Medical Billing Fraud
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March 7, 2018
Florida dermatologist and owner of Treasure Coast Dermatology agreed to pay $2.5 million to settle claims he violated the False Claims Act by billing Medicare and TRICARE for procedures he did not perform. The allegations originated in a whistleblower lawsuit filed under the qui tam provisions of the False Claims Act by Patricia Cleary, a former patient of Dr. Ioannides. She will receive a whistleblower award of $475,000 from the proceeds of the government’s recovery. DOJ (SDFL)February 26, 2018
Brattleboro Memorial Hospital, Inc. paid $1,655,000 to settle claims it violated the False Claims Act by submitting outpatient laboratory claims lacking documentation necessary to support reimbursement by Medicare and Medicaid. The allegations originated in a whistleblower lawsuit filed under the qui tam provisions of the False Claims Act by Amy Beth Main. She will receive a whistleblower award from the proceeds of the government’s recovery. DOJ (VT)February 7, 2018
New York surgeon Syed Imran Ahmed was sentenced to 156 months in prison -- and ordered to pay roughly $7 million in restitution, forfeit roughly $7 million and pay a $20,000 fine -- for his role in a scheme that involved the submission of millions of dollars in false and fraudulent claims to Medicare. According to evidence presented at trial, Ahmed, who practiced at Kingsbrook Jewish Medical Center and Wyckoff Heights Medical Center in Brooklyn, Franklin Hospital in Valley Stream, and Mercy Medical Center in Rockville Centre, New York, billed the Medicare program for incision-and-drainage and wound debridement procedures that he did not perform. DOJFebruary 6, 2018
Kentucky ENT physician Phillip B. Klapper, M.D., Patricia Klapper, and Phillip B. Klapper, P.S.C. agreed to pay roughly $2.8 million to settle claims they violated the False Claims Act by submitting claims under the Federal Employees’ Compensation Act which falsely indicated that audiological tests were performed by licensed and certified personnel and/or the testing results were altered to enable some claimants to appear to have hearing losses. DOJ (WDKY)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)January 29, 2018
A judgment of roughly $16 million was entered against Orthopaedic and Neuro Imaging LLC for violating the False Claims Act by submitting claims for contrast dye MRI scans not properly supervised by a physician. DOJ (DE)Rotech Agrees to Pay $9.68 Million to Settle False Claims Act Liability Related to Improper Billing for Portable Oxygen
Posted 04/16/18
By the C|C Whistleblower Lawyer Team
The Justice Department announced a settlement last week for $9.68 million with Rotech Healthcare Inc. to settle charges of knowingly submitting false claims for portable oxygen contents to Medicare. The settlement included an admission by Rotech that is knowingly billed portable oxygen contents to Medicare for beneficiaries who neither used nor required them and that Rotech billed...
Banner Health Agrees to Pay $18 Million to Settle Whistleblower Case
Posted 04/13/18
By the C|C Whistleblower Lawyer Team
Banner Health has agreed to pay over $18 million to settle allegations that 12 of its hospitals in Arizona and Colorado knowingly submitted false claims to Medicare by admitting patients who could have been treated on a less costly outpatient basis. Headquartered in Arizona, Banner Health owns and operates 28 acute-care hospitals in multiple states.
“Taxpayers should not bear...
Genetic Testing Company Settles Whistleblower Suit for $11.4M
Posted 03/14/18
Silicon Valley-based Natera, Inc. agreed to pay over $11 million to resolve claims it improperly billed government healthcare programs for its non-invasive prenatal tests and screenings in violation of the False Claims Act by billing for the tests with an incorrect billing code. In resolution of the allegations, Natera will pay over $10.6 million to the federal government and $756,183 to a number of state Medicaid...