Medicare
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June 26, 2017
Dr. Miguel Burgos, the medical director of four Florida infusion clinics, and Yosbel Marimon, the owner of the clinics, were sentenced respectively to 64 months and 90 months in prison for their roles in a $13.7 million Medicare fraud conspiracy that involved submitting claims for expensive infusion-therapy drugs that were never purchased, never provided and not medically necessary. DOJJune 26, 2017
AMI Monitoring Inc. (aka Spectocor), its owner Joseph Bogdan, Medi-Lynx Cardiac Monitoring LLC, and Medicalgorithmics SA, the current majority owner of Medi-Lynx, agreed to pay roughly $13.5 million to resolve allegations they violated the False Claims Act by billing Medicare for higher and more expensive levels of cardiac monitoring services than requested by the ordering physicians. The allegations originated in a whistleblower lawsuit filed under the qui tam provisions of the False Claims Act by former Spectocor sales manager Eben Steele. He will receive a whistleblower award of roughly $2.4 million from the proceeds of the government's recovery. DOJCelgene to Pay $280M to Resolve Fraud Allegations
Posted 07/26/17
By the C|C Whistleblower Lawyer Team
Pharmaceutical manufacturer Celgene Corp. agreed to pay $280 million to settle claims that it illegally promoted two cancer drugs, Thalomid and Revlimid, for unapproved uses. The case was filed by a former Celgene sales representative under the False Claims Act, which allows individuals to sue to recover government dollars and share in any recovery.
The New York Times reports...
July 24, 2017
Myra Gross, a former patient of Dr. James Norman, owner of Florida-based Norman Parathyroid Center, and her husband Dr. David Gross, will receive a whistleblower award of roughly $600,000 from the $4 million Dr. Norman agreed to pay 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. DOJ (MDFL)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 14, 2017
Mildrey Gonzalez and her daughter Milka Alfaro were sentenced to 135 and 151 months in prison, respectively, and to pay roughly $22.9 million in restitution for their roles in a $20 million Medicare fraud conspiracy that involved paying illegal health care kickbacks to patient recruiters and medical professionals. They previously admitted they secretly co-owned and operated seven home health agencies in the Miami area, yet failed to disclose their ownership interests in any of these agencies to Medicare, as required by relevant rules and regulations. They further admitted to paying illegal health care kickbacks to a network of patient recruiters in order to bring Medicare beneficiaries into the scheme, to paying bribes and kickbacks to medical professionals in return for providing home health referrals, and to directing co-conspirators to open shell corporations, into which millions of dollars’ worth of fraud proceeds were funneled. DOJJune 13, 2017
New Jersey doctor Robert Claude McGrath and his chiropractor son Robert Christopher McGrath admitted to conspiring to defraud Medicare by using unqualified people to give physical therapy to Medicare recipients. Together with their practice, the Atlantic Spine & Joint Institute, they also agreed to pay $1.78 million to resolve allegations they violated the False Claims Act through the illegal billings. The allegations originated in a whistleblower lawsuit filed under the qui tam provisions of the False Claims Act by Linda Stevens, a former billing manager at Atlantic Spine. She will receive a whistleblower award of roughly $338,200 from the proceeds of the government's recovery. DOJ (DNJ)Mother and Daughter Owners of Home Health Agencies Each Sentenced to Over 10 Years in Prison for Roles in $20 Million Fraud Scheme
Posted 06/16/17
By the C|C Whistleblower Lawyer Team
A mother and daughter who secretly co-owned and operated seven home health care agencies in the Miami, Florida area were each sentenced to over 10 years in prison for their roles in a $20 million Medicare fraud conspiracy that involved paying illegal health care kickbacks to patient recruiters and medical professionals.
Mildrey Gonzalez, 61, and her daughter, Milka Alfaro,...