Medical Billing Fraud
This archive displays posts tagged as relevant to medical billing fraud. You may also be interested in our pages:
June 22, 2017
Dr. James M. Crumb, a physical medicine and rehabilitative specialist currently practicing in Alabama as Mobility Metabolism and Wellness, P.C.,and Coastal Neurological Institute, P.C., a local neurosurgeon physician group, agreed collectively to pay $1.4 million to resolve allegations they violated the False Claims Act by billing federal health care programs for medically unreasonable and unnecessary ultrasound guidance used with routine lab blood draws, and with Botox and trigger point injections. As a result of this billing scheme, the defendants sometimes billed 15 to 30 identical ultrasound guidance claims for a single patient office visit. DOJ (SDAL)June 15, 2017
Kentucky allergists Bruce Wolf and Kiro John Yun agreed to pay $740,578 to resolve allegations their medical practice group of otolaryngologists Wolf and Yun, P.S.C., specializing in allergy, asthma and immunology, violated the False Claims Act by billing the government for Sublingual Immunotherapy serum preparation and overstated units of serum preparation for injection vials. Sublingual immunotherapy is an alternative way to treat allergies without injections whereby an allergist prescribes a patient with an allergen that is sprayed under the tongue to boost tolerance to substances and reduce symptoms but it is not covered by Medicare because it is considered investigational. DOJ (WDKY)June 7, 2017
Texas-based medical and physical therapy provider Union Treatment Center agreed to pay $3 million to settle charges it violated the False Claims Act by defrauding the federal workers’ compensation (FECA) program. The company will also waive claims for payment exceeding $1.6 million and be permanently excluded from participating in federal health care programs. According to the government, UTC fraudulently billed the FECA program for services it did not render, routinely overcharged for medical examinations, falsely inflated the time patients spent in therapy, billed for unnecessary services and supplies, and paid kickbacks in exchange for patient referrals. The allegations originated in a whistleblower lawsuit filed under the qui tam provisions of the False Claims Act. DOJ (WDTX)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...