Top Ten Healthcare Fraud Recoveries of 2021
Posted 01/11/22
Medical Devices and DME
This archive displays posts tagged as relevant to medical devices and durable medical equipment. You may also be interested in our pages:
January 5, 2022
Two Florida men, Reinier Gonzalez Caballero and Alexeis Napoles Manresa, have each been sentenced to a little over four years in prison for laundering the ill-gotten proceeds of a $3 million healthcare fraud scheme against Medicare. Over a couple months in 2019, durable medical equipment company Universal Ortho Supplies, Inc. billed Medicare for orthosis and prosthetics that were never prescribed by physicians, nor provided to patients. The reimbursements were then turned over to the defendants, who attempted to disguise the source of the funds by setting up shell corporations and opening up fake bank accounts. Two co-conspirators have already been convicted and sentenced; another two have pleaded guilty and await sentencing. USAO SDFLDecember 8, 2021
The owner and medical director of Georgia’s Milton Hall Surgical Associates, Jeffrey M. Gallups, will pay $3 million, and medical device manufacturer Entellus Medical will pay $1.2 million, to resolve claims that they entered into an unlawful kickback arrangement. The government alleged that Gallups received cash payments and all-expense paid trips from Entellus in return for directing MHSA physicians to utilize sinuplasty related medical devices exclusively from Entellus and increase the number of sinuplasty procedures performed. In addition, Gallups was alleged to have received “commissions” from medical testing laboratory NextHealth, in exchange for directing MHSA doctors to order medically unnecessary toxicology and genetic tests from NextHealth. The settlement resolves a qui tam action initiated by former MHSA physician Myron Jones, M.D., who will receive approximately $614,000 from the settlement. USAO ND GARecent Settlements Show Kickbacks are Always a DOJ Enforcement Priority
Posted 11/15/21
November 8, 2021
Florida-based medical device company Arthrex Inc. has agreed to pay $16 million and enter into a five-year corporate integrity agreement to resolve allegations of paying kickbacks to a Colorado-based orthopedic surgeon in exchange for the surgeon’s use and recommendation of its products. According to a qui tam suit by whistleblower Joseph Shea, the kickbacks were disguised as royalty payments for the surgeon’s contributions to Arthrex’s SutureBridge and SpeedBridge products. For his role in the case, Shea will receive a relator’s share of $2.5 million. USAO MANovember 5, 2021
Two men who pleaded guilty to causing $134 million in false claims to be submitted to Medicare and CHAMPVA have been sentenced to federal prison and ordered to pay restitution of over $29 million. Michael Nolan of Florida was sentenced to 6.5 years, while Richard Epstein of Colorado was sentenced to about 5 years. Using a telemarketing company called REMN Management LLC, as well as a telemedicine company called Comprehensive Telcare LLC, Nolan and Epstein had bribed physicians to sign medically unnecessary orders for durable medical equipment, which they then sold to co-conspirators as support for the false claims. USAO MDFLCatch of the Week: Fraudulent Sleep Tests in Fresno
Posted 10/29/21
August 26, 2021
SuperCare Health, Inc., which provides home respiratory services and DME, will pay $3.3 million to resolve claims that the company submitted false claims for non-invasive ventilators in cases where those patients were no longer using the NIVs. The case was initiated by the filing a whistleblower complaint by a former SuperCare respiratory therapist, Benjamin Martinez. Mr. Martinez will receive a $612,000 whistleblower reward from the federal government. USAO CD CalCatch of the Week: Telemedicine Company Owner Charged in $784 Million Kickback Scheme
Posted 08/20/21
Catch of the Week: Waived Copayments and “Free” Glucometers Result in $160 Million Recovery in Whistleblower Action Against Previously-Barred Arriva Medical
Posted 08/4/21
