Medical Billing Fraud
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May 26, 2017
Abington Memorial Hospital agreed to pay $491,672, to resolve allegations it violated the False Claims Act through the conduct of employee forging physician signatures on forms submitted to Medicare for home care services. DOJ (EDPA)May 8, 2017
Kansas medical equipment supplier Pos-T-Vac, Inc. agreed to pay $1 million to settle allegations it violated the False Claims Act by charging Medicare for vacuum supplies not medically necessary, lacking documentation of medical necessity, and/or not properly ordered by a physician. DOJ (DKS)Houston-Area Psychiatrist Convicted of Health Care Fraud for Role in $158M Medicare Fraud Scheme
Posted 05/24/17
By the C|C Whistleblower Lawyer Team
A jury convicted Texas psychiatrist Riaz Mazcuri of conspiracy to commit health care fraud and five counts of health care fraud. He is the latest to be convicted in a $158 million dollar scheme to defraud Medicare by submitting false claims for partial hospitalization program (PHP) services, an intensive outpatient treatment for mental illness. Thus far, 15 others have been...
April 27, 2017
Forrest S. Kuhn, Jr., M.D., a Kentucky physician specializing in allergy, asthma and immunology, agreed to pay roughly $750,000 to resolve allegations he violated the False Claims Act by submitting false claims to Medicare, Medicaid, and other government health care programs for allergy tests never performed. DOJ (WDKY)April 20, 2017
Illinois-based drugstore giant Walgreen Co. agreed to pay $9.86 million to resolve allegations 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 former Walgreens pharmacist and a former pharmacy technician. They will receive a whistleblower award of roughly $2.3 million from the proceeds of the government's recovery. DOJ (EDCA)March 31, 2017
Tennessee based Exemplary Behavior, LLC and its principal, Andre Anderson, agreed to pay $20,000 to settle allegations they violated the False Claims Act by submitting false claims for payment to the Defense Health Agency’s TRICARE program for the provision of therapy services, including Applied Behavior Analysis (“ABA”) to children with Autism Spectrum Disorder (“ASD”). Specifically, the settlement resolves charges that Exemplary Behavior submitted false claims to TRICARE as a result of their (1) double billing for services rendered; (2) billing for services not rendered by the billing provider; (3) providing group therapy while billing for individual therapy; and (4) billing for services, including ABA therapy, that were not actually provided. DOJ (MDTN)DOJ: Chicago Chiropractor Billed over $10 Million for Nonexistent Services
Posted 03/28/17
By the C|C Whistleblower Lawyer Team
Seeking to crackdown on fraud within the chiropractic field, the Department of Justice recently announced the indictment of Chicago-based chiropractor Henry Posada on 18 counts of health care fraud. The government alleges that from 2008 to 2016, Posada fraudulently billed over $10 million in chiropractic services to both Medicare and private insurers. According to the...