Medicare
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November 1, 2021
Geisinger Community Health Services, based in Pennsylvania, has agreed to pay over $18.5 million to resolve its liability following a self-disclosure of violations of the False Claims Act. The violations occurred between 2012 and 2017 and involved physician certifications of terminal illness, patient elections of hospice care, and physician face-to-face encounters with home health patients. USAO MDPACatch of the Week: Fraudulent Sleep Tests in Fresno
Posted 10/29/21
October 28, 2021
Rehab Authority, LLC, a physical therapy provider in Minnesota, has agreed to pay $4 million to resolve allegations by whistleblower Cami Lane that it violated the False Claims Act. RehabAuthority clinics had allegedly submitted false claims to Medicare, Medicaid, TRICARE, and the Veterans Health Administration for one-on-one outpatient physical therapy that was not provided. USAO MNOctober 25, 2021
Curant, Inc., which owns pharmacies in Florida and Georgia, has agreed to pay $4.6 million to resolve allegations of paying kickbacks to a third-party marketer, waiving mandatory copays from patients, and overbilling TRICARE for compound pain and scar creams. The alleged misconduct occurred between 2013 and 2015. USAO NDGACatch of the Week: Laboratory and Two Founders Will Pay up to $16M Over Fraudulent Billing for Urine Drug Testing
Posted 10/22/21
October 20, 2021
MD Spine Solutions LLC, d/b/a MD Labs Inc., and its owners, co-founders Denis Grizelj and Matthew Rutledge, have agreed to pay up to $16 million to settle fraud allegations raised by an unnamed whistleblower. MD Labs had allegedly billed Medicare, Medicaid, and other federal healthcare programs for presumptive urine drug testing as well as confirmatory urine drug testing run on the same samples, which is frequently baseless or useless. USAO MAOctober 8, 2021
U.S. Medical Management, LLC (USMM) and VPA, P.C. (VPA) have agreed to pay $8.5 million to resolve claims raised in five separate qui tam lawsuits that USMM and VPA billed Medicare for medically unnecessary laboratory and diagnostic testing services between 2010 and 2015. Although the government did not join any of the lawsuits, the whistleblower who filed first will receive $1.53 million under the alternate remedy provision of the False Claims Act. USAO EDMICatch of the Week: CMS Suspends UnitedHealth and Anthem Medical Advantage Plans for Charging Too Much in Premiums
Posted 09/24/21
