Provider Fraud
This archive displays posts tagged as relevant to fraud by healthcare providers. You may also be interested in our pages:
May 1, 2020
Milwaukee-based Center for Pain Management, S.C. and its owner, Nosheen Hasan, will pay at least $1.35 million to resolve claims that they received unlawful kickbacks in exchange for ordering medically unnecessary tests from a urine drug testing laboratory, Midwest Laboratory Sales & Consulting, LLC, in violation of the False Claims Act. The investigation was initiated by a whistleblower, who will receive a share of the settlement. USAO ED WIApril 30, 2020
Oncology practice group Florida Cancer Specialists & Research Institute LLC entered into a deferred prosecution agreement admitting to a criminal antitrust conspiracy in the form of an agreement with another provider not to compete to provide chemotherapy and radiation treatments to cancer patients in southwest Florida. FCS will pay a $100 million criminal penalty and cooperate with ongoing federal antitrust investigations into market allocation and other anticompetitive conduct in the oncology industry. DOJApril 29, 2020
North Carolina physician Ibrahim Oudeh and his wife Teresa Sloan-Oudeh will pay up to $8.8 million to resolve claims of Medicare and Medicaid fraud. Between 2010 and 2017, the Oudehs reportedly submitted more than 40,000 false claims, including more than 37,000 claims for laboratory tests, including nerve-conduction studies that Dr. Oudeh was not qualified to interpret, the vast majority of which were medically unnecessary. To submit as many claims as they did, defendants falsely billed for office visits, in some instances billing for more than 24 hours of visits in a single calendar day. The Oudehs sometimes used outside physicians to interpret laboratory tests, but paid those physicians less than their practice’s Medicare reimbursement, a violation of the Anti-Markup Rule. Defendants will forfeit $3.3 million in assets and pay an additional $5.5 million. USAO EDNC; NCApril 22, 2020
Hospital chain Centra Health Inc. and physician group Blue Ridge Ear, Nose, Throat and Plastic Surgery, Inc., will pay a total of $9.35 million to resolve claims that they entered into an improper financial arrangement in violation of the Stark Law, Anti-Kickback Law, and False Claims Act. The improper agreements included guaranteed physician compensation, physician compensation arrangements that took into account the value of referrals, and financial arrangements with physicians that were not memorialized in a written and executed contract. A former Blue Ridge ENT physician, who filed a qui tam action regarding the improper arrangements, will receive an undisclosed share of the settlement. USAO WD VANew Lawsuit Against Anthem Shows the Government’s Commitment to Medicare Advantage Fraud
Posted 04/3/20
Charges Filed in Shameful COVID-19 and Genetic-Cancer-Screening Test Scam
Posted 04/3/20
