Posts Tagged ‘Medicare fraud’
Three Sentenced for Roles in Compounding Pharmacy Kickback and Fraud Scheme
Three men, including two from Florida, were sentenced for their roles in a $54 million pharmacy kickback, bribery, and fraud scheme involving TRICARE. The federal program provides health insurance benefits to active duty and retired service members and their families. Prison Time David Byron Copeland of Tallahassee was sentenced to four years and three months…
Read MoreMiami Medical Coder Charged in Medicare Advantage Fraud Scheme
A Miami woman recently was charged for her role in a long-running Medicare Advantage fraud scheme to defraud Medicare out of tens of millions of dollars. Kenia Valle Boza, the former director of Medicare Risk Adjustment Analytics at HealthSun, was indicted in Miami federal court for allegedly orchestrating a scheme to submit false and fraudulent…
Read MoreCigna to Pay $173M to Settle False Claims Act Litigation Filed by Whistleblower
Health insurance giant Cigna agreed to pay nearly $173 million to resolve allegations it violated the False Claims Act by knowingly submitting false diagnosis codes under the federal Medicare Advantage program to increase its payments. In a lawsuit filed last year, the feds alleged that between 2014 and 2019, Cigna submitted to the Centers for…
Read MoreFlorida Nurse Practitioner Guilty in Healthcare Fraud Scheme
A South Florida advanced registered nurse practitioner convicted for her role in a healthcare fraud scheme that billed Medicare more than $200 million in false and fraudulent claims, faces the possibility of decades behind bars. Thousands of Fraudulent Orders Signed Elizabeth Hernandez of Homestead was indicted in April 2022 on ten counts relating to her…
Read MoreLincare To Pay $29M to Settle Medicare Overbilling Healthcare Fraud Case
Florida-based Lincare Holdings has agreed to pay $29 million to settle allegations it overbilled Medicare and Medicare Advantage plans for oxygen equipment provided to patients with respiratory-related illnesses. The settlement, which is the largest ever healthcare fraud settlement in the Eastern District of Washington settles claims that Lincare violated the False Claims Act. Lincare Agrees…
Read MoreDOJ Healthcare Fraud Crackdown on COVID-19 Testing Scam
The Department of Justice’s (DOJ) aggressive crackdown on COVID-19 testing scams finds healthcare providers under scrutiny.
Read MoreFlorida Man Pleads Guilty in Multimillion-Dollar DME Medicare Kickback Case
An Orlando, Fla. man faces up to ten years behind bars for his role in a durable medical equipment (DME) kickback scheme in which he and his co-conspirators were paid approximately $2.1 million and caused losses to Medicare and other healthcare benefit programs of at least $3.6 million. Patrick Fitchner pleaded guilty in New Jersey…
Read MorePennsylvania Lab Owner Sentenced to Prison in Illegal Kickback Scheme Involving Labs
The owner of two Pennsylvania testing labs in was sentenced to 18 months in prison, ordered to forfeit $9 million in criminal proceeds and pay more than $77 million in restitution for his involvement in an illegal kickback scheme. Ravitej Reddy pleaded guilty in 2020 to three conspiracy counts and one substantive count related to…
Read MoreBrain Health Scan Company Founder Settles False Claims Act Whistleblower Lawsuit
The co-founder of a New York-based company that purported to provide brain health scans (EEGs) for early detection of cognitive impairments has agreed to pay $220,000 to resolve allegations he violated the False Claims Act. The company, Evoke Neuroscience Inc., also will pay $225,000. According to the U.S. Department of Justice, David Hagedorn, Evoke’s co-founder…
Read MoreMaryland MD Convicted in COVID-19 Fraud Case with Nationwide Ties
A Maryland doctor who was one of 18 people indicted in April 2022 as part of a nationwide crackdown on COVID-19-related fraud has been convicted on five counts of healthcare fraud. According to court documents and evidence presented during trial, between March 2020 and December 2021, Ron Elfenbein submitted more than $15 million in false…
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