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This archive displays posts tagged as relevant to Medicare and fraud in the Medicare program. You may also be interested in our pages:

Page 39 of 53

August 2, 2017

Atlanta-based pain management clinic Atlanta Medical Clinic and its owner Dr. Timothy Dembowski agreed to pay $250,000 to resolve charges they violated the False Claims Act by billing for services performed by a physician suspended from the Medicare program and administering foreign, non-FDA approved drugs, which are not eligible for reimbursement under the Medicare program.  DOJ (NDGA)

Tagged in: FCA Federal, Medicare, Provider Fraud,

July 24, 2017

Dr. James Norman, the owner and operator of Norman Parathyroid Center, agreed to pay $4 million to resolve allegations he violated the False Claims Act by billing Medicare for pre-operative examination services for which he had already received payment from the government.  These extra fees ranged from $150 to $750 for Florida residents, to $1,750 or more for patients who lived out-of-state, adding up to hundreds of thousands of dollars in illicit billing.  The allegations originated in a whistleblower lawsuit filed under the qui tam provisions of the False Claims Act by a former patient of Dr. Norman, Myra Gross, and her husband, Dr. David Gross.  They will receive a whistleblower award of roughly $600,000 from the proceeds of the government's recovery.  DOJ (MDFL)

Tagged in: FCA Federal, Medicare, Provider Fraud, Whistleblower Case, Whistleblower Rewards,

July 24, 2017

Tennessee-based Pain Management Group P.C. agreed to pay $312,000 to settle charges it violated the False Claims Act by billing for medically unnecessary urine drug tests and non-FDA approved pharmaceuticals Botox, Supartz, and Eufflexa, which the company purchased from foreign-based suppliers.  DOJ (MDTN)

Tagged in: Healthcare Fraud, Medicare, Provider Fraud,

July 14, 2017

Rodney Hesson and Gertrude Parker, owners of Nursing Home Psychological Services and Psychological Care Services, were respectively sentenced to 180 months and 84 months in prison and to respectively pay $13.8 million and $7.3 million in restitution for their involvement in a $25.2 million Medicare fraud scheme involving billing Medicare for psychological testing services that nursing home residents did not need or in some instances did not receive.  DOJ

Tagged in: Healthcare Fraud, Lack of Medical Necessity, Medicare, SNF,

July 14, 2017

Narco Freedom, Inc., a former operator of outpatient chemical dependency clinics, Joining Hands Management Inc., an operator of short-term residences known as “three-quarter houses,” and Joining Hands co-owner Devorah Haigler, settled claims of violating the False Claims Act.  The government will receive a $50.5 million allowed claim in the Narco Freedom bankruptcy proceeding, and Joining Hands and Haigler will pay $300,000.  The government alleged the defendants engaged in a kickback scheme whereby Narco made monthly cash payments to Joining Hands in exchange for Haigler and others referring residents of Joining Hands three-quarter houses to NARCO outpatient programs.  The allegations originated in a whistleblower lawsuit under the qui tam provisions of the False Claims Act.  An unidentified whistleblower will receive an undisclosed whistleblower award from the proceeds of the government's recovery.  DOJ (SDNY)

Tagged in: FCA Federal, Healthcare Fraud, Medicare, Provider Fraud, Whistleblower Case, Whistleblower Rewards,

July 13, 2017

New York podiatrist Perrin D. Edwards pled guilty to health care fraud for illegally charging Medicare and private insurance companies for podiatry services he never provided and agreed to pay $410,000 to resolve charges of violating the False Claims Act.  DOJ (NDNY)

Tagged in: Medical Billing Fraud, Medicare, Provider Fraud,

July 6, 2017

Pennsylvania hospice company Compassionate Care of Gwynedd Inc., and a subsidiary of New Jersey-based Compassionate Care Hospice Group Inc., agreed to pay $2 million to resolve allegations it violated the False Claims Act by providing unnecessary hospice services.  The government alleged the company admitted patients by using a diagnosis of “debility” that was not medically justified.  The allegations originated in a whistleblower lawsuit filed under the qui tam provisions of the False Claims Act.  The whistleblowers will receive an award of more than $350,000 from the proceeds of the government's recovery.  DOJ (DNJ)

Tagged in: FCA Federal, Home Health and Hospice, Lack of Medical Necessity, Medicare, Whistleblower Case,

July 5, 2017

Reliant Care Group, Reliant Care Management Company, Reliant Care Rehabilitative Services, and a number of Reliant affiliated skilled nursing facilities agreed to pay roughly $8.4 million to settle charges they violated the False Claims Act by billing Medicare for unnecessary physical, speech, and occupational therapy to nursing home residents.  DOJ (EDMO)

Tagged in: Healthcare Fraud, Lack of Medical Necessity, Medicare, SNF,

June 30, 2017

Dawn Bentley, a Detroit-area medical biller, was sentenced to 50 months in prison and to pay roughly $3.3 million for her role in a $7.3 million Medicare and Medicaid fraud scheme involving medical services that were billed to Medicare and Medicaid but not rendered as billed.  DOJ

Tagged in: Healthcare Fraud, Medicaid, Medical Billing Fraud, Medicare,

June 29, 2017

Innovative Therapies, Inc. and its parent company Cardinal Health, Inc. agreed to pay roughly $2.7 million to settle charges they violated the False Claims Act by submitting false claims to Medicare through their marketing of certain negative pressure wound treatment devices as durable medical equipment when they knew these devices did not have the expected life of a durable device.  The allegations originated in a whistleblower lawsuit filed under the qui tam provisions of the False Claims Act by a former ITI employee.  The whistleblower will receive an award of $488,700 from the proceeds of the government's recovery.  DOJ (MDTN)

Tagged in: FCA Federal, Healthcare Fraud, Medical Devices and DME, Medicare, Whistleblower Case, Whistleblower Rewards,

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