13, 2015

Hallmark Health Systems agreed to pay $1.75 million to settle allegations it improperly billed the Massachusetts Medicaid Program (MassHealth) for certain inpatient admissions at its hospitals, resulting in overpayments by MassHealth. The settlement alleges that from March 2008 to December 2013, Hallmark used a specific default code that classified MassHealth patients as having received short-stay inpatient services, when an observation or outpatient level of care would have been more appropriate. MA

Tagged in: FCA State, Medicaid, Medical Billing Fraud,

April 7, 2015

Dr. Punyamurtula Kishore along with his company Preventive Medicine Associates, Inc. pleaded guilty for running a Medicaid fraud scheme involving millions of dollars in taxpayer funds. Kishore was sentenced to 360 days in jail and ordered to pay $9.3 million in restitution. Based on the government’s investigation, Dr. Kishore used bribes, or kickbacks, to induce sober house owners to send their residents’ urine drug screening business to his laboratories for testing. MA

Tagged in: Healthcare Fraud, Medicaid,

April 7, 2015

Texas Attorney General Ken Paxton announced New Jersey-based pharmaceutical product manufacturer Glenmark Generics Inc. USA agreed to pay $25 million to resolve the State’s investigation under the Texas Medicaid Fraud Prevention Act against Glenmark for fraudulently reporting inflated drug prices to the Medicaid program. TX

Tagged in: FCA State, Medicaid, Medical Billing Fraud,

April 1, 2015

Keli House Community Services, Inc., a nonprofit serving New Yorkers with disabilities and their families, agreed to reimburse New York’s Medicaid program $363,643 for using unqualified individuals to provide services to Medicaid recipients who participated in the Home and Community Based Services Program offered by the New York State Office of Persons with Developmental Disabilities. NY

Tagged in: Medicaid,

March 20, 2015

Florida Attorney General Pam Bondi’s Medicaid Fraud Control Unit announced the arrests of four individuals for allegedly recruiting the homeless to defraud Medicaid. According to the investigation, Christina Benson, owner of Tranquility Healthcare Solutions, billed Medicaid for services not provided or warranted for homeless men and women who were recruited by her associates to pose as patients. In less than a year and a half, Tranquility fraudulently billed Medicaid approximately $3.2 million. FL

Tagged in: Healthcare Fraud, Medicaid,

March 12, 2015

Florida Attorney General Pam Bondi announced the plea of a Gadsden County Home Health Care Provider, Melissa Simmons, for defrauding the Florida Medicaid program out of more than $13,000. The charges originated from the receipt of an anonymous tip through the Florida Medicaid Fraud Hotline. FL

Tagged in: Medicaid,

March 11, 2015

Olufemi Afuape and Oluyemisi Afuape, owners of Zion Rehab Services, were ordered to pay $1,407,325.50 in restitution to the Georgia Department of Community Health for billing the Georgia Medicaid program for physical, occupational and speech therapy without regard to whether the services were medically necessary and without regard to whether the services were actually delivered. GA

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

March 9, 2015

New York Attorney General Eric T. Schneiderman announced that Mental Health Association of Rockland County, Inc. agreed to pay $304,000 to resolve claims its managers and employees altered records in advance of a Medicaid audit so that the records would appear to support claims that were submitted by MHA Rockland to New York State’s Medicaid program. The allegations originated in a whistleblower lawsuit filed by two former MHA Rockland employees under the qui tam provisions of the New York False Claims Act, who will receive an undisclosed portion of the settlement. NY

Tagged in: Medicaid,

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