Boca Man Admits to Selling MD Orders

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A Boca Raton man has pleaded guilty to conspiracy and kickback charges for his role in selling fraudulent doctors’ orders to others, who used them to obtain at least $25 million in fraudulent payments from Medicare. According to information filed in the case, Nagaindra Srivastav was the owner of B2B Apps Solutions, a Tampa-based company.…

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Lawsuit Alleges Cigna Upcoded Tens of Thousands of Medicare Advantage Claims

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The U.S. Department of Justice has joined a whistleblower lawsuit accusing Cigna Corp. of overbilling Medicare Advantage by submitting false patient diagnosis information to inflate payments The lawsuit seeks damages and penalties under the False Claims Act. The whistleblower lawsuit originally was filed in 2017 in the United States District Court for the Southern District…

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Compounding Pharmacies to Pay $6.8M in Prescriptions-for-Money Scam

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Three pharmacies and a billing company have agreed to pay more than $6.8 million to resolve allegations that they violated the False Claims Act by waiving co-pays, charging the government higher prices than allowed, and trading federal healthcare business with other pharmacies. Those implicated are: DermaTran Health Solutions, LLC; Pharmacy Insurance Administrators, LLC; Legends Pharmacy;…

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Feds Use Data Analytics to Detect Fraud

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A Jacksonville-based healthcare provider accused of making false or fraudulent claims with the Florida Medicaid program agreed to pay $700,000 to resolve allegations it violated the False Claims Act. The case against Physicians Group Services resolves allegations that PGS submitted claims to Florida’s Medicaid program for quantitative urine drug testing that were medically unnecessary because…

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