Medicare
This archive displays posts tagged as relevant to Medicare and fraud in the Medicare program. You may also be interested in our pages:
September 25, 2019
Dhanabapa LLC, doing business as E-Z Pharmacy, and owner Shardaben Patel have agreed to pay $1.1 million to settle allegations of defrauding Medicare and violating the False Claims Act in billing Medicare for prescription medications that were not actually dispensed. The fraudulent billing occurred from 2012 to 2016 and included medications such as Advair Diskus, Humalog, Novolog, Renvela, and Lidoderm. USAO EDPACatch of the Week: Texas Hospital Exec Sentenced to 10 Years in Prison for Medicare Fraud
Posted 09/18/19
September 17, 2019
Physician Alliance Ltd. (PAL) and its medical director agreed to pay $178,000 to resolve False Claims Act allegations for improperly billing Medicare for providing patients with electric acupuncture medical devices that is affixed behind patients' ears. Since Medicare does not reimburse for acupunctural devices, PAL allegedly billed Medicare for the “implantation of neurostimulator electrodes,” a procedure that requires surgery and for which Medicare reimburses in the thousands of dollars. The case was investigated out of the Eastern District of Pennsylvania. DOJSeptember 13, 2019
Texas hospital administrator Starsky Bomer was convicted of violating the Anti-Kickback Statute and conspiring to commit healthcare fraud for paying kickbacks to group homes and others in exchange for referrals to outpatient treatments for severe mental illness at his affiliated hospital, resulting in $16 million dollars of false claims to Medicare. The kickbacks came in the form of salary payments and payments for transportation to owners of group homes. Mr. Bomer was sentenced to ten years in prison for his involvement in the scheme. DOJCatch of the Week – South Florida Health Care Facility Owner Sentenced to 20 Years in $1.3 Billion Fraud - The Largest Health Care Fraud Scheme Ever Charged by the DOJ
Posted 09/13/19
September 12, 2019
New Jersey doctor Joseph DeCorso pleaded guilty to fraudulently prescribing orthotic braces over the phone for two telemedicine companies, resulting in a $13 million loss to Medicare. Dr. DeCorso admitted that the telemedicine companies preyed on elderly and disabled Medicare beneficiaries, on behalf of whom he submitted orders for medically unnecessary braces. He prescribed these braces without ever speaking to or consulting with these patients. The case was investigated by the FBI and the U.S. Department of Health and Human Services Office of the Inspector General. DOJMedicare Whistleblowers: The Most Common Questions Answered About Reporting Medicare Fraud
Posted 09/10/19
What potential whistleblowers need to know about reporting fraud in government healthcare programs.