Medical Billing Fraud
This archive displays posts tagged as relevant to medical billing fraud. You may also be interested in our pages:
February 8, 2019
Two executives from the South Carolina Early Autism Project (SCEAP) have been convicted of causing false statements to be submitted to Medicare and TRICARE and causing them to be overcharged by millions of dollars. According to statements by SCEAP employees, co-founder Ann Davis Eldridge and executive Angela Breitweiser Keith instructed employees to include travel and wait time in their billing in order to inflate time spent providing services. To further incentivize this practice, they implemented billing goals that had to be met in order to qualify for bonuses such as gift cards and vacations, all paid for by the company. Since then SCEAP has repaid almost $9 million, and as part of their plea agreement, both Keith and Eldridge will serve 1-year sentences. USAO SCFebruary 7, 2019
Six people associated with a string of substance abuse treatment centers have been indicted for defrauding Ohio's Medicaid program of over $31 million. Ryan Sheridan, the owner and operator of the businesses, along with Jennifer Sheridan, Kortney Gherardi, Lisa Pertee, Thomas Bailey, and Arthur Smith, allegedly submitted claims that were false on a number of fronts, including but not limited to: billing without proper documentation, for medically unnecessary services, provided by unqualified persons, and upcoded to a more costly service. Altogether, 134,744 false claims were submitted for more than $48.5 million in services. USAO NDOHFebruary 6, 2019
Families United Services, Inc. (FUS) and owner Pamela McKenzie have agreed to pay $645,000 to settle allegations of defrauding Georgia's Medicaid program from 2010 to 2012 by submitting claims for unprovided mental health services. As part of the settlement, FUS has been excluded from participating in federal healthcare programs for a period of five years. USAO NDGAFebruary 5, 2019
Two doctors from the Florida-based Fishman & Sheridan Eye Care Specialists clinic have agreed to pay a combined $157,312.32 to settle their liability under the False Claims Act. Drs. Craig D. Fishman and Jeffrey A. Sheridan were outed in a qui tam complaint filed by former business partner Dr. Michael Pennachio and office manager Sharon Drake, which alleged that from 2011 to 2017, Fishman and Sheridan knowingly billed Medicare for blepharoplasty and ptosis repair surgeries that were purportedly performed on the same patients, even though they are mutually exclusive eyelid repair surgeries. For exposing the fraud, Pennachio and Drake will receive a relator's share of $26,000. USAO MDFLJanuary 28, 2019
East Cost Stepping Stones, Inc., a behavioral services provider based in Jacksonville, Florida, has agreed to pay $360,000 to resolve allegations under the False Claims Act. The company was alleged to have falsely billed TRICARE for applied behavioral analysis therapy services for children with autism by misrepresenting the services provided and who provided them, failing to document services as required, and fabricating and altering medical records. USAO MDFLJanuary 15, 2019
New York has reached a $9 million settlement with Diamond Braces, a chain of dental offices, and its principal Oleg Drut, DDS, for false claims Diamond made to NY's Medicaid program for orthodontic procedures that were performed by personnel who were not certified to perform the work they did as required by NY state law. NYTop Ten Healthcare Recoveries of 2018
Posted 01/15/19
-
- Amerisource Bergen Corporation - In...