Posts Tagged ‘kickbacks’
The Federal Government Nets $2.2B in Settlements and Judgements Under the False Claims Act, Including $1.7B in Healthcare-Related Fraud
Settlements and judgements under the False Claims Act (FCA) surpassed $2.2 billion for the fiscal year ending Sept. 30, 2022. Of that, $1.7 billion related to matters involving the healthcare industry, including drug and medical device manufacturers, durable medical equipment, home health and managed care providers, hospitals, pharmacies, hospice organizations, and physicians. The government and…
Read MoreMiami Doctors Convicted in DME Kickback Scheme
Two Miami doctors, indicted in August 2021 were recently found guilty, after a two-week trial, for their roles in a scheme to defraud Medicare by submitting claims for durable medical equipment (DME) that Medicare beneficiaries did not need. According to court documents and evidence presented at trial, chiropractor Dean Zusmer owned one of four DME…
Read MoreDME Company Owner Found Guilty in Massive Kickback Scheme
A Chicago man faces up to 20 years behind bars for his part in a conspiracy to pay illegal kickbacks to generate business for his durable medical equipment (DME) pharmacy. Mark Sorensen, 53, was president and owner of Symed, a Medicare-enrolled durable medical equipment pharmacy. Prosecutors alleged that between 2015 and 2018, he illegally bought…
Read MoreSurgeon Sentenced in Compound Medication Kickback Scheme
A Baltimore, Maryland doctor licensed in several states, will be spending the next three years behind bars for writing and referring compounded drug prescriptions in return for illegal kickbacks. Dr. Thomas Raley, Jr., 53, specialized in orthopedic and spine surgery and provided patients with pain management services in Virginia, Maryland and other states since 1998.…
Read MoreAmerican Senior Communities Settles for $5.5 Million in FCA Case
Thanks to the work of a whistleblower, the U.S. Department of Justice recently settled with an Indiana-based skilled nursing and long-term care services company for $5.5 million to resolve allegations that it violated the False Claims Act. A former American Senior Communities (ASC) employee filed a whistleblower lawsuit in 2017 alleging that that ASC was…
Read MoreHealthcare Fraud Roundup
Medical Clinic Fraud The owner of a Miami-based medical clinic was recently sentenced to 60 months in prison for directing a $38 million healthcare fraud scheme. Armando Valdes also was ordered to forfeit four real estate properties, including a beachfront condo in Pompano Beach, as well as numerous luxury vehicles, including a Cadillac Escalade and…
Read MoreThree Dozen Charged in $1.2 Billion Healthcare Fraud Scheme
The U.S. Department of Justice, through coordinated investigations across 13 districts, has filed criminal charges against three dozen defendants who allegedly were involved in $1.2 billion in fraudulent telemedicine, cardiovascular and cancer genetic testing, and durable medical equipment schemes. Those charged include a telemedicine company executive, owners and executives of clinical laboratories, durable medical equipment…
Read MoreFlorida Doctor Sentenced for Role in Sober Home Fraud
A Florida psychiatrist and medical director of two South Florida addiction treatment facilities was recently sentenced to four-and-a-half years in prison for his role in a fraud scheme in which he billed $112 million for services that were never provided or were medically unnecessary. After a 15-day trial in March, Jose Santiero of Miami Lakes…
Read MoreFlorida Man Gets 14 Years in Genetic Testing Fraud Scheme
The owner and operator of telemarketing and telemedicine companies faces 14 years behind bars after pleading guilty to healthcare and wire fraud and evading taxes. Through information filed Feb. 3, Marc Sporn of Delray Beach was accused of creating an elaborate scheme that cost Medicare more than $20 million dollars. According to court documents, Sporn…
Read MoreSix MDs Added to Laboratory Civil False Claims Case Filed in April
The U.S. Department of Justice has added six physicians to a Civil False Claims Act complaint it originally filed in April in a laboratory testing fraud case. According to the complaint, the Texas physicians received thousands of dollars in kickbacks in return for their referrals for laboratory testing. The original complaint was filed against two…
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