Posts Tagged ‘Medicare fraud’
Pharmacy Owner Pleads Guilty to $8.3M Fraud Scheme
A Fort Lauderdale man who invested in three pharmacies that participated in the Medicare program pleaded guilty to taking part in an $8.3 million fraud scheme. According to court documents, Michael Murphy, 37, invested in Cure Pharmacy in Jacksonville and two other pharmacies. From around November 2019 until March 2021, he and his co-conspirators engaged…
Read MoreGroup Home Owners Convicted in $1M Fraud Scheme
A Texas couple who owned and operated group homes recently was found guilty of perpetrating a $1 million dollar scheme to defraud Medicare. Lindell King, 52, and his wife Ynedra Diggs, 44 were charged with sending their group home residents to Behavioral Medicine of Houston (BMH), in exchange for kickbacks. BMH was a community mental…
Read MoreOIG to Recover $4B in 2020 Resulting From Investigative Efforts
The U.S. Department of Health and Human Services Office of Inspector General recently reported that it expects to recover more than $4 billion in misspent Medicare, Medicaid and other HHS dollars as a result of its investigative efforts. While that is a lot of money, it is considerably less than the nearly $5.9 billion the…
Read MoreFeds Recover $2.6B in 2019
The federal government recently announced it won or negotiated more than $2.6 billion in healthcare fraud adjustments and settlements during the last fiscal year (2019). As a result of its efforts, as well as those of preceding years, approximately $3.6 billion was recovered. Of that total, approximately $2.5 billion was transferred to the Medicare Trust…
Read MoreCOVID-19 Healthcare Fraud: It’s Started
A Georgia woman was arrested earlier this month in connection with a scheme in which she is alleged to have sought to pay and receive illegal kickbacks in exchange for referring Medicare beneficiaries for expensive cancer screening and COVID-19 tests. Loosened healthcare regulations, including blanket waivers of the federal Anti-kickback Statute (AKS) and physician self-referral…
Read MoreSecond FCA Whistleblower Case Dismissed – What’s a Lawyer to Do?
For the second time in the last few weeks, a Florida district court judge has dismissed a whistleblower lawsuit filed against a healthcare company alleging fraud. The most recent dismissal, which took place on February 6, was of a lawsuit against electronic software company Epic that alleged it had overbilled for anesthesia procedures. In dismissing…
Read MoreWoman Sentenced for Healthcare Fraud Has Sentence Commuted
A Hialeah woman who was sentenced to 35 years in prison for her role in a multimillion-dollar healthcare fraud case was among a group of people to have their sentences commuted by President Donald Trump last week. Judith Negron, the owner of American Therapeutic Corporation (ATC), a fraudulent Miami-area mental healthcare company, served ten years…
Read MoreOIG Alert: Beware of Genetic Testing Scam
The U.S. Department of Health and Human Services Office of Inspector General (HHS OIG) recently sent out an alert about a fraud scheme involving genetic testing. The government watchdog agency said Medicare beneficiaries are being offered the chance to get tested for certain genetic conditions through the use of a simple cheek swab, but they…
Read MoreOIG Cracks Down on Home Health Questionable Billing Practices
A few years back, as part of its Work Plan, the U.S. Department of Health and Human Services Office of the Inspector General (OIG) announced it was seeking to identify home health agencies, supervising physicians, and geographic areas whose Medicare claims had characteristics similar to those observed by the agency in cases of home health…
Read MoreIncident-to Billing Investigation Ends in $118,000 Fine
A physician in Texarkana, Texas recently agreed to pay $118,000 to settle allegations he engaged in improper billing practices for his Medicare patients at three of his clinics. According to the allegations, Dr. Donald S. Douglas’ advanced practice nurses (APNs) were hired to assist him with seeing patients in his clinics. By law, if the…
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