Thread: Feds Charge 243 People for Medicare Fraud

Feds Charge 243 People for Medicare Fraud

by REEM NASR




Lynch: Doctors, Pharmacy Owners, Others Bilked $712 Million from Gov't 2:54

The government charged 243 people for Medicare fraud totaling $712 million in false billings. That is according to an announcement made on Thursday by Attorney General Loretta Lynch and Department of Health and Human Services Secretary Sylvia Mathews Burwell.

The charges came following a nationwide sweep led by the Medicare Fraud Strike Force in 17 districts. The charges include 46 doctors, nurses and other licensed medical professionals, "for their alleged participation in Medicare fraud schemes involving approximately $712 million in false billings."

Read More from CNBC: Gov't charges 243 people for Medicare fraud totaling $712 million

The coordinated take-down is the largest such crackdown in the Medicare Fraud Strike Force's history, in the number of defendants charged and loss amount.

The Centers for Medicare & Medicaid Services also suspended a number of providers as a result of the sweep.

Read More: New Obamacare survey shows users love it, but can they keep it?

"This action represents the largest criminal health care fraud takedown in the history of the Department of Justice and it adds to an already remarkable record of enforcement," said Attorney General Lynch in a statement.

"The defendants charged include doctors, patient recruiters, home health care providers, pharmacy owners and others. They billed for equipment that wasn't provided, for care that wasn't needed and for services that weren't rendered. In the days ahead, the Department of Justice will continue our focus on preventing wrongdoing and prosecuting those whose criminal activity drives up medical costs and jeopardizes a system that our citizens trust with their lives. We are prepared- and I am personally determined- to continue working with our federal, state and local partners to bring about the vital progress that all Americans deserve."

http://www.nbcnews.com/news/us-news/...-fraud-n377776

6/19/2015

http://www.alipac.us/f12/feds-contin...border-320497/

Hello John Doe2, Many health care pros when caught like this just license in another state and move there, I look for a list of names caught in this sweep and cannot find one. That is not surprising, I've never found one. Do you know where the "black list" of medical providers may be or the do not use list?

Having them busted and not criminally charged and convicted does not stop them from "setting up shop" elsewhere. Many of them today set up shop next door to the legal medical marijuana shops.

Here are some of the doctors, nurses, hospitals, etc. convicted and fined or sent to prison in 6 months.

Criminal and Civil Enforcement

Criminal and Civil Enforcement Archive


Related Information

• OIG Most Wanted Fugitives
• Child Support Enforcement
• Medicare Fraud Strike Force

June 2015

June 18, 2015; U.S. Department of Justice National Medicare Fraud Takedown Results in Charges Against 243 Individuals for Approximately $712 Million in False Billing
Attorney General Loretta E. Lynch and Department of Health and Human Services (HHS) Secretary Sylvia Mathews Burwell announced today a nationwide sweep led by the Medicare Fraud Strike Force in 17 districts, resulting in charges against 243 individuals, including 46 doctors, nurses and other licensed medical professionals, for their alleged participation in Medicare fraud schemes involving approximately $712 million in false billings. In addition, the Centers for Medicare & Medicaid Services (CMS) also suspended a number of providers using its suspension authority as provided in the Affordable Care Act. This coordinated takedown is the largest in Strike Force history, both in terms of the number of defendants charged and loss amount.

• HHS-OIG Fact Sheet
• U.S. Department of Justice Documents
• Video: Daniel R. Levinson's Gives Remarks at Health Care Fraud Takedown Press Conference

June 18, 2015; U.S. Department of Justice

Covenant Hospice Inc. to Pay $10.1 Million for Overcharging Medicare, Tricare and Medicaid for Hospice Services
On June 18, Covenant Hospice Inc. agreed to pay $10,149,374 to reimburse the government for alleged overbilling of Medicare, Tricare and Medicaid for hospice services, the Department of Justice announced today. Covenant Hospice Inc. is a non-profit hospice care provider which operates in Southern Alabama and the Florida Panhandle.

June 18, 2015; U.S. Attorney; District of Connecticut

Ridgefield Doctor Pays $218,633 to Settle Allegations under the False Claims Act
Deirdre M. Daly, United States Attorney for the District of Connecticut, today announced that EDWARD BERMAN, MD, a physician with a practice in Ridgefield, has entered into a civil settlement with the government in which he will pay $218,633 to resolve allegations that BERMAN violated the False Claims Act.June 18, 2015; U.S. Attorney; Eastern District of Pennsylvania

Health Care Fraud Sentence Handed Down
PHILADELPHIA - Jermaine Hairston, 40, of Philadelphia, PA, was sentenced today to 38 months in prison and three years of supervised release, for health care fraud and aggravated identity theft. Hairston stole the personal identifying information of an emergency room physician and used it to call in fake prescriptions for expensive medications in the names of individuals on medical assistance. Hairston, and others, would pick up the prescription medication, generating a claim to the patient's health insurance, and then sell the medication for cash.

June 18, 2015; U.S. Attorney; Western District of Tennessee

Nurse Practitioner Indicted for Identity Theft, Defrauding More Than $330,000 in Health Care Services
Jackson, TN - A nurse practitioner has been indicted for forging the signature of a physician on nearly 150 treatment forms, causing Medicare and TennCare to disburse more than $330,000 in payments for unauthorized services.

June 18, 2015; U.S. Attorney; Southern District of Illinois
United States Attorney Stephen R. Wigginton Announces "Home Alone IV" And Nationwide Takedown Of Health Care Scams
Stephen R. Wigginton, United States Attorney for the Southern District of Illinois, and Gerald Roy, Special Agent in Charge, United States Department of Health and Human Services Office of Inspector General, Office of Investigations for Region 7 (Kansas City office) today announced indictments and arrests arising out of Operation Home Alone IV. The indictments are a fourth wave of charges targeting the abuse of a Medicaid program in Illinois that provides personal assistants to Medicaid recipients to assist them with general household activities and personal care. The program is intended for recipients under 60 years of age and is designed to reduce Medicaid expenditures by avoiding more expensive institutional care, including nursing home care.

June 18, 2015; U.S. Attorney; Northern District of Illinois 12 Charged In Chicago As Part Of Largest National Medicare Fraud Takedown In History
CHICAGO - Attorney General Loretta E. Lynch and Department of Health and Human Services (HHS) Secretary Sylvia Mathews Burwell announced today a nationwide takedown by Medicare Fraud Strike Force operations in 17 districts, resulting in charges against 243 individuals, including 46 doctors, nurses and other licensed medical professionals, for their alleged participation in Medicare fraud schemes involving approximately $712 million in false billings. In addition, the Centers for Medicare & Medicaid Services (CMS) also suspended a number of providers using its suspension authority as provided in the Affordable Care Act. This coordinated takedown is the largest in Strike Force history, both in terms of the number of defendants charged and loss amount. Zachary T. Fardon, United States Attorney for the Northern District of Illinois, announced thirteen defendants who were charged in four local cases as part of the national package.

June 18, 2015; U.S. Attorney; Southern District of Florida
Seventy-Three Charged in Southern District of Florida as Part of Largest National Medicare Fraud Takedown in History
Wifredo A. Ferrer, United States Attorney for the Southern District of Florida, Attorney General Loretta E. Lynch, George L. Piro, Special Agent in Charge, Federal Bureau of Investigation (FBI), Miami Field Office, Shimon R. Richmond, Special Agent in Charge, U.S. Department of Health and Human Services, Office of Inspector General (HHS-OIG), Amy L. Parker, Assistant Special Agent in Charge, Eastern Region, U.S. Office of Personnel Management, Office of Inspector General (OPM-OIG), Pam Bondi, Florida Attorney General, and, David W. Bourne, Special Agent in Charge, U.S. Food and Drug Administration's (FDA) Office of Criminal Investigations, Miami Field Office, announce that seventy-three (73) South Florida residents were charged for their alleged participation in various schemes to defraud Medicare and Medicaid out of more than $262,567.878.

June 18, 2015; U.S. Attorney; Eastern District of Michigan Sixteen Charged in Detroit Area as Part of Largest National Medicare Fraud Takedown in History
DETROIT, MI - Attorney General Loretta E. Lynch and Department of Health and Human Services (HHS) Secretary Sylvia Mathews Burwell announced today a nationwide sweep led by the Medicare Fraud Strike Force in 17 districts, resulting in charges against 243 individuals, including 46 doctors, nurses and other licensed medical professionals, for their alleged participation in Medicare fraud schemes involving approximately $712 million in false billings. In addition, the Centers for Medicare & Medicaid Services (CMS) also suspended a number of providers using its suspension authority as provided in the Affordable Care Act. This coordinated takedown is the largest in Strike Force history, both in terms of the number of defendants charged and loss amount.

June 18, 2015; U.S. Attorney; Eastern District of Louisiana 11 Individuals Operating 14 Companies Charged in New Orleans Fraud Schemes Amounting to Almost $110 Million in Fraud
Attorney General Loretta E. Lynch, U.S. Attorney Kenneth A. Polite of the Eastern District of Louisiana, Special Agent in Charge Michael Anderson of the FBI's New Orleans Field Office, and Special Agent in Charge Mike Fields of the U.S. Department of Health and Human Services Office of Inspector General's (HHS-OIG) Dallas Regional Office announced today that 11 individuals - including two doctors and a clinical psychologist - were charged for their roles in five separate fraud schemes based in New Orleans that, combined, submitted close to $110 million in fraudulent claims to Medicare.June 18, 2015; U.S. Attorney; Western District of Kentucky Twelve Charged In Western District Of Kentucky As Part Of Largest National Medicare Fraud Takedown In History
LOUISVILLE, Ky. - Acting United States Attorney John E. Kuhn, Jr. today announced the results of a health care fraud sweep in the Western District of Kentucky as part of the largest national Medicare fraud takedown led by the Justice Department and Department of Health and Human Services (HHS) Medicare Fraud Strike Force. The three day sweep, in the Western District of Kentucky, resulted in charges against 12 individuals, including three medical physicians, for their alleged participation in health care fraud schemes, involving approximately $7.8 million in fraudulent billings.June 18, 2015; U.S. Attorney; Northern District of Ohio Twelve charged for healthcare fraud violations totaling $28 million
Twelve people were charged in federal court this week as part of a nationwide sweep targeting healthcare fraud violations, law enforcement officials said.June 18, 2015; U.S. Attorney; Northern District of Texas Seven Charged in North Texas As Part Of Largest National Medicare Fraud Takedown In History
DALLAS - Attorney General Loretta E. Lynch and Department of Health and Human Services (HHS) Secretary Sylvia Mathews Burwell announced today a nationwide sweep led by the Medicare Fraud Strike Force in 17 districts, resulting in charges against 243 individuals, including 46 doctors, nurses and other licensed medical professionals, for their alleged participation in Medicare fraud schemes involving approximately $712 million in false billings. In addition, the Centers for Medicare & Medicaid Services (CMS) also suspended a number of providers using its suspension authority as provided in the Affordable Care Act. This coordinated takedown is the largest in Strike Force history, both in terms of the number of defendants charged and loss amount.June 17, 2015; U.S. Attorney; Southern District of FloridaFlorida Physician Agrees to Pay $4 Million and To Accept a 5-Year Exclusion From Medicare to Resolve False Claims Act Allegations
Wifredo A. Ferrer, United States Attorney for the Southern District of Florida, and Shimon R. Richmond, Special Agent in Charge, U.S. Department of Health and Human Services, Office of Inspector General (HHS-OIG), Miami Region, announced that Donald C. Proctor, Jr., M.D., a Mohs surgeon and facial plastic surgeon practicing in Vero Beach, Florida, and Grove Place Surgery Center, LLC, an ambulatory surgical center managed by Dr. Proctor, have agreed to pay $4 million to resolve allegations that they violated the False Claims Act by billing Medicare for Mohs surgeries and other surgical procedures that Dr. Proctor either did not perform or were medically unnecessary. Dr. Proctor also agreed to be excluded from Medicare, Medicaid, and all federally funded health care programs for at least five years.June 17, 2015; U.S. Attorney; Southern District of New YorkManhattan U.S. Attorney Settles Civil Fraud Claims Against Inspire Pharmaceuticals, Inc. For Its Misleading Marketing Designed To Cause Prescriptions Of Azasite For Non-Fda Approved Uses
Preet Bharara, the United States Attorney for the Southern District of New York, and Scott J. Lampert, Special Agent in Charge of the U.S. Department of Health and Human Services, Office of Inspector General's ("HHS-OIG") New York Region, announced today that the United States has settled civil fraud claims under the False Claims Act and common law against INSPIRE PHARMACEUTICALS, INC. ("INSPIRE"). According to the allegations of the complaint, although the Food and Drug Administration ("FDA") had approved AzaSite only for the treatment of bacterial conjunctivitis, a bacterial infection of the eye more commonly known as pink eye, INSPIRE sought to generate more revenue by aggressively marketing the drug for the non-FDA-approved treatment of blepharitis, a different eye condition involving inflammation of the eyelids.June 17, 2015; U.S. Attorney; Eastern District of TexasFormer Shelby County Hospital CFO Sentenced in EHR Incentive Case
TYLER, Texas - The former Chief Financial Officer of Shelby Regional Medical Center has been sentenced to federal prison in the Eastern District of Texas, announced U.S. Attorney John M. Bales today.June 16, 2015; U.S. Attorney; Northern District of TexasRegistered Nurse Co-Owner of Ultimate Care Home Health Services, Inc. Pleads Guilty to Role in Healthcare Fraud Conspiracy
DALLAS - A 52-year-old registered nurse from Cedar Hill, Texas, who owned a home health company, appeared in federal court this afternoon and pleaded guilty to her role in a health care fraud conspiracy, announced John Parker, Acting U.S. Attorney for the Northern District of Texas.June 16, 2015; U.S. Department of JusticeFlorida Skilled Nursing Facility Agrees to Pay $17 Million to Resolve False Claims Act Allegations
Hebrew Homes Health Network Inc., its operating subsidiaries and affiliates, and William Zubkoff, the former president and executive director of Hebrew Homes Health Network Inc. (collectively Hebrew Homes), have agreed to pay $17 million to resolve allegations that Hebrew Homes violated the False Claims Act by improperly paying doctors for referrals of Medicare patients requiring skilled nursing care, the Department of Justice announced today. Hebrew Homes provided skilled nursing services at seven rehabilitation and skilled nursing facilities in Miami-Dade County, Florida. This is the largest settlement involving alleged violations of the Anti-Kickback Statute by skilled nursing facilities in the United States.June 16, 2015; U.S. Attorney; Middle District of FloridaUnited States Settles False Claims Act Allegations Against Jacksonville-Based Home Health Company For $1,293,169
Jacksonville, Florida B United States Attorney A. Lee Bentley, III announces that the United States has settled allegations that a Jacksonville-based home health company knowingly billed the government for millions of dollars of medically unnecessary services by submitting false claims to Medicare. The allegations resolved include liability under the False Claims Act (FCA).June 16, 2015; U.S. Attorney; Western District of KentuckyFormer Bowling Green Physician Charged With Conspiracy To Dispense Controlled Substances, Health Care Fraud And Money Laundering
BOWLING GREEN, Ky. - Acting U.S. Attorney John E. Kuhn, Jr. today announced the indictment of former Warren County, Kentucky, physician Charles Fred Gott on charges of conspiracy to distribute and dispense controlled substances during the course of his professional practice that were not for a legitimate medical purpose, health care fraud, and money laundering.June 15, 2015; U.S. Department of JusticeChildren's Hospital to Pay $12.9 Million to Settle False Claims Act Allegations
Children's Hospital, Children's National Medical Center Inc. and its affiliated entities (collectively CNMC) have agreed to pay $12.9 million to resolve allegations that they violated the False Claims Act by submitting false cost reports and other applications to the components and contractors of the Department of Health and Human Services (HHS), as well as to Virginia and District of Columbia Medicaid programs, the Department of Justice announced today. CNMC is based in Washington, D.C., and provides pediatric care throughout the metropolitan region.June 12, 2015; U.S. Attorney; Middle District of FloridaUnited States Files Lawsuit Against Jacksonville-Based Ambulance Company
Jacksonville, Florida B United States Attorney A. Lee Bentley, III announces today that the United States has formally filed a lawsuit against Liberty Ambulance Services, Inc., a Jacksonville-based ambulance company. This lawsuit is brought pursuant to the False Claims Act and the Anti-Kickback Statute.June 11, 2015; U.S. Attorney; Eastern District of PennsylvaniaCharge Of "Causing A Death" Added To Indictment Against Main Line Doctor
PHILADELPHIA - A superseding indictment was filed today against Dr. Jeffrey Bado, 59, of Philadelphia, PA, charging him with distribution of a controlled substance resulting in death and 82 additional counts of distribution of controlled substances. Bado, a doctor of Osteopathic Medicine, was first indicted on February 4, 2015 for the alleged illegal distribution of pain medications from his Philadelphia and Bryn Mawr medical offices. The superseding indictment also contains the original two counts of maintaining a drug-involved premises, 200 counts of illegally distributing oxycodone, a Schedule II controlled substance, outside the usual course of professional practice and for no legitimate medical purpose, 33 counts of health care fraud, and four counts of making false statements to federal agents.June 11, 2015; U.s. Attorney; Northern District of OklahomaSettlement Reached in Medicare Fraud Lawsuit Against Tulsa Doctor and His Medical Clinic
TULSA, Okla.-United States Attorney Danny C. Williams Sr. for the Northern District of Oklahoma announced today that Jerome E. Block, M.D. and his clinic, Integrations Medical Clinic, have agreed to pay a total of $105,000 in civil penalties to settle allegations of submitting false Medicare claims to the United States.June 9, 2015; U.S. Department of Justice Former President of Riverside General Hospital Sentenced to 45 Years in Prison in $158 Million Medicare Fraud Scheme
The former president of a Houston hospital, his son and a co-conspirator were sentenced today to 45 years, 20 years and 12 years in prison, respectively, for their roles in a $158 million Medicare fraud scheme.June 9, 2015; U.S. Attorney; Middle District of GeorgiaUnited States Settles Kickback Allegations With Georgia Hospital
WASHINGTON - The Department of Justice announced today that the United States has settled a False Claims Act lawsuit with Health Management Associates (HMA) and Clearview Regional Medical Center for $595,155. The lawsuit filed in the Middle District of Georgia alleged that from 2008 to 2009 the hospital paid kickbacks to an obstetric clinic that served primarily undocumented Hispanic women, in return for referral of those patients for labor and delivery at the hospital. The hospital then billed the Medicaid program in Georgia for the services provided to the referred patients. Clearview, located in Monroe, Georgia, was named Walton Regional Medical Center and was owned by hospital operator HMA during the time period relevant to the lawsuit. Clearview is now owned by Community Health Systems (CHS), which purchased HMA in January 2014.June 9, 2015; U.S. Attorney; Middle District of FloridaCollier County Man Sentenced To Six Years In Connection With Sunshine Pharmacy Health Care Fraud
Fort Myers, Florida - Senior United States District Judge John E. Steele has sentenced Adam Parrish (35, Naples) to six years in federal prison for conspiracy to commit health care fraud, aggravated identity theft, and improperly using a DEA Registration Number. He pleaded guilty on February 18, 2015.June 5, 2015; U.S. Attorney; Western District of North CarolinaSix Charged In Health Care Fraud Scheme Targeting Medicaid
CHARLOTTE, N.C. - Six members of a health care fraud ring that targeted Medicaid by submitting approximately $10 million in fraudulent reimbursement claims have been charged with health care fraud conspiracy, announced Jill Westmoreland Rose, Acting U.S. Attorney for the Western District of North Carolina.June 5, 2015; U.S. Attorney; Northern District of GeorgiaAtlanta Dentist to Pay Settlement to Resolve False Claims Act Allegations
ATLANTA - The United States Attorney's Office for the Northern District of Georgia announced that it has reached a settlement with Dennis Jaffe and Dennis B. Jaffe D.M.D., P.C., to pay $324,327.05 to settle health fraud claims -- specifically that Jaffe violated the False Claims Act by fraudulently billing Medicaid for tooth extraction procedures and for fraudulently billing for services rendered by a dental assistant when Jaffe was not present in the office. Under the terms of the settlement, Jaffe is also excluded from all federal and state healthcare programs.June 4, 2015; U.S. Department of JusticeUnited States Settles Kickback Allegations with Georgia Hospital
The Department of Justice announced today that the United States has settled a False Claims Act lawsuit with Health Management Associates (HMA) and Clearview Regional Medical Center for $595,155. The lawsuit filed in the Middle District of Georgia alleged that from 2008 to 2009 the hospital paid kickbacks to an obstetric clinic that served primarily undocumented Hispanic women, in return for referral of those patients for labor and delivery at the hospital. The hospital then billed the Medicaid program in Georgia for the services provided to the referred patients. Clearview, located in Monroe, Georgia, was named Walton Regional Medical Center and was owned by hospital operator HMA during the time period relevant to the lawsuit. Clearview is now owned by Community Health Systems (CHS), which purchased HMA in January 2014.June 4, 2015; U.S. Attorney; Middle District of FloridaPalm Harbor Oncologist Indicted For Buying Unapproved Cancer Medications From Foreign Sources And Defrauding Medicare
Tampa, Florida - United States Attorney A. Lee Bentley, III announces the unsealing of a twenty-one count indictment charging Dr. Anda Norbergs (59, Palm Harbor) with nine counts of receiving misbranded drugs in interstate commerce and twelve counts of health care fraud. If convicted, she faces up to three years in federal prison for each count of receiving misbranded drugs and up to ten years on each count of health care fraud. The indictment also notifies Dr. Norbergs that the United States is seeking a money judgment of at least $700,000, which is alleged to be proceeds of the offense.June 3, 2015; U.S. Attorney; District of IdahoCalifornia Man Pleads Guilty to Obtaining a Controlled Substance by Fraud and Billing Medicaid for a Fraudulent Prescription
BOISE - Michael James Lott, 32, of Roseville, California, pleaded guilty on June 3, 2015, to acquiring and obtaining a controlled substance by misrepresentation, fraud, and deception and false statement relating to health care matters, U.S. Attorney Wendy J. Olson announced. Lott was indicted by a federal grand Jury in Boise on January 13, 2015.June 2, 2015; U.S. Attorney; Southern District of West VirginiaOhio woman sentenced for defrauding Huntington medical provider
Huntington, W. Va. - Teresa Lewis, 60, of South Point, Ohio, was sentenced yesterday to a year and a day in federal prison for defrauding the Huntington Retina Center, where she worked, United States Attorney Booth Goodwin announced. Chief United States District Judge Robert C. Chambers imposed the sentence.June 2, 2015; U.S. Attorney; District of New JerseyTwo New York Doctors Sentenced To Prison For Taking Bribes In Test-Referrals Scheme With New Jersey Clinical Lab
NEWARK, N.J. - Two doctors with a practice in New York were each sentenced today to 20 months in prison for accepting bribes in exchange for test referrals as part of a long-running and elaborate scheme operated by Biodiagnostic Laboratory Services LLC (BLS), of Parsippany, New Jersey, its president and numerous associates, U.S. Attorney Paul J. Fishman announced.June 1, 2015; U.S. Attorney; Middle District of TennesseeNashville-Based Friendship Home Healthcare And Related Companies Pay U.S. And Tennessee $6.5 Million To Resolve False Claims Act Lawsuit
A group of home health care companies collectively known as "Friendship" and the companies' owner Theophilus Egbujor paid $6.5 million, plus interest, to resolve allegations that they improperly billed TennCare, Medicare and TRICARE for home health services, announced David Rivera, United States Attorney for the Middle District of Tennessee. Friendship and its owner also agreed to be bound by the terms of a Corporate Integrity Agreement with the Department of Health and Human Services-Office of Inspector General (HHS-OIG) in an effort to avoid future fraud and compliance failures.June 1, 2015; U.S. Attorney; Northern District of IllinoisHealth Care Provider Sentenced To 75 Months For $2.5 Million Health Care Fraud
CHICAGO - A former owner and operator of Selectcare Health, Inc., a provider of outpatient physical and respiratory therapy located in Park Ridge and Skokie, was sentenced to federal prison for engaging in a $2.5 million health care fraud scheme. Ankur Roy, 38, of Miami Beach, Florida, was sentenced last Friday to 75 months in prison followed by 3 years of supervision after his release by U.S. District Court Judge Gary Feinerman.
May 2015

May 28, 2015; U.S. Attorney; District of New JerseyGarden State Cardiovascular Specialists P.C. Agrees To Pay $3.6 Million For Allegedly Submitting False Claims To Federal Health Care Programs
NEWARK, N.J. - Garden State Cardiovascular Specialists P.C. (Garden State), a cardiology practice which owns and operates several facilities in New Jersey under the name NJ MedCare/NJ Heart, has agreed to pay more than $3.6 million to resolve allegations that its facilities falsely billed federal health care programs for tests that were not medically necessary, U.S. Attorney Paul J. Fishman announced today.May 28, 2015; U.S. Attorney; Central District of CaliforniaValley Duo that Bilked Medicare by Billing Nearly $2 Million for Unneeded Power Wheelchairs Found Guilty of Federal Fraud Charges
LOS ANGELES - A Los Angeles-area woman and man who were responsible for more than $1.8 million in fraudulent Medicare billings - almost entirely for medically unnecessary power wheelchairs - have been found guilty of health care fraud.May 28, 2015; U.S. Attorney; District of MarylandPain Clinic Owners, Distributors and Runners Indicted for Allegedly Conspiring to Operate "Pill Mills"
Baltimore, Maryland - A federal grand jury has returned three indictments charging a total of 16 individuals with drug conspiracy and other charges for operating purported pain management clinics that the indictments allege were actually "pill mills." The indictments were returned on May 20, 2015, and unsealed late yesterday upon the arrest of eight defendants. In addition to yesterday's arrests, agents executed search warrants at 14 locations, including clinics, pharmacies and residences.May 27, 2015; U.S. Department of JusticeDurable Medical Equipment Suppliers to Pay $7.5 Million to Resolve False Claims Act Allegations
Orbit Medical Inc. and Rehab Medical Inc. will pay $7.5 million to resolve allegations that Orbit submitted false claims to federal health care programs for power wheelchairs and accessories, the Justice Department announced today. Orbit Medical and Rehab Medical, a partial successor of Orbit, are durable medical equipment suppliers based in Salt Lake City, Utah and Indianapolis, Indiana, respectively.May 27, 2015; U.S. Attorney; Northern District of Illinois Chicago Area Psychologist Pleads In Nationwide Medicare Fraud Strike Force Takedown
CHICAGO - An area psychologist pled guilty today to engaging in a health care fraud scheme to defraud the Medicare program, federal law enforcement officials announced today. SHARON A. RINALDI, a licensed psychologist, was charged in a five-count indictment returned in October 2012 with defrauding Medicare by submitting thousands of false claims for providing psychotherapy services to Medicare beneficiaries residing in skilled nursing homes in the Chicago area. Rinaldi submitted false claims to Medicare seeking a total reimbursement of approximately $1.1 million and as a result of those false claims, Medicare paid Rinaldi at least $447,155 in funds to which she was not entitled. Rinaldi, 60, of Inverness, pled to one count of health care fraud before U.S. District Court Judge Robert M. Dow. Rinaldi also has agreed to forfeit of more than $100,000 that was seized from her home and a personal bank account in September 2012.May 27, 2015; U.S. Attorney; District of IdahoCalifornia Supplier of Oxycodone and Boise Heroin and Oxycodone Dealer Sentenced in Federal Court
BOISE - Ajellon Dedeaux, 27, of Rancho Cordova, California, was sentenced yesterday to 144 months in federal prison for distributing tens of thousands of oxycodone pills to Boise in a large scale drug trafficking conspiracy, U.S. Attorney Wendy J. Olson announced. U.S. District Judge Edward J. Lodge also ordered Dedeaux to pay a $1000 fine, serve five years of supervised release, and to forfeit $1,750,000 in drug proceeds.May 27, 2015; U.S. Attorney; Middle District of PennsylvaniaHamilton Health Center Agrees To Settlement Of Federal Civil Matter
HARRISBURG - The United States Attorney's Office for the Middle District of Pennsylvania announced that Hamilton Health Center, Inc., a federally qualified health center in Harrisburg, Pennsylvania, has agreed to pay the United States $270,000 to settle False Claims Act allegations. The settlement results from a self-disclosure by Hamilton to the Office of Inspector General of the U.S. Department of Health and Human Services (OIG) through the OIG's Provider Self-Disclosure Protocol.May 27, 2015; U.S. Department of Justice Owner of Los Angeles Medical Supply Company Sentenced to Seven Years in Prison for $3.3 Million Medicare Fraud Scheme
The former owner of a Los Angeles-based medical supply company was sentenced today to seven years in prison for his role in a fraud scheme that resulted in $3.3 million in fraudulent claims to Medicare.May 26, 2015; U.S. Attorney; Northern District of IllinoisLockport Pharmacist Indicted For Allegedly Falsely Billing $2.4 Million For Prescription Claims
CHICAGO - A southwest suburban pharmacist was indicted on federal charges for health care fraud, federal law enforcement officials announced today. The defendant, WALTER BEICH, the owner and licensed pharmacist at Lockport Pharmacy, Inc. operating as Corwin Pharmacy, was charged in a twelve-count indictment returned by a federal grand jury last week, alleging he participated in a scheme to defraud various health care benefit programs in the amount of $2,400,000. The indictment also charges Beich with aggravated identity theft for his use of patient and physician names and identifying information during his scheme. The indictment also seeks forfeiture in the amount of $2.4 million, the amount of the alleged loss to the health care providers. Beich, 61, of Lockport, Illinois, was arraigned in federal court this morning and was released on a $4,500 unsecured bond and is scheduled for a status in front of U.S. District Court Judge John W. Darrah on June 26, 2015.May 22, 2015; U.S. Attorney; Northern District of New YorkCentral New York Doctor Sentenced To 18 Months Imprisonment
SYRACUSE, NEW YORK - United States Attorney Richard S. Hartunian announced the sentencing today of Mahesh Kuthuru, age 43, a physician of a Utica and Fulton area pain management practice.May 22, 2015; U.S. Department of Justice Detroit-Area Neurosurgeon Admits Causing Serious Bodily Injury to Patients in $11 Million Health Care Fraud Scheme
A Detroit-area neurosurgeon pleaded guilty today in two separate criminal cases that resulted in serious bodily injury to his patients and more than $11 million in Medicare, Medicaid and private insurance companies.May 21, 2015; U.S. Department of Justice Assistant Administrator of Riverside General Hospital Sentenced to 40 Years in Prison for $116 Million Medicare Fraud Scheme
The former assistant administrator of Riverside General Hospital was sentenced today to 40 years in prison for his role in a $116 million Medicare fraud scheme. To date, 10 individuals have pleaded guilty or been convicted for their involvement in the scheme.May 21, 2015; U.S. Attorney; Northern District of CaliforniaWatsonville Nursing Home Owners, Operators And Manager Agree To Pay $3.8 Million To Settle Allegations Of False Claims
SAN FRANCISCO - The owners, operators, and manager of two nursing homes in Watsonville, Calif., have agreed to pay $3.8 million to settle allegations that they submitted false claims to the United States, announced United States Attorney Melinda Haag, U.S. Department of Health and Human Services OIG (HHS-OIG) Special Agent in Charge Ivan Negroni, and Federal Bureau of Investigation Special Agent in Charge David J. Johnson.May 21, 2015; U.S. Attorney; District of New JerseyOwner Of Parsippany-Based Diagnostic Testing Facility
NEWARK, N.J. - A Morris County, New Jersey, man was sentenced today to 12 months in prison for his role in a scheme to bill for diagnostic testing services he did not render and to enable a cardiologist to evade the Medicare program's pre-payment review of his claims, U.S. Attorney Paul J. Fishman announced.May 20, 2015; U.S. Department of Justice Physician Pleads Guilty For Role in Detroit-Area Medicare Fraud Scheme
A licensed physician and former owner of a Detroit-area medical practice pleaded guilty today for his role in a $4.2 million health care fraud scheme.May 20, 2015; U.S. Department of JusticeMedco to Pay $7.9 Million to Resolve Kickback Allegations
Medco Health Solutions Inc., a wholly-owned subsidiary of the pharmacy benefit manager Express Scripts Holding Company, of Missouri, has agreed to pay the government $7.9 million to settle allegations that it engaged in a kickback scheme in violation of the False Claims Act, the Justice Department announced today. Medco provides pharmacy benefit management services to clients who receive subsidies under the Medicare Retiree Drug Subsidy program.May 20, 2015; U.S. Department of JusticeGovernment Settles False Claims Act Allegations against Florida Neurologist for $150,000
Dr. Sean Orr of Jacksonville, Florida, has agreed to pay $150,000 to settle allegations that he violated the False Claims Act by providing medically unnecessary services and drugs to federal health care program beneficiaries, the Department of Justice announced today. Dr. Orr is a neurologist formerly employed by Baptist Neurology Inc. and Baptist Medical Center-Jacksonville.May 19, 2015; U.S. Attorney; District of MarylandPharmacy Owner Sentenced for Conspiracy to Distribute Contraband Cigarettes, Health Care Fraud, and Receiving and Distributing Misbranded Drugs
Baltimore, Maryland - U.S. District Judge William D. Quarles, Jr. sentenced the owner of Health Way Pharmacy, Salim Yusufov, age 43, of Reisterstown, Maryland, today to 12 months home confinement as part of four years' probation, for a conspiracy to traffic over $6.6 million in contraband cigarettes, health care fraud, and receipt and delivery of misbranded drugs. Judge Quarles also ordered Yusufov to forfeit $200,000.May 19, 2015; U.S. Attorney; District of IdahoTwin Falls Former Pharmacy Technician Sentenced for Diverting Controlled Substances
BOISE - Krista Federer, 46, of Twin Falls, Idaho, was sentenced today to 12 months and one day in prison for distributing a controlled substance, U.S. Attorney Wendy J. Olson announced. U.S. District Judge Edward J. Lodge also ordered Federer to serve three years of supervised release, and to pay a $1,000 fine.May 18, 2015; U.S. Department of Justice Administrator and Biller of Illinois Physician Group Convicted in $4.5 Million Medicare Fraud Scheme
A federal jury in Chicago on May 15, 2015, convicted the administrator and biller of a Schaumburg, Illinois, in-home visiting physician group for their participation in a $4.5 million health care fraud scheme that included billing Medicare for services rendered to patients who were dead and services rendered by medical professionals who worked over 24 hours in a day.May 15, 2015; U.S. Attorney; Southern District of IllinoisMarion Woman Sentenced For Healthcare Fraud
Stephen R. Wigginton, United States Attorney for the Southern District of Illinois, announced today, that Charlietta M. Lee, 51, of Marion, Illinois, was sentenced for engaging in a scheme to commit health care fraud by defrauding the Home Services Program, which is a Medicaid Waiver Program designed to allow individuals to stay in their homes instead of entering a nursing home.May 15, 2015; U.S. Attorney; District of New JerseyNew Jersey Doctor Sentenced To 14 Months In Prison For Taking Bribes In Test-Referrals Scheme Involving New Jersey Clinical Lab
NEWARK, N.J. - A doctor with a medical practice in Montclair, New Jersey, was sentenced today to 14 months in prison for accepting bribes in exchange for test referrals as part of a long-running and elaborate scheme operated by Biodiagnostic Laboratory Services LLC (BLS), of Parsippany, New Jersey, its president and numerous associates, U.S. Attorney Paul J. Fishman announced.May 14, 2015; U.S. Department of JusticeLong-Term Care Pharmacy to Pay $31.5 Million to Settle Lawsuit Alleging Violations of Controlled Substances Act and False Claims Act
PharMerica Corporation has agreed to pay the United States $31.5 million to resolve a lawsuit alleging that they violated the Controlled Substances Act by dispensing Schedule II controlled drugs without a valid prescription and violated the False Claims Act by submitting false claims to Medicare for these improperly dispensed drugs, the Justice Department announced today.May 14, 2015; U.S. Department of Justice New Orleans Jury Convicts Two Doctors, a Nurse and an Office Manager for Roles in $50 Million Fraud Scheme
A jury in New Orleans convicted four employees of medical service clinics yesterday for their roles in a $50 million Medicare fraud scheme.May 14, 2015; U.S. Attorney; District of ConnecticutAmbulance Companies Pay $595,000 to Settle Allegations of Medically Unnecessary Ambulance Transportation
Deirdre M. Daly, United States Attorney for the District of Connecticut, announced that EFK OF CONNECTICUT, INC., d/b/a NELSON AMBULANCE SERVICE, located in North Haven, and SKMP ENTERPRISES, INC., d/b/a ACCESS AMBULANCE SERVICE, located in Bridgeport, have entered into a civil settlement agreement with the government in which they will pay $595,000 to resolve allegations that they improperly billed the Medicare and Medicaid programs.May 14, 2015; U.S. Attorney; Southern District of New YorkManhattan U.S. Attorney Settles Civil Fraud Claims Against Westchester Medical Center Arising From Its Violations Of The Anti-Kickback Statute And The Stark Law
Preet Bharara, the United States Attorney for the Southern District of New York, Scott J. Lampert, Special Agent in Charge of the U.S. Department of Health and Human Services, Office of Inspector General's ("HHS-OIG") New York Region, and Diego Rodriguez, the Assistant Director-in-Charge of the New York Office of the Federal Bureau of Investigation ("FBI"), announced today that the United States has settled civil fraud claims under the False Claims Act against WESTCHESTER COUNTY HEALTH CARE CORPORATION d/b/a WESTCHESTER MEDICAL CENTER ("WMC") related to WMC's alleged violations of the Anti-Kickback Statute and the Stark Law and submission of costs reports to Medicare seeking reimbursement for charges WMC did not incur. In connection with the settlement, which was approved by U.S. District Judge Lewis A. Kaplan on May 14, 2015, the defendant agreed to pay a total of $18,800,000 to resolve its liabilities, and made admissions as to its conduct.May 14, 2015; U.S. Attorney; Western District of PennsylvaniaPennsylvania Physician Sentenced to Prison for False Tax Returns, Healthcare Fraud
JOHNSTOWN, Pa. - A resident of the Dominican Republic, has been sentenced in federal court to one year and one day in prison and ordered to pay restitution of $121,000 to Highmark Blue Cross/Blue Shield on his conviction of filing false individual and corporate tax returns and health care fraud, United States Attorney David J. Hickton announced today.May 13, 2015; U.S. Department of Justice Southern California Medical Supply Company Owner Sentenced to Four Years in Prison for $8.3 Million Medicare Fraud Scheme
A registered nurse who owned a medical supply company was sentenced today in Los Angeles to four years in federal prison for her role in an $8.3 million Medicare fraud scheme.May 12, 2015; U.S. Department of Justice Owner of Miami Home Health Care Company Sentenced to 10 Years in Prison for Lead Role in $13 Million Medicare Fraud Scheme
An owner of a Miami home health care company was sentenced today to 10 years in prison for his leading role in a $13 million Medicare fraud scheme that involved paying kickbacks and bribes to patient recruiters, Medicare beneficiaries and others in South Florida doctors' offices and medical clinics.May 12, 2015; Northern District of CaliforniaUnited States Joins Lawsuit Against Bay Area Sleep Clinics
SAN JOSE - The United States has joined a whistleblower action pending in the Northern District of California against the owners and operators of Bay Sleep Clinic and their related businesses, Qualium Corporation and Amerimed Corporation, announced United States Attorney Melinda Haag and U.S. Department of Health and Human Services Special Agent in Charge, Ivan Negroni.May 12, 2015; Western District of LouisianaShreveport woman sentenced to 27 months in prison for health care fraud, wire fraud
SHREVEPORT, La. - United States Attorney Stephanie A. Finley announced that the owner and operator of a Shreveport intensive outpatient program company was sentenced Monday to 27 months in prison for charging Medicare for services never rendered.May 11, 2015; U.S. Attorney; Eastern District of PennsylvaniaUnited States Sues Supply Company And Delaware County Couple For Healthcare Fraud
PHILADELPHIA - The United States filed a civil healthcare fraud lawsuit today against John M. Hastings and Sarah Cintron Hastings, of Drexel Hill, Pennsylvania, and their medical supply company, Diabetic Care Solutions, Inc. The complaint, announced by United States Attorney Zane David Memeger, alleges that the couple operated the company in an attempt to bypass Hastings' exclusion from the Medicare program.May 8, 2015; U.S. Department of Justice Dallas Physician and His Employee Arrested for Alleged $5.2 Million Medicare Fraud Scheme
A physician who ran a medical house call service business in Dallas, and an employee of that business were arrested this morning on charges related to their alleged participation in a $5.2 million health care fraud scheme.May 8, 2015; Middle District of FloridaUnited States Settles False Claims Act Allegations Against Multiple Jacksonville Hospitals And An Ambulance Company For $7.5 Million
Jacksonville, FL - United States Attorney A. Lee Bentley, III announces that the United States has settled allegations that nine hospitals in Jacksonville had a practice of routinely ordering basic life support ambulances when this type of transport was not medically necessary. The United States has also settled allegations with an ambulance company for its role in submitting millions of dollars of false claims to federal healthcare programs. The allegations resolved included liability under the False Claims Act (FCA).May 7, 2015; U.S. Department of JusticeSixteen Hospitals to Pay $15.69 Million to Resolve False Claims Act Allegations Involving Medically Unnecessary Psychotherapy Services
The Justice Department announced today that 16 separate hospitals and their respective corporate parents have agreed to collectively pay $15.69 million to resolve False Claims Act allegations that the providers sought and received reimbursement from Medicare for services that were not medically reasonable or necessary, the U.S. Department of Justice announced today.May 7, 2015; U.S. Attorney; Eastern District of PennsylvaniaMedicare Beneficiary Pleads Guilty In Ambulance Fraud Scheme
PHILADELPHIA - Keisha Regusters, 38, of Philadelphia, PA, pleaded guilty today to a fraud scheme involving kickbacks from an ambulance company. U.S. District Court Judge William H. Yohn, Jr. scheduled a sentencing hearing for August 11, 2015. Regusters faces a possible advisory sentencing guideline range of six to 12 months in prison, up to three years of supervised release, restitution, a fine of up to $500,000, and a $200 special assessment.May 6, 2015; U.S. Department of Justice Houston Doctor and Group Home Owner Indicted for Alleged Roles in $5.2 Million Medicare Fraud Scheme
A Houston doctor and a group home owner were arrested on charges related to their alleged participation in a $5.2 million Medicare fraud scheme involving false claims for mental health treatment.May 6, 2015; U.S. Attorney; District of ConnecticutState Fraud Enforcement Official Arrested, Charged with Wire Fraud
Deirdre M. Daly, United States Attorney for the District of Connecticut, announced that LYNWOOD PATRICK, JR., 39, of East Hartford, was arrested today on a federal criminal complaint charging him with wire fraud in connection with his submission of a fraudulent application for a personal mortgage modification.May 6, 2015; U.S. Attorney; Eastern District of North CarolinaPharmacy Company Agreed To Pay $5 Million To Settle Claims That It Gave Gift Cards And Waived Copayments For Medicare And Medicaid Patients In Violation Of The Anti-Kickback Statute
RALEIGH - United States Attorney Thomas G. Walker announced that Physician Pharmacy Alliance, Inc., ("PPA"), agreed to pay $5 Million to settle claims that, under prior ownership, PPA gave improper gift cards in order to induce referrals or enrollments of Medicare and Medicaid patients, and routinely waived copayments of Medicare and Medicaid patients, in violation of the Anti-kickback statute.May 6, 2015; U.S. Attorney; Southern District of New YorkManhattan U.S. Attorney Settles Civil Fraud Claims Against Vascular Surgery Clinic And Surgeon For Fraudulently Billing Medicare For Nonreimbursable Vascular Surgery Procedures
Preet Bharara, the United States Attorney for the Southern District of New York, and Scott Lampert, Special Agent in Charge of the U.S. Department of Health and Human Services, Office of Inspector General's ("HHS-OIG") New York Region, announced today that the United States has settled civil fraud claims under the False Claims Act against MATTOO & BHAT MEDICAL ASSOCIATES, P.C. ("MBPC") and DR. FENG QIN ("DR. QIN") related to MBPC's submission of fraudulent claims for reimbursement by Medicare for vascular surgical procedures that are not covered under Medicare. In connection with the settlement, which was approved by U.S. District Judge Louis L. Stanton on May 1, 2015, the defendants agreed to pay a total of $1,150,000 to resolve their liabilities.May 5, 2015; U.S. Attorney; Southern District of New YorkManhattan U.S. Attorney Announces Conviction Of Doctor And Owner Of Bronx Clinic Involved In Illegal Distribution Of More Than Five Million Oxycodone Pills
Preet Bharara, the United States Attorney for the Southern District of New York, announced the conviction of KEVIN LOWE, the owner of "Astramed," a purported medical clinic with multiple locations in the Bronx, New York, and from which more than five million tablets of the prescription painkiller oxycodone were unlawfully distributed over a three-year period. LOWE was convicted yesterday following a two-week jury trial presided over by U.S. District Judge Lorna G. Schofield.May 5, 2015; U.S. Attorney; District of New JerseyTwo Doctors Each Sentenced to 37 Months in Prison for Taking Bribes in Test-Referrals Scheme with New Jersey Clinical Lab
NEWARK, N.J. - Two doctors were sentenced to prison today for accepting bribes in exchange for test referrals as part of a long-running and elaborate scheme operated by Biodiagnostic Laboratory Services LLC (BLS), of Parsippany, New Jersey, its president and numerous associates, U.S. Attorney Paul J. Fishman announced.May 4, 2015; U.S. Attorney; District of ColumbiaDurable Medical Equipment Supplier to Pay United States $300,000 To Resolve False Claims Allegations
WASHINGTON - American Rehab Equipment Company, formerly known as Patients First Medical Equipment Company, has agreed to pay the United States and the District of Columbia a total of $300,000 to settle allegations that it violated the False Claims Act by overcharging the District of Columbia Medicaid Program for custom power wheelchairs provided to residents of nursing facilities.May 4, 2015; U.S. Attorney; Southern District of CaliforniaFive Southern California Ambulance Companies to Pay More Than $11.5 Million to Resolve Kickback Allegations
SAN DIEGO - In a lawsuit unsealed in federal court today, five ambulance companies have entered into civil settlements with the Department of Justice requiring them to collectively pay more than $11.5 million in payments to the United States to resolve kickback allegations.May 4, 2015; U.S. Attorney; District of NevadaEndoscopy Center Ceo Sentenced For Billing Fraud Scheme
LAS VEGAS, Nev. - Tonya Rushing, former CEO of the now-defunct Endoscopy Center of Southern Nevada, was sentenced today by Senior U.S. District Judge Larry R. Hicks to one year and one day in prison for conspiring with Dipak Desai, the former owner of the center, to commit health care fraud, announced U.S. Attorney Daniel G. Bogden for the District of Nevada.May 1, 2015; U.S. Attorney; Southern District of New YorkManhattan U.S. Attorney Announces $60 Million Civil Fraud Settlement With Accredo Health Group Over Kickback Scheme Involving Prescription Drug
Preet Bharara, the United States Attorney for the Southern District of New York, Diego Rodriguez, the Assistant Director-in-Charge of the New York Office of the Federal Bureau of Investigation ("FBI"), and Scott J. Lampert, Special Agent in Charge of the U.S. Department of Health and Human Services, Office of Inspector General's New York Regional Office ("HHS-OIG") announced yesterday a $60 million settlement of a civil fraud lawsuit against ACCREDO HEALTH GROUP ("ACCREDO") concerning a kickback scheme with NOVARTIS PHARMACEUTICALS CORP. ("NOVARTIS") involving the prescription drug Exjade. In addition to filing a Notice of Intervention against and Stipulation and Order of Settlement and Dismissal with ACCREDO, the Government has elected to intervene against NOVARTIS over the same conduct previously filed by a whistleblower. As alleged in the lawsuit, NOVARTIS provided kickbacks, in the form of patient referrals and related benefits, to ACCREDO in exchange for ACCREDO's recommending refills to Exjade patients. In connection with the scheme, the defendants understated the serious and potentially life-threatening side effects of Exjade when promoting the drug's benefits to patients.
April 2015

April 30, 2015; U.S. Department of JusticeMiami-Area Physician Sentenced to 60 Months in Prison for Role in $5.5 Million Medicare Fraud Scheme
A Miami-area medical doctor was sentenced today to 60 months in prison for his role in a $5.5 million Medicare fraud scheme involving fraudulent billings by a psychiatric hospital in Hollywood, Florida.April 30, 2015; U.S. Attorney; Central District of CaliforniaHawthorne Woman Sentenced to 6½ Years in Federal Prison for Running Wheelchair Scam that Cost Medicare Nearly $3.5 Million
LOS ANGELES - A Hawthorne woman who ran a company that submitted more than $7 million in fraudulent claims to Medicare - primarily for power wheelchairs that were not needed by patients - and caused the government health insurance program to lose nearly $3.5 million has been sentenced to 78 months in federal prison.April 30, 2015; U.S. Attorney; District of MassachusettsMaine Nursing Home Operator to Pay $300,000 to Resolve Allegations Concerning Claims for Rehabilitation Therapy
BOSTON - A skilled nursing facility operator in Maine, Rousseau Management, Inc., entered into an agreement with the United States to pay $300,000 to resolve allegations concerning inflated Medicare claims.April 29, 2015; U.S. Attorney; Middle District of GeorgiaHospital Authority Of Irwin County Resolves False Claims Act Investigation For $520,000
Michael J. Moore, United States Attorney for the Middle District of Georgia, and Samuel S. Olens, Attorney General for the State of Georgia, announced today they have reached a civil settlement with the Hospital Authority of Irwin County (ICH), Dr. Mahendra Amin, Dr. Ashfaq Saiyed, Dr. Romana Bairan, Dr. Arturo Ruanto, Dr. Concordio Ursal, Dr. Drew Howard, Dr. Steve Anderson, Dr. Robert Reese, and Dr. Marshall Tanner. The Defendants agreed to pay $520,000 to resolve allegations that they caused false claims to be submitted to Medicare and Medicaid.April 29, 2015; U.S. Attorney; District of New JerseyNew Jersey Doctor Sentenced To One Year And One Day In Prison For Taking Bribes In Test-Referral Scheme With New Jersey Clinical Lab
NEWARK, N.J. - A doctor with practices in Wall Township and Howell Township, New Jersey, was sentenced today to one year and one day in prison for accepting bribes in exchange for test referrals as part of a long-running scheme operated by Biodiagnostic Laboratory Services LLC (BLS), of Parsippany, New Jersey, its president and numerous associates, U.S. Attorney Paul J. Fishman announced.April 27, 2015; U.S. Department of JusticeGeorgia Hospital to Pay $20 Million to Resolve False Claims Act Allegations
The Medical Center of Central Georgia (MCCG) has agreed to pay $20 million to settle allegations that the hospital violated the False Claims Act by billing Medicare for more expensive inpatient services that should have been billed as less costly outpatient or observation services, the Justice Department announced today. MCCG is located in Macon, Georgia, and is the second largest hospital in the state.April 27, 2015; U.S. Attorney; Northern District of AlabamaFormer Community Health Clinic CFO Pleads Guilty in Scheme to Defraud Millions from Government
BIRMINGHAM -- The former financial officer of two non-profit health clinics in Alabama for the poor and homeless pleaded guilty today to multiple federal charges related to a scheme to defraud millions of dollars from the clinics and the federal government health agencies that provide most of their funding.April 24, 2015; U.S. Attorney; District of MassachusettsFormer Clinical Care Technician Charged with Stealing Pain Medication from Patients in Intensive Care
BOSTON - A former clinical care technician at Tufts New England Medical Center was charged yesterday with stealing pain medication from patients in intensive care.April 23, 2015; U.S. Department
of Justice Louisiana Doctor Pleads Guilty to Health Care Fraud Charges for Writing False Home Health Certifications in $56 Million Fraud Scheme
A Louisiana doctor pleaded guilty to federal health care fraud charges today, admitting that he wrote false home health care certifications that were used in a multi-million dollar Medicare fraud scheme.April 21, 2015; U.S. Department of JusticeTexas-Based Citizens Medical Center Agrees to Pay United States $21.75 Million to Settle Alleged False Claims Act Violations
Citizens Medical Center, a county-owned hospital in Victoria, Texas, has agreed to pay the United States $21,750,000 to settle allegations that it violated the False Claims Act by engaging in improper financial relationships with referring physicians, the Justice Department announced today.April 21, 2015; U.S. Department of JusticeFamily Dermatology PcCAgrees to Pay United States More Than $3.2 Million to Settle Alleged False Claims Act Violations
Family Dermatology P.C. which owns and operates a dermatopathology laboratory in Georgia and a number of dermatology practices throughout the Eastern United States, has agreed to pay the United States $3,247,835 plus interest to settle allegations that it violated the False Claims Act by engaging in improper financial relationships with a number of its employed physicians, the Justice Department announced today.April 21, 2015; U.S. Department of JusticeTexas-Based Citizens Medical Center Agrees to Pay United States $21.75 Million to Settle Alleged False Claims Act Violations
Citizens Medical Center, a county-owned hospital in Victoria, Texas, has agreed to pay the United States $21,750,000 to settle allegations that it violated the False Claims Act by engaging in improper financial relationships with referring physicians, the Justice Department announced today.April 21, 2015; U.S. Department of JusticeGovernment Sues Skilled Nursing Chain HCR Manorcare for Allegedly Providing Medically Unnecessary Therapy
The government has intervened in three False Claims Act lawsuits and filed a consolidated complaint against HCR ManorCare alleging that ManorCare knowingly and routinely submitted false claims to Medicare and Tricare for rehabilitation therapy services that were not medically reasonable and necessary, the Department of Justice announced today. ManorCare is one of the nation's largest healthcare providers, operating approximately 281 skilled nursing facilities (SNFs) in 30 states.April 21, 2015; U.S. Attorney; Eastern District of Michigan Operator of Detroit Adult Day Care Center and Two Home Health Care Company Owners Sentenced in $29 Million Medicare Fraud Conspiracy
WASHINGTON - The former operator of a Detroit adult day care center and two former owners of Detroit-area home health care companies were sentenced to prison today for their roles in a $29 million Medicare fraud scheme.April 17, 2015; U.S. Attorney; Southern District of GeorgiaPooler Couple Sentenced To Federal Prison For Health Care Fraud Scheme
Savannah, GA - Sheryl Evans, 55, of Pooler, Georgia, was sentenced earlier this week to 13 months in prison by United States District Court Judge William T. Moore, Jr. after pleading guilty to her role in a scheme to defraud the South Carolina Medicaid and federal Medicare programs. Sheryl Evans's husband and partner-in-crime, Robert Evans, 53, also of Pooler, was sentenced to 6 months in prison. Additionally, the couple was ordered to repay over $189,000 of fraudulently obtained proceeds.April 17, 2015; U.S. Attorney; Northern District of IllinoisLeader of a $23 Million Medicare Fraud Conspiracy Sentenced to 10 Years in Prison
CHICAGO-A Chicago man was sentenced today to a 120 month term of imprisonment for taking control of two Chicago-area home health companies and using them to bilk Medicare out of more than $20 million. JACINTO "JOHN" GABRIEL, JR., 48, has been in custody since February 2014, when he entered a guilty plea to charges of conspiracy to commit health care fraud and tax evasion.April 17, 2015; U.S. Attorney; Eastern District of MissouriLocal Podiatrist Sentenced on Health Care Fraud Charges
St. Louis, MO - LAWRENCE B. IKEN, DPM, was sentenced to 12 months and one day in prison and ordered to pay restitution of $999,170 on charges involving the submission of false documents and reimbursement claims related to podiatric services purportedly provided by Dr. Iken from 2006 through July 2014. His company, Iken LLC, was sentenced to two years of probation on the same charges. As part of his plea in January, Dr. Iken agreed to a money judgment of $999,170, which represents the amount of reimbursement that he and his company received for the false health care claims.April 16, 2015; U.S. Department of Justice Owner of Miami Home Health Company Sentenced to 113 Months in Prison for $32 Million Medicare Fraud Scheme
An owner of a Miami home health care company was sentenced today to 113 months in prison in connection with a $32 million Medicare fraud scheme.April 16, 2015; U.S. Department of Justice Valencia, California, Doctor Indicted in $6.5 Million Medicare Fraud Scheme
An indictment was unsealed today charging a doctor from Valencia, California, with operating a $6.5 million scheme to defraud the Medicare program by billing Medicare for medical services that were not actually provided.April 15, 2015; U.S. Department of Justice Michigan Home Health Agency Owner Pleads Guilty in Connection with $2.6 Million Home Health Care Scheme
The owner of a greater Detroit-area home health care agency pleaded guilty today to fraud and money laundering charges in connection with her role in a $2.6 million home health care scheme.April 15, 2015; U.S. Attorney; District of ConnecticutDentist Involved in Medicaid Fraud Scheme Pleads Guilty
Deirdre M. Daly, United States Attorney for the District of Connecticut, announced that MEHRAN ZAMANI, DDS, 50, of Pound Ridge, N.Y., pleaded guilty today in Hartford federal court to a federal health care fraud offense stemming from a multimillion Medicaid fraud scheme.April 15, 2015; U.S. Attorney; Eastern District of MissouriFarmington, Missouri, Pharmacist Pleads Guilty to Three Medicaid Fraud Charges
St. Louis, MO - PATRICIA A. HOEHN, Farmington, Missouri, pled guilty today to three felony counts involving false statements to the Missouri Medicaid program.April 15, 2015; U.S. Attorney; Western District of Pennsylvania$1.3M Settlement with Asbury Health Center Resolves False Claims Act Allegations
PITTSBURGH - Asbury Health Center, a continuing-care retirement community located in Pittsburgh, has agreed to pay the United States $1,331,837.96 to settle False Claims Act allegations, United States Attorney David J. Hickton announced today.April 14, 2015; U.S. Department of JusticeSouth Florida Doctor Indicted for Medicare Fraud
A South Florida Doctor was charged in a seventy-six count indictment for participating in a Medicare fraud scheme, announced U.S. Attorney Wifredo A. Ferrer of the Southern District of Florida, Special Agent in Charge George L. Piro of the FBI's Miami Field Office, Special Agent in Charge Shimon Richmond of the U.S. Department of Health and Human Services Office of the Inspector General's Miami Region (HHS-OIG), Special Agent in Charge Michael D. Angelucci of the U.S. Railroad Retirement Board's Office of Inspector General (RRB) and Special Agent in Charge John Khin of the Defense Criminal Investigative Service (DCIS).April 14, 2015; U.S. Attorney; Eastern District of TexasTexas Doctor Sentenced to Prison for Health Care Fraud Scheme
TYLER, Texas - A 63-year-old Dallas County, Texas, physician, has been sentenced to federal prison for health care fraud and identity theft violations in the Eastern District of Texas, announced U.S. Attorney John M. Bales.April 13, 2015; U.S. Attorney; Southern District of FloridaMiami Office Manager Convicted for Her Participation in Medicare Fraud Scheme
A former office manager of a Miami based physical and occupational therapy clinic was convicted, following a four day trial, for her participation in a scheme that involved the fraudulent submission of more than $3.3 million dollars in false billing to Medicare.April 9, 2015; U.S. Department of JusticeTwo Cardiovascular Disease Testing Laboratories to Pay $48.5 Million to Settle Claims of Paying Kickbacks and Conducting Unnecessary Testing
Cardiovascular testing disease laboratories Health Diagnostics Laboratory Inc. (HDL), of Richmond, Virginia, and Singulex Inc., of Alameda, California, have agreed to resolve allegations that they violated the False Claims Act by paying remuneration to physicians in exchange for patient referrals and billing federal health care programs for medically unnecessary testing, the Department of Justice announced today. Under the settlements, which stem from three related whistleblower actions filed under the federal False Claims Act, HDL will pay $47 million and Singulex will pay $1.5 million. The government also intervened in the lawsuits as to similar allegations against another laboratory, Berkeley HeartLab Inc.; a marketing company, BlueWave Healthcare Consultants Inc., and its owners, Floyd Calhoun Dent and J. Bradley Johnson; and former CEO Latonya Mallory of HDL.April 7, 2015; U.S. Attorney; District of UtahCache Valley Cancer Treatment And Research Clinic Pleads Guilty To Misdemeanor Information Involving Receipt And Delivery Of Misbranded Drugs
SALT LAKE CITY - Cache Valley Cancer Treatment and Research Clinic, a cancer treatment clinic located in Logan, pled guilty in U.S. District Court Tuesday afternoon to receipt of misbranded drugs and delivery for sale. The Misdemeanor Information charging the clinic was filed March 31, 2015. The clinic is owned and operated by Dr. Ali Ben-Jacob, a resident of Utah and an oncologist.April 6, 2015; U.S. Attorney; Southern District of CaliforniaMastermind of $1 Million Medicare Fraud Sentenced to 30 Months
SAN DIEGO-Gevorg "George" Kupelian was sentenced today to 30 months in custody for his role in a fraud scheme that involved billing Medicare for medical tests on unsuspecting seniors that were either medically unnecessary or were never performed.April 2, 2015; U.S. Attorney; Eastern District of TennesseeCleveland Doctor Sentenced For Defrauding Medicare
CHATTANOOGA, Tenn. - On Apr. 2, 2015, Dr. Raymond Sean Brown, 44, of McDonald, Tenn., was sentenced serve 28 months in prison by the Honorable Curtis L. Collier. In November 2014, Brown pleaded guilty to an information charging him with the use of misbranded drugs with the intent to defraud.April 2, 2015; U.S. Attorney; District of New JerseyNew York Doctor Admits Taking Bribes In Test-Referral Scheme With New Jersey Clinical Lab
NEWARK, N.J. - A doctor with a practice in Rockville Centre, New York, today admitted accepting bribes in exchange for test referrals as part of a long-running and elaborate scheme operated by Biodiagnostic Laboratory Services LLC (BLS), of Parsippany, New Jersey, its president and numerous associates, U.S. Attorney Paul J. Fishman announced.April 2, 2015; U.S. Attorney; District of New JerseyNew Jersey Doctor Sentenced To Over Three Years In Prison For Taking Bribes In Test-Referrals Scheme Involving New Jersey Clinical Lab
NEWARK, N.J. - A doctor with an office in North Arlington, New Jersey, was sentenced today to 37 months in prison for accepting bribes in exchange for test referrals as part of a long-running scheme operated by Biodiagnostic Laboratory Services LLC (BLS), of Parsippany, New Jersey, its president, and numerous associates, U.S. Attorney Paul J. Fishman announced.April 1, 2015; U.S. Attorney; Eastern District of PennsylvaniaDelaware County Nightclub Owners Plead Guilty To Tax And Fraud Charges
PHILADELPHIA - Romeo Callueng, 45, and Susan Callueng, 43, of Woodlyn, PA, pleaded guilty on March 26, 2015 to tax evasion and fraud in connection to a health care benefit program. The Calluengs, who owned the "Club 27" nightclub at 27 Bank Street in Philadelphia, were receiving assistance from Medicaid and LIHEAP (Low Income Heating and Energy Assistance Program) despite making substantially more than the maximum income eligibility. Each defendant pleaded guilty to one count of fraud and four counts of tax evasion for evading income taxes in 2006, 2007, 2008, and 2009.
March 2015

March 31, 2015; U.S. Department of JusticeOhio-Based Health System Pays United States $10 Million to Settle False Claims Act Allegations
Robinson Health System Inc. has agreed to pay $10 million to settle claims that it violated the False Claims Act, the Anti-Kickback Statute and the Stark Statute by engaging in improper financial relationships with referring physicians, the Justice Department announced today. Robinson is a nonprofit corporation based in Ohio that operates a number of health care facilities in Portage County, Ohio, including Robinson Memorial Hospital.March 31, 2015; U.S. Attorney; Eastern District of PennsylvaniaAmbulance Company Co-Owner Sentenced To Six Years For Fraud
PHILADELPHIA - Nazariy Kmet, 37, of Jamison, PA, a co-owner and the President of Life Support Corporation (Life Support), was sentenced today to 72 months in prison, for an extensive health care fraud scheme. The defendant pleaded guilty to health care fraud conspiracy and paying kickbacks. The company, Life Support, which is now defunct, had been located in the Feasterville-Trevose area and had been incorporated in 2010.March 31, 2015; U.S. Attorney; District of New JerseyTwo New Jersey Doctors Sentenced To Prison For Taking Bribes In Test-Referrals Scheme With New Jersey Clinical Lab
NEWARK, N.J. - Two New Jersey doctors were each sentenced today to prison for accepting bribes in exchange for test referrals as part of a long-running scheme operated by Biodiagnostic Laboratory Services LLC (BLS), of Parsippany, New Jersey, its president and numerous associates, U.S. Attorney Paul J. Fishman announced.March 31, 2015; U.S. Attorney; District of Puerto Rico<acronym title="Google Page Ranking">PR</acronym> Department Of Health Employee And Another Individual Indicted For Theft Of Government Records And Aggravated Identity Theft
SAN JUAN, P.R. - Yesterday, a Federal grand jury returned an eight-count indictment charging two individuals for conspiracy, theft of government records, unlawful transfer of means of identification, aggravated identity theft, and wrongful disclosure of individually identifiable health information, announced Rosa Emilia Rodríguez-Vélez, United States Attorney for the District of Puerto Rico. The Internal Revenue Service (IRS) Criminal Investigation Division and Health and Human Services, Office of Inspector General are in charge of the investigation. The Puerto Rico Department of Health Medicaid Office, Fraud Unit provided significant assistance during the investigation.March 30, 2015; District of MassachusettsMaine Nursing Home to Pay $1.2 Million to Resolve Allegations Concerning Rehabilitation Therapy
BOSTON - A Maine skilled nursing facility, Ross Manor, entered into an agreement with the United States to pay $1.2 million to resolve allegations concerning inflated Medicare claims for rehabilitation therapy.March 30, 2015; Western District of MissouriFormer Joplin Oncologist Pleads Guilty to Dispensing Foreign, Misbranded Drugs
SPRINGFIELD, Mo. - Tammy Dickinson, United States Attorney for the Western District of Missouri, announced that an oncologist who operated a clinic in Joplin, Mo., pleaded guilty in federal court today to dispensing foreign, misbranded drugs to his cancer patients.March 25, 2015; U.S. Attorney; Middle District of Florida Federal Jury Finds Husband And Wife Guilty Of Operating A Clinic To Defraud Medicare
Tampa, FL - United States Attorney A. Lee Bentley, III announces that a federal jury has found Miami residents Gladys Fuertes (40) and her husband, Mario Fuertes (3, guilty of conspiracy to commit health care fraud, health care fraud, and obstructing a health care investigation. They are facing a maximum penalty of 10 years in federal prison on the conspiracy count and on each of the 10 health care fraud counts, and up to five years in federal prison on each of the two obstruction counts. Gladys Fuertes was also convicted of four counts of aggravated identity theft and faces a mandatory sentence of two years in prison for those charges. The sentencing hearing has been scheduled for June 23, 2015. Both individuals were indicted on March 13, 2014, and arrested in Miami on March 26, 2014.March 24, 2015; U.S. Attorney; District of New JerseyDoctor Sentenced to Nine Months in Prison for Taking Cash Kickbacks on Patient Referrals, failing to report nearly $1 million in income
NEWARK, N.J. - A doctor practicing family medicine in East Orange, New Jersey, was sentenced today to nine months in prison for receiving cash kickbacks for diagnostic testing referrals and failing to file tax returns on almost $1 million in income over a three-year period, U.S. Attorney Paul J. Fishman announced.March 23, 2015; U.S. Attorney; Western District of MichiganPortage Hospital Pays $4.44 Million To Resolve Voluntary Disclosure Regarding False Medicare Claims For Home Health Care Services
GRAND RAPIDS, MICHIGAN - Portage Hospital, LLC, in Hancock, Michigan, has agreed to pay the United States $4,446,392.43 to settle allegations that a hospital-owned home health care agency, Portage Health Home Care & Hospice, violated the False Claims Act by submitting false claims to Medicare for home health care services purportedly rendered by a staff physical therapist.March 23, 2015; U.S. Department of JusticeMichigan Physician Pleads Guilty for Role in $3.6 Million Medicare Fraud Scheme
A Detroit-area medical doctor who referred Medicare beneficiaries for home health services in exchange for illegal cash kickbacks as part of a $3.6 million home health care fraud scheme pleaded guilty today for his role in the scheme.March 20, 2015; U.S. Department of Justice Owner of Los Angeles Medical Supply Company Convicted in $3.3 Million Medicare Fraud Scheme
A federal jury in Los Angeles found the owner of a medical supply company guilty of four counts of health care fraud today in connection with a $3.3 million Medicare fraud scheme.March 20, 2015; U.S. Department of Justice Owner of Medical Equipment Supply Company Convicted for $3.5 Million Medicare and Medi-Cal Fraud Scheme
A jury in federal court in Los Angeles convicted the former owner of a durable medical equipment supply company of health care fraud charges in connection with a $3.5 million Medicare and Medi-Cal fraud scheme.March 19, 2015; U.S. Department of JusticeCardiac Monitoring Company to Pay $6.4 Million for Alleged Overbilling of Government Health Care Programs
BioTelemetry Inc., a heart monitoring company headquartered in Malvern, Pennsylvania, has agreed to pay $6.4 million to resolve allegations made under the False Claims Act (FCA) that its subsidiary, CardioNet, overbilled Medicare and other federal health programs for Mobile Cardiac Outpatient Telemetry (MCOT) services when those services were not reasonable or medically necessary, the Justice Department announced today.March 19, 2015; U.S. Department of JusticeAdventist Health System to Pay $5.4 Million to Resolve False Claims Act Allegations
Adventist Health System Sunbelt Healthcare Corporation (Adventist) has agreed to pay $5,412,502 to resolve claims that it violated the False Claims Act by providing radiation oncology services to Medicare and TRICARE beneficiaries that were not directly supervised by radiation oncologists or similarly qualified persons, the Department of Justice announced today. Adventist is a non-profit healthcare organization operating a large network of hospitals in the South and the Midwest, and doing business in Florida as Florida Hospital.March 19, 2015; U.S. Attorney; Northern District of IllinoisOwner and Executives Convicted in Medicare Referral Kickback Conspiracy at Closed Sacred Heart Hospital
CHICAGO - The former owner and chief executive officer, the chief operating officer, and the chief financial officer of the now-closed Sacred Heart Hospital were convicted by a jury after a nearly two-month trial of collectively paying hundreds of thousands of dollars in illegal kickbacks in exchange for the referral of hospital patients who were insured by Medicare and Medicaid. The jury found that EDWARD J. NOVAK, 60, of Park Ridge, Sacred Heart's owner and chief executive officer, ROY M. PAYAWAL, 66, of Burr Ridge, executive vice president and chief financial officer, and CLARENCE NAGELVOORT, 59, of Chicago, paid physicians concealed bribes and kickbacks to induce patient referrals and to increase the patient census, which, in turn, increased hospital revenue.March 19, 2015; U.S. Attorney; Eastern District of New YorkNew York Pharmacist Charged With Defrauding Medicare And Medicaid Of More Than $5 Million Through Fraudulent Billing Of Prescription Medications
A twenty-four-count indictment was unsealed this morning in federal court in Brooklyn, New York, charging Andrew Barrett, a licensed pharmacist, with health care fraud, filing false claims, unlawful monetary transactions, filing false personal tax returns, and the filing of and assisting in the preparation of false corporate tax returns.1 Barrett will be arraigned at 2:00 pm today before U.S. Magistrate Judge Steven M. Gold at the U. S. Courthouse, 225 Cadman Plaza East, Brooklyn, New York.March 18, 2015; U.S. Department of JusticeOwner of Medical Clinic and Accountant Plead Guilty for Roles in $50 Million Medicare Fraud Scheme
The owner and operator of a New Orleans-based medical clinic and an accountant pleaded guilty today in federal court in New Orleans for their roles in a $50 million Medicare fraud scheme.March 17, 2015; U.S. Attorney; Middle District of FloridaUnited States Settles False Claims Act Allegations Against Jacksonville-Based Dermatology Practice For $787,814
Jacksonville, Florida - U.S. Attorney A. Lee Bentley, III announces that the United States has settled allegations that a Jacksonville-based dermatology practice knowingly billed the government for services that were cosmetic in nature and not medically necessary, as well as "up-coded" certain bills to receive higher than allowed reimbursement. The allegations resolved included liability under the False Claims Act (FCA).March 16, 2015; U.S. Attorney; District of South CarolinaHHS OIG Top 10 Most Wanted Sentenced to 57 Months Prison
Columbia, South Carolina---- United States Attorney Bill Nettles stated that Karo Gotti Blkhoyan, a/k/a "Gotti," age 34, of Glendale, California was sentenced last week in federal court in Columbia, South Carolina, for Conspiracy to Commit Money Laundering , a violation of 18 U.S.C. § 1956(h). Senior United States District Judge Cameron McGowan Currie of Columbia sentenced Blkhoyan to 57 months and three years supervised release. Blkhoyan was fugitive for approximately two years, when was arrested at the San Francisco International Airport attempting to re-enter the country.March 16, 2015; U.S. Department of Justice Los Angeles-Area Pharmacist Pleads Guilty to Medicare Part D Fraud Scheme
A pharmacist who owned and operated a pharmacy in Los Angeles pleaded guilty today in connection with a Medicare fraud scheme, announced Assistant Attorney General Leslie R. Caldwell of the Justice Department's Criminal Division, Acting U.S. Attorney Stephanie Yonekura of the Central District of California and Assistant Director in Charge David Bowdich of the FBI's Los Angeles Field Office.March 13, 2015; U.S. Department of JusticeOwner of Detroit Home Health Care Companies Pleads Guilty to $12.6 Million Fraud Scheme
The owner of two home health care companies pleaded guilty to Medicare fraud and tax fraud charges in connection with his role in a scheme to fraudulently bill Medicare for $12.6 million in home health services that were not provided or were obtained through illegal kickbacks. Ten other individuals have been convicted at trial or pleaded guilty in this case.March 13, 2015; U.S. Attorney; Eastern District of PennsylvaniaNew Jersey Doctor Charged With Running Pill Mill And Attempting To Burn It Down
PHILADELPHIA - Dr. Mudassar Sharif, 40, of Bernards Township, NJ, was charged yesterday by indictment with illegally dispensing prescription pills through Garden State Primary Care, which he owned, in Kearny, NJ, announced United States Attorney Zane David Memeger. Sharif is also charged with trying to set fire to the building that houses the medical practice.March 12, 2015; U.S. Attorney; Eastern District of LouisianaTwenty Individuals and One Corporation Indicted in Conspiracy to Commit $30 Million in Health Care Fraud
NEW ORLEANS-U.S. Attorney Kenneth A. Polite announced that a 26-count indictment was returned against twenty individuals and one corporation, charging approximately $30,052,295 in Medicare fraud.March 12, 2015; U.S. Department of JusticeHouston-Area Owner of Medical Equipment Companies Convicted in a $3.4 Million Medicare Fraud Scheme
A federal jury in Houston yesterday convicted the owner of two Texas medical equipment companies for his role in a $3.4 million Medicare fraud scheme.March 12, 2015; U.S. Attorney; Southern District of IllinoisWoman Admits Billing Home Services Program While In Jail
Stephen R. Wigginton, United States Attorney for the Southern District of Illinois, announced today that on March 12, 2015, Angela Jones, 51, of Madison, IL, pled guilty to a one-count indictment charging that she engaged in a scheme to commit health care fraud. At her sentencing Jones will face up to 10 years of imprisonment, a fine of up to $250,000 and up to 3 years of supervised release. Sentencing has been set for July 10, 2015, at 2:30 pm in United States District Court in East St. Louis, Illinois.March 11, 2015; U.S. Attorney; Middle District of LouisianaLicensed Clinical Social Worker Sentenced To Prison For Health Care Fraud
BATON ROUGE, LA -United States Attorney Walt Green announced that CARLA CLARK, age 50, of Pineville, Louisiana, was sentenced yesterday by Chief U.S. District Judge Brian A. Jackson to 21 months imprisonment, 2 years of supervised release following imprisonment, and ordered to pay $413,109 in restitution for her role in a health care fraud scheme involving two Louisiana companies.March 10, 2015; U.S. Attorney; Northern District of Illinois Nurse Charged With Health-Care Fraud Scheme For Billing Medicare for Unnecessary Services
CHICAGO - A registered nurse was arrested today on a federal health care fraud charges. The nurse defendant, JAMES ADEMIJU, who operates two nursing agencies, Adonis Inc. and BestMed-Care Services Ltd., was arrested this morning and charged with health care fraud in a criminal complaint. The complaint alleges a scheme to defraud Medicare by billing for unnecessary nursing services that were provided to patients who were not confined to the home and who were obtained via illegal payments for patient referrals. For over three years, beginning in 2011, a total of approximately $5 million was paid to the two agencies by Medicare for services rendered to patients deemed to be homebound.March 10, 2015; U.S. Attorney; Eastern District of PennsylvaniaMedicare Beneficiary Pleads Guilty To Receiving Kickbacks In Health Care Matters
PHILADELPHIA - Craig Brown, 46, of Philadelphia, PA, pleaded guilty today to receiving kickbacks and making false statements in a health care matter, announced United States Attorney Zane David Memeger. The defendant faces a maximum possible sentence of 25 years in prison, three years of supervised release, a $1.25 million fine, a $500 special assessment, and an order of restitution. U.S. District Court Judge William H. Yohn, Jr. scheduled a sentencing hearing for June 10, 2015.March 9, 2015; U.S. Department of JusticeFlorida Home Health Care Company Agrees to Pay $1.1 Million to Resolve False Claims Act Allegations
Recovery Home Care Inc., Recovery Home Care Services Inc. (collectively Recovery Home Care) and National Home Care Holdings LLC have agreed to pay $1.1 million to resolve allegations that the Recovery Home Care entities violated the False Claims Act by improperly paying doctors for referrals of home health care services provided to Medicare patients, the Department of Justice announced today. The Recovery Home Care entities provide home health care services to Medicare beneficiaries and were purchased by National Home Care Holdings LLC in 2012, after the conduct addressed by the settlement occurred.March 6, 2015; U.S. Department of Justice New York Doctor Pleads Guilty in $14.2 Million Medicare Fraud Scheme
A New York doctor pleaded guilty today for his involvement in a scheme to fraudulently bill Medicare for $14.2 million in claims for medically unnecessary treatments.March 4, 2015; U.S. Attorney; District of MaineRockport Dentist Settles Federal Health Care Fraud Complaint
Portland, Maine: United States Attorney Thomas E. Delahanty II announced that Dr. Daniel P. Schecter, a dentist who provided services in Rockport, Maine, has paid $484,744.80 to settle claims involving improper billing to MaineCare (Maine's Medicaid program).March 2, 2015; U.S. Department of JusticeUnited States Settles False Claims Act Allegations Against Patient Safety Consultant and His Companies
Dr. Charles Denham, of Laguna Beach, California, has agreed to pay the United States $1 million to settle allegations that he violated the False Claims Act by soliciting and accepting kickbacks, the Justice Department announced today. Denham is a patient safety consultant who operates the consulting company Health Care Concepts Inc. and the research organization Texas Medical Institute of Technology, both of which are also parties to the settlement. In 2009 and 2010, Denham was co-chair of the Safe Practices Committee of the National Quality Forum.March 2, 2015; U.S. Attorney; District of MassachusettsNew York Catholic Nursing Chain to Pay $3.5 Million to Resolve Allegations Concerning Claims for Rehabilitation Therapy
BOSTON - A New York operator of skilled nursing facilities entered into an agreement with the United States to pay $3.5 million to resolve allegations concerning inflated Medicare claims for rehabilitation therapy.February 27, 2015; U.S. Department of Justice Two Miami Residents Sentenced to 72 Months in Prison for Their Roles in $63 Million Medicare Fraud Scheme
Two Miami residents were sentenced to serve 72 months in prison for their roles in a $62 million Medicare fraud scheme involving intensive mental health treatment programs.February 27, 2015; U.S. Department of Justice Michigan Psychotherapy Clinic Owner Sentenced to 87 Months in Prison for his Role in $3.3 Million Medicare Fraud Scheme
A former Michigan resident who directed a $3.3 million psychotherapy fraud scheme, was sentenced today to 87 months in prison, announced Assistant Attorney General Leslie R. Caldwell of the Justice Department's Criminal Division, U.S. Attorney Barbara L. McQuade of the Eastern District of Michigan, Special Agent in Charge Paul M. Abbate of the FBI Detroit Field Office and Special Agent in Charge Lamont Pugh III of the Department of Health and Human Services Office of Inspector General's (HHS-OIG) Detroit Office.February 27, 2015; U.S. Attorney; Eastern District of ArkansasBaptist Health Medical Center North Little Rock Enters Into Settlement Agreement Under False Claims Act
LITTLE ROCK - Christopher R. Thyer, United States Attorney for the Eastern District of Arkansas, announced that, the government, acting through the United States Department of Justice and on behalf of the Office of Inspector General (OIG) of the Department of Health and Human Services (HHS) (collectively the "United States"), and Baptist Health Medical Center North Little Rock (BHMC-NLR) entered into a settlement agreement under the False Claims Act. BHMC-NLR agreed to pay $2,700,000 to resolve its liability.February 27, 2015; U.S. Attorney; District of MassachusettsNursing Agency Operator to be Incarcerated for 92 Months and Forfeits Home
BOSTON - The owner of a home nursing agency was sentenced yesterday to 92 months in prison for fraudulently billing millions of dollars of services to Medicare and then laundering the proceeds.February 27, 2015; U.S. Attorney; District of MarylandAnnapolis Woman Sentenced To 3 Years In Prison For Treating Patients While Fraudulently Posing As A Physician's Assistant
Baltimore, Maryland - U.S. District Judge Richard D. Bennett sentenced Shawna Michelle Gunter, age 37, of Annapolis, Maryland, late yesterday to three years in prison followed by three years of supervised release, which includes six months of home detention with electronic monitoring, for wire fraud and aggravated identity theft in connection with a scheme to pose as a physician's assistant to obtain employment, diagnose and treat 137 infants and children, and write over 400 prescriptions, all without a medical license. Judge Bennett also entered an order that Gunter pay restitution of $53,530.39.
February 2015

February 26, 2015; U.S. Attorney; Southern District of FloridaThree Individuals Arrested for More Than $2.4 million in Medicare and Medicaid Fraud
Three individuals have been arrested - one of whom was arrested in Colombia - for more than $2.4 million in Medicare and Medicaid fraud. The defendants in this case allegedly defrauded Medicaid and Medicare by paying and receiving kickbacks and bribes in return for creating and providing false and fraudulent home health prescriptions and plans of care to patient recruiters and causing the submission of false and fraudulent claims.February 26, 2015; U.S. Attorney; Eastern District of PennsylvaniaLife Support Ambulance, Co-Owner, And Manager Sentenced For Health Care Fraud
PHILADELPHIA - Bogdan Kmet, 30, of Warminster, PA, an owner of Life Support Corporation, Rostislav Kmet, 26, of Philadelphia, a company manager, and Life Support, Inc., were sentenced today to 36 months in prison, 46 months in prison, and five years of probation, respectively, for an extensive health care fraud scheme. The defendants pleaded guilty to health care fraud and paying kickbacks. The company was located in the Feasterville-Trevose area and was incorporated in 2010. A second owner, Nazariy Kmet, 35, of Jamison, PA, is scheduled to be sentenced March 31, 2015.February 26, 2015; U.S. Attorney; Western District of PennsylvaniaFormer Hospice COO Charged with Health Care Fraud, Lying to a Federal Grand Jury
PITTSBURGH - A Louisiana woman has been indicted by a federal grand jury in Pittsburgh on charges of health care fraud and making false declarations before a grand jury, United States Attorney David J. Hickton announced today.February 25, 2015; U.S. Attorney; Eastern District of PennsylvaniaMedicare Beneficiary Pleads Guilty In Kickback Scheme Involving Ambulance Transport Services
PHILADELPHIA - William Conner, 61, of Philadelphia, PA, pleaded guilty today to receiving kickbacks and making false statements to law enforcement officials in connection with unnecessary ambulance transportation services. Conner faces a maximum possible sentence of 20 years in prison, three years of supervised release, a $1 million fine, a $400 special assessment, and an order of restitution. U.S. District Court Judge William H. Yohn, Jr. scheduled a sentencing hearing for May 28, 2015.February 25, 2015; U.S. Department of JusticeDetroit Area Patient Recruiter and Physical Therapist Convicted in $1.6 Million Medicare Fraud Scheme
A federal jury in Detroit today convicted a patient recruiter and a physical therapist for their roles in a $1.6 million Medicare fraud scheme, announced Assistant Attorney General Leslie R. Caldwell of the Justice Department's Criminal Division, U.S. Attorney Barbara L. McQuade of the Eastern District of Michigan, Special Agent in Charge Paul M. Abbate of the FBI's Detroit Field Office and Special Agent in Charge Lamont Pugh III of the Department of Health and Human Services Office of Inspector General (HHS-OIG) Chicago Regional Office.February 25, 2015; U.S. Attorney; District of New JerseyPhysician's Assistant Admits Taking More Than $70,000 In Bribes In Test-Referral Scheme With New Jersey Clinical Lab
NEWARK, N.J. - A Staten Island, New York, physician's assistant today admitted accepting bribes in exchange for test referrals as part of a long-running and elaborate scheme operated by Biodiagnostic Laboratory Services LLC (BLS), of Parsippany, New Jersey, its president and numerous associates, U.S. Attorney Paul J. Fishman announced.February 25, 2015; U.S. Attorney; Western District of TennesseeFederal Indictments Returned Against Jackson-Area Residents In Health Care Fraud Scheme Targeting Medicare Card-Holders
Jackson, Tenn. - Calvin Bailey, 64, of Jackson, Tennessee; Sandra Bailey, 64, of Jackson, Tennessee; and Cindy Mallard, 49, of Bradford, Tennessee; have been charged in an indictment alleging a conspiracy to commit health care fraud and to pay illegal kickbacks in connection with health care services, announced United States Attorney for the Western District of Tennessee, Edward L. Stanton III. Sandra Bailey was also indicted for eight counts of health care fraud and nine counts of paying illegal kickbacks to health care providers and patient-referral sources.February 25, 2015; U.S. Attorney; Southern District of West VirginiaTrivillian's Pharmacy, owner plead guilty to federal health care and drug crimes
CHARLESTON, W.Va. - United States Attorney Booth Goodwin announced today that Paula Butterfield, owner and pharmacist-in-charge of Trivillian's Pharmacy, a long-standing Kanawha City retail and compounding pharmacy, pleaded guilty to making a false statement in a healthcare matter. Butterfield also pleaded guilty on behalf of Trivillian's to one count of health care fraud and one count of misbranding drugs.February 24, 2015; U.S. Department of Justice Former Owner of Durable Medical Equipment Company Pleads Guilty in $5 Million Health Care Fraud Scheme
A Miami man pleaded guilty today to health care fraud charges in connection with a $5 million scheme to defraud Medicare.February 24, 2015; U.S. Attorney; Western District of LouisianaUnited States Attorney Announces $650,000 Settlement with Acadiana Cardiology, Acadiana Cardiovascular Center, and Convicted Doctor, Mehmood Patel, for False Claims Allegations
LAFAYETTE, La. - United States Attorney Stephanie A. Finley announced a $650,000 settlement was reached with Acadiana Cardiology LLC, Acadiana Cardiovascular Center and convicted doctor, Mehmood Patel, M.D., concerning allegations that Patel performed unnecessary medical procedures and billed Medicare.February 24, 2015; U.S. Attorney; Eastern District of CaliforniaManteca Oncologist Agrees To Pay $550,000 To Resolve False Claims Act Allegations
SACRAMENTO, Calif - United States Attorney Benjamin B. Wagner announced today that Prabhjit S. Purewal, M.D., a Manteca based oncologist, agreed to pay the United States $550,000 to settle allegations that he defrauded Medicare, Tricare and Medicaid by billing these public insurers for chemotherapy drugs the US Food and Drug Administration had not approved for use in the United States. Dr. Purewal has paid the United States $400,000 to date.February 24, 2015; U.S. Attorney; Eastern District of PennsylvaniaAdditional Charges Filed Against Doctor In Pill Mill Case
William J. O'Brien III, 49 of Philadelphia was charged today by Superseding Indictment with 23 additional counts of illegally distributing oxycodone, methadone, and amphetamines, all Schedule II controlled substances, outside the usual course of professional practice and for no legitimate medical purpose, announced United States Attorney Zane David Memeger. According to the superseding indictment, O'Brien's so-called Apatients@ could for a fee obtain prescriptions for these addictive and dangerous controlled substances without a physical examination or any other medical care or treatment. O'Brien typically charged customers $250 cash for the first appointment to buy prescriptions and $200 for each appointment to obtain refills.February 24, 2015; U.S. Attorney; Northern District of IllinoisSuspended Physician Sentenced To 1.5 Years For Illegally Dispensing Oxycodone And Falsely Billing Medicare In Undercover Probe
CHICAGO - A suburban physician whose medical license was suspended was sentenced today to 18 months in prison for health care fraud and illegally prescribing controlled substance medications. The defendant, SATHISH NARAYANAPPA BABU, who owned Anik Life Sciences Medical Corp., pled guilty in September 2014 to illegally prescribing oxycodone and other controlled substances, and fraudulently billing Medicare approximately $500,000, and fraudulently collecting approximately $216,000, for services he did not provide. Babu, 48, of Bolingbrook, operated Anik Life Sciences, a home-visiting physician's office, in Darien and, previously, in Arlington Heights.February 20, 2015; U.S. Attorney; Western District of MichiganCEO of Kentwood Pharmacy Pleads Guilty
GRAND RAPIDS, MICHIGAN - Kim Duron Mulder, 55, formerly of Grand Rapids, and Charles Wayne Brooks, 63, of Alma, entered guilty pleas today before United States District Judge Robert J. Jonker on charges related to the illegal restocking and re-dispensing of recycled drugs at Kentwood Pharmacy. Mr. Mulder, formerly the CEO of Kentwood Pharmacy, pled guilty to a conspiracy to commit health care fraud based on billing Medicare, Medicaid, and private insurance plans for misbranded and adulterated drugs. Mr. Brooks, a pharmacist at Kentwood Pharmacy's facility in Alma, pled guilty to misbranding prescription drugs that had been previously dispensed and returned to pharmacy stock. Mr. Mulder faces up to ten years' imprisonment; Mr. Brooks faces up to three years' imprisonment.February 23, 2015; U.S. Department of JusticeTwo Florida Couples Agree to Pay $1.13 Million to Resolve Allegations that They Accepted Kickbacks in Exchange for Home Health Care Referrals
Two South Florida medical doctors and their wives have agreed to settle allegations that they violated the False Claims Act when their wives accepted sham marketer salaries in exchange for their husbands' referrals to a home health care company called A Plus Home Health Care Inc., the Justice Department announced today. Under the settlements, Dr. Alan and Lynn Buhler will pay to the United States $1.047 million and Dr. Craig and Cynthia Prokos will pay $90,000. Dr. Buhler practices in Plantation, Florida, and Dr. Prokos practices in Jupiter, Florida.February 23, 2015; U.S. Attorney; Northern District of IllinoisPsychologist And Pschotheraphy Services Owner Sentenced To Over Seven Years, And Employee Sentenced To Over Five Years In $1.5 Million Medicare Fraud
Chicago - Bryce Woods, 37, an employee of Take Action, Inc., and Inner Arts, Inc., which claimed to provide psychotherapy services to Medicare beneficiaries residing in skilled nursing homes in the Chicago area, was sentenced today by U.S. District Court Judge Virginia M. Kendall to 70 months in federal prison for submitting false claims totaling more than $1.5 million to Medicare for psychotherapy services. Codefendant Keenan R. Ferrell, 55, who was the owner and operator of Take Action, Inc., and Inner Arts, Inc., as well as a licensed psychologist in Illinois, was sentenced to 88 months in federal prison back in August 2014.February 23, 2015; U.S. Attorney; District of New JerseyBergen County, New Jersey, Doctor Charged With Fraudulently Billing For Office Visits That Were Never Rendered
NEWARK, N.J. - A family medicine physician with offices in Cresskill and Little Falls, New Jersey, was arrested this morning and charged with fraudulently billing Medicare, Medicaid and private health care insurance companies hundreds of thousands of dollars for physician office visits that were never rendered, U.S. Attorney Paul J. Fishman announced.February 20, 2015; U.S. Attorney; Southern District of IllinoisEast Saint Louis Man Sentenced For Healthcare Fraud
Stephen R. Wigginton, United States Attorney for the Southern District of Illinois, announced today that Maurice L. Burks, 44, of East St. Louis, IL, was sentenced on a one-count indictment charging that Burks engaged in a scheme to commit health care fraud. On February 20, 2015, the district court sentenced Burks to six months of incarceration and ordered him to pay $1,016.82 in restitution as well as a $100 special assessment.February 20, 2015; U.S. Attorney; Eastern District of New YorkMedical Drug Re-Packager And Company's Senior Executives Indicted On Fraud Charges And Criminal Violations Of The Food, Drug And Cosmetic Act
Earlier today, a 37-count indictment was unsealed in Brooklyn federal court charging Med Prep Consulting, Inc. ("Med Prep"), a Tinton Falls, New Jersey, medical drug re-packager and processer, together with its president and owner Gerald Tighe and pharmacist-in- charge Stephen Kalinoski, with wire fraud and violations of the Federal Food, Drug and Cosmetic Act ("FDCA") for introducing adulterated and misbranded drugs into interstate commerce with the intent to defraud and mislead the U.S. Food and Drug Administration ("FDA") and Med Prep's customers, who consisted of hospitals and other healthcare providers.February 19, 2015; U.S. Attorney; Northern District of OklahomaSettlement Reached in Medicare Fraud Lawsuit Against Catoosa Doctor and Owner of Vision and Eye Care Medical Diagnostic and Laster Center, Inc.
TULSA, Okla.- Robert Charles Duke and his Catoosa business, Vision and Eye Care Medical Diagnostic and Laser Center, Inc., have agreed to pay a total of $150,000 to settle allegations of submitting false Medicare and Medicaid claims to the United States and the State of Oklahoma.February 19, 2015; U.S. Attorney; Western District of VirginiaLocal Doctor Pleads Guilty To Child Porn, Prescription Drug Charges
ROANOKE, VIRGINIA - A Roanoke County doctor who was indicted in August on charges of prescribing oxycodone outside the usual course of professional practice and receipt of child pornography, pled guilty today in the United States District Court for the Western District of Virginia in Roanoke.February 18, 2015; U.S. Attorney; Southern District of IllinoisIllinois Woman Sentenced For Healthcare Fraud
Stephen R. Wigginton, United States Attorney for the Southern District of Illinois, announced today that, Lakeshia W. White, 24, of Cahokia, IL, was sentenced on a one-count indictment charging that she engaged in a scheme to commit health care fraud. The district court sentenced White to three years of probation and ordered her to pay $1,957.72 in restitution as well as a $100 special assessment.February 18, 2015; U.S. Attorney; Southern District of New YorkManhattan U.S. Attorney Settles Civil Fraud Claims Against Compassionate Care Hospice For Fraudulently Billing Medicare And Medicaid For Hospice Nursing Services Not Adequately Provided
Preet Bharara, the United States Attorney for the Southern District of New York, and Scott Lampert, Special Agent in Charge of the U.S. Department of Health and Human Services, Office of Inspector General's ("HHS-OIG") New York Region, announced today that the United States has settled civil fraud claims under the False Claims Act against COMPASSIONATE CARE HOSPICE OF NEW YORK, LLC ("CCH-NEW YORK") and COMPASSIONATE CARE HOSPICE GROUP LTD. ("CCH GROUP" and collectively, "CCH") related to CCH's submission of fraudulent claims for reimbursement by Medicare and Medicaid, for hospice nursing services not adequately provided by CCH-NEW YORK.February 17, 2015; U.S. Attorney; Eastern District of TexasFormer Hospital Employee Sentenced for HIPAA Violations
TYLER, TEXAS - A former employee of an East Texas hospital has been sentenced to federal prison for criminal HIPAA violations in the Eastern District of Texas, announced U.S. Attorney John M. Bales.February 17, 2015; U.S. Department of Justice Owner of Miami Home Health Company Pleads Guilty for Lead Role in $13 Million Medicare Fraud Scheme
An owner of a Miami home health care company pleaded guilty today in connection with a $13 million Medicare fraud scheme that involved paying kickbacks and bribes to Medicare beneficiaries, doctors' offices, medical clinics and others in exchange for patient referrals and fraudulent prescriptions to support fraudulent billings to Medicare.February 17, 2015; U.S. Attorney; Southern District of IllinoisArea Men Sentenced For Healthcare Fraud Crimes
Stephen R. Wigginton, United States Attorney for the Southern District of Illinois, announced today, that Quincy O. Gamble, 39, of Cahokia, Illinois, and Lawrence Thigpen, 53, of Collinsville, Illinois, were sentenced on Friday, February 13, 2015, for engaging in a scheme to commit health care fraud by defrauding the Home Services Program, which is a Medicaid Waiver Program designed to allow individuals to stay in their homes instead of entering a nursing home.February 17, 2015; U.S. Attorney; Eastern District of MissouriLocal Physician Convicted of Health Care Fraud Charges
St. Louis, MO - DR. DEVON GOLDING has been convicted of multiple health care fraud related charges for billing for services not rendered and false statements involving a health care benefit plan. The five-day trial was held before United States District Judge John A. Ross. The verdict was returned late Friday evening, February 13, 2015.February 13, 2015; U.S. Attorney; Middle District of Louisiana Healthcare Company Executives Sentenced to Prison for Fraud and Kickbacks
BATON ROUGE, LA - United States Attorney Walt Green announced that IMEH U. EBERE, age 55, of Baton Rouge, Louisiana, and SHEILA R. HIVES, age 51, of Baker, Louisiana, have each been sentenced by Chief U.S. District Judge Brian A. Jackson for health care fraud offenses in connection with their roles at Golden Medical Equipment & Supply, Inc. ("Golden"), a Baton Rouge-based company that provided durable medical equipment in the Baton Rouge area. EBERE was sentenced to serve twenty-two (22) months in prison, followed by a two-year term of supervised release, and was ordered to pay $444,061.72 in restitution. HIVES was sentenced to a term of probation and was ordered to pay $7,687.50 in restitution.February 13, 2015; U.S. Department of JusticeIllinois Physician Pleads Guilty to Taking Kickbacks from Pharmaceutical Company and Agrees to Pay $3.79 Million to Settle Civil False Claims Act Case
The Department of Justice announced today that an Illinois physician, Dr. Michael J. Reinstein, pleaded guilty to a federal crime for receiving illegal kickbacks and benefits totaling nearly $600,000 from two pharmaceutical companies in exchange for regularly prescribing an anti-psychotic drug - clozapine - to his patients. Reinstein also agreed to pay the United States and the state of Illinois $3.79 million to settle a parallel civil lawsuit alleging that, by prescribing clozapine in exchange for kickbacks, Reinstein caused the submission of false claims to Medicare and Medicaid for the clozapine he prescribed for thousands of elderly and indigent patients in at least 30 Chicago-area nursing homes and other facilities.February 13, 2015; U.S. Attorney; Northern District of OhioAkron doctor sentenced to 10 years in prison for illegally prescribing Painkillers, even after patients died
An Akron physician was sentenced to 10 years in prison for illegally prescribing hundreds of thousands of doses of painkillers and other pills to customers for no legitimate medical purpose, even after at least eight customers died from overdose-related deaths, law enforcement officials said.February 12, 2015; U.S. Attorney; Southern District of TexasFour Arrested for Conspiring to Commit Health Care Fraud and Money Laundering
HOUSTON - Aliksandr Beketav, 53, Mikhail Shiforenko, 43, Alexsandr Voronov, 46, and Daniela Gozes-Wagner, 32, have been arrested following the return of a federal indictment alleging a health care fraud conspiracy and conspiracy to commit money laundering, announced U.S. Attorney Kenneth Magidson.February 11, 2015; U.S. Department of JusticeAstraZeneca to Pay $7.9 Million to Resolve Kickback Allegations
AstraZeneca LP, a pharmaceutical manufacturer based in Delaware, has agreed to pay the government $7.9 million to settle allegations that it engaged in a kickback scheme in violation of the False Claims Act, the Justice Department announced today. AstraZeneca markets and sells pharmaceutical products in the United States, including a drug sold under the trade name Nexium.February 11, 2015; U.S. Attorney; District of New JerseyJersey City, New Jersey, Pediatrician Admits Making Nearly $200,000 Billing Medicaid For Bogus Treatments
TRENTON, N.J. - A licensed pediatrician practicing in Jersey City, New Jersey, today admitted fraudulently billing Medicaid for more than 1,000 wound repair procedures that were never performed, U.S. Attorney Paul J. Fishman announced.February 10, 2015; U.S. Attorney; District of NevadaMan Who Operated Reno Consulting Firm Sentenced To 2 1/2 Years In Prison For Theft And Failing To Pay Employment Taxes
RENO, Nev. - Michael Stickler, 54, of Reno, was sentenced on Monday, Feb. 9, 2015, by U.S. District Judge Miranda M. Du to 2.5 years in federal prison, three years of supervised release, 100 hours of community service, and ordered to pay $200,000 in restitution to the U.S. Department of Health and Human Services and $100,899 to the IRS for his convictions on theft of federal grant money and failing to pay employment taxes, announced U.S. Attorney Daniel G. Bogden for the District of Nevada.February 10, 2015; U.S. Department of JusticeIowa Home Care Company to Pay $5.63 Million to Settle False Claims Act Allegations
ResCare Iowa Inc. has agreed to pay $5.63 million to the United States and the state of Iowa to resolve allegations that it violated the False Claims Act by submitting false home healthcare billings to the Medicare and Medicaid programs, the Department of Justice announced today. ResCare Iowa - a subsidiary of Louisville, Kentucky, based ResCare Inc. - provides home healthcare services to patients in the state of Iowa.February 10, 2015; U.S. Department of JusticeOwner of Miami Home Health Company Pleads Guilty for Role in $6.9 Million Medicare Fraud Scheme
The owner of a Miami home health care agency pleaded guilty today in connection with a $6.9 million Medicare fraud scheme. Assistant Attorney General Leslie R. Caldwell of the Justice Department's Criminal Division, U.S. Attorney Wifredo A. Ferrer of the Southern District of Florida, Special Agent in Charge George L. Piro of the FBI's Miami Field Office and Special Agent in Charge Derrick Jackson of the U.S. Department of Health and Human Services Office of Inspector General's (HHS-OIG) Miami Regional Office made the announcement.February 9, 2015; U.S. Department of Justice Ambulance Company Manager Sentenced to 78 Months in Prison for $5.5 Million Medicare Fraud Scheme
The general manager of a Southern California ambulance company was sentenced today to 78 months in federal prison for his role in a $5.5 million scheme to defraud the Medicare program.February 6, 2015; U.S. Attorney; District of MinnesotaOwner and Director of Eden Prairie Daycare Center Pleads Guilty to Theft of Public Money
United States Attorney Andrew M. Luger today announced the guilty plea of KHADRA ABDISAFAD HIRSI, 47, for stealing money in the form of child care subsidies from the U.S. Department of Health and Human Services and the State of Minnesota. The defendant pleaded guilty on February 4, 2015, before Judge Donovan W. Frank in U.S. District Court in St. Paul, Minn., to one count of Theft of Public Money.February 6, 2015; U.S. Department of JusticeUnited States Settles False Claims Act Suit Against Good Shepherd Hospice Inc. and Related Entities
Today, Good Shepherd Hospice Inc., Good Shepherd Hospice of Mid America Inc., Good Shepherd Hospice, Wichita, L.L.C., Good Shepherd Hospice, Springfield, L.L.C., and Good Shepherd Hospice - Dallas L.L.C. (collectively Good Shepherd) agreed to pay $4 million to resolve allegations that Good Shepherd submitted false claims for hospice patients who were not terminally ill. Good Shepherd is a for-profit hospice headquartered in Oklahoma City which provides hospice services in Oklahoma, Missouri, Kansas and Texas.February 6, 2015; U.S. Department of JusticeUnlicensed Detroit Doctor Convicted in $4.69 Million Medicare Fraud Scheme
A federal jury in Detroit today convicted an unlicensed physician for his participation in a nearly $4.7 million Medicare fraud scheme, announced Assistant Attorney General Leslie R. Caldwell of the Justice Department's Criminal Division, U.S. Attorney Barbara L. McQuade of the Eastern District of Michigan, Special Agent in Charge Paul M. Abbate of the FBI's Detroit Field Office and Special Agent in Charge Lamont Pugh III of the U.S. Department of Health and Human Services Office of Inspector General (HHS-OIG) Chicago Regional Office.February 6, 2015; U.S. Department of JusticeMedtronic Inc. to Pay $2.8 Million to Resolve False Claims Act Allegations Related to "SubQ Stimulation" Procedures
Medical device manufacturer Medtronic Inc. has agreed to pay the United States $2.8 million to resolve allegations under the False Claims Act that Medtronic caused certain physicians to submit false claims to federal health care programs for a medical procedure known as "SubQ stimulation," the Justice Department announced today. Medtronic Inc. is a medical technology company based in Minnesota.February 5, 2015; U.S. Department of JusticeMinnesota-Based ev3 to Pay United States $1.25 Million to Settle False Claims Act Allegations
Medical device manufacturer ev3 Inc., formerly known as Fox Hollow Technologies Inc., has agreed to pay the United States $1.25 million to resolve allegations under the False Claims Act that Fox Hollow caused certain hospitals to submit false claims to Medicare for unnecessary inpatient admissions related to minimally-invasive atherectomy procedures, the Justice Department announced today.February 4, 2015; U.S. Attorney; Eastern District of KentuckySomerset Optometry Practice to Pay U.S. Government $800,000 to Settle False Claims Act Violations
LONDON, KY - An optometry practice in Pulaski County has agreed to pay the U.S. Government $800,000 to settle civil allegations that it billed federal health care programs for medically unnecessary and worthless eye examinations provided to nursing home residents over the course of several years.February 4, 2015; U.S. Attorney, Western District of TennesseeAgeless Men's Health, LLC To Pay $1.6 Million To The Government For Overbilling Medicare And Tricare
Memphis, Tenn. - Ageless Men's Health, LLC (AMH) will pay $1.6 million to the government to resolve allegations that it billed Medicare and Tricare for medically unnecessary evaluation and management services (office visits) while administering testosterone replacement therapy shots. AMH has approximately 30 locations throughout the United States and operates testosterone replacement therapy clinics.February 4, 2015; U.S. Attorney, District of ConnecticutFEDERAL LAW ENFORCEMENT AUTHORITIES ANNOUNCE FORMATION OF TASK FORCE TO FIGHT PUBLIC CORRUPTION
United States Attorney Deirdre M. Daly and representatives from five federal law enforcement agencies today announced the formation of the Connecticut Public Corruption Task Force to investigate corrupt public officials, the misuse of public funds and related criminal activity.February 4, 2015; U.S. Attorney, Southern District of FloridaDelray Beach Doctor Charged with Health Care Fraud
A Delray Beach doctor has been charged with eight counts of health care fraud.February 4, 2015; U.S. Attorney; District of New JerseyThirty-five Defendants - Including 24 Doctors - Have Pleaded Guilty to Roles in Massive Scheme
NEWARK, N.J. - A Middlesex County doctor with practices in Jersey City, New Jersey, today admitted accepting bribes in exchange for test referrals as part of a long-running and elaborate scheme operated by Biodiagnostic Laboratory Services LLC (BLS), of Parsippany, New Jersey, its president and numerous associates, U.S. Attorney Paul J. Fishman announced.February 4, 2015; U.S. Attorney; Eastern District of PennsylvaniaDoctor Indicted On Charges He Illegally Distributed Drugs From Two Offices
PHILADELPHIA - Dr. Jeffrey Bado, 59, of Philadelphia, PA, was charged today by indictment with illegally distributing pain medications from his Philadelphia and Bryn Mawr medical offices, announced United States Attorney Zane David Memeger. Bado is charged with two counts of maintaining a drug-involved premises, 200 counts of illegally distributing oxycodone, a Schedule II controlled substance, outside the usual course of professional practice and for no legitimate medical purpose, as well as 33 counts of health care fraud and four counts of making false statements to federal agents.February 3, 2015; Department of Justice Home Health Agency Owner Sentenced to 10 Years in Prison for Role in Miami Health Care Fraud Scheme
A South Florida man was sentenced to 10 years in prison today in connection with a long-running $6.2 million Medicare fraud scheme involving Professional Medical Home Health LLC (Professional Home Health), a Miami home health care agency that purported to provide home health and therapy services, as well as similar schemes at two additional Miami home health care agencies. A second defendant was also sentenced to two years in prison today for his role as a patient recruiter in the fraud scheme at Professional Home Health.February 3, 2015; U.S. Attorney; Southern District of TexasMcAllen Area Ambulance Company Owner Pleads Guilty in Health Care Fraud Scheme
McALLEN, Texas - Frank Gonzalez, 32, has pleaded guilty to conspiracy to commit health care fraud and aggravated identity theft, announced U.S. Attorney Kenneth Magidson and Texas Attorney General Ken Paxton. Gonzalez, of Mission, is the owner of a McAllen area ambulance transportation company who was charged in a federal indictment for his role in a scheme to defraud Medicare and Texas Medicaid through fraudulent billings.February 2, 2015; U.S. Attorney; Southern District of TexasHusband and Wife Convicted in Multi-Million Dollar Healthcare Fraud Scheme
HOUSTON - William Owuama, 55, and Marla Owuama, 47, of Houston, have entered guilty pleas to charges related to a healthcare fraud scheme in which they billed Medicare for more than $9 million, announced U.S. Attorney Kenneth Magidson.February 2, 2015; U.S. Department of JusticeCommunity Health Systems Professional Services Corporation and Three Affiliated New Mexico Hospitals to Pay $75 Million to Settle False Claims Act Allegations
Community Health Systems Professional Services Corporation (CHSPSC) and three affiliated New Mexico hospitals (collectively CHS) have agreed to pay the United States $75 million to settle allegations that they violated the False Claims Act by making illegal donations to county governments which were used to fund the state share of Medicaid payments to the hospitals, the Justice Department announced today. CHSPSC is based in Franklin, Tennessee, and manages more than 200 affiliated hospitals in 29 states. The three New Mexico hospitals are Eastern New Mexico Medical Center in Chaves County, Mimbres Memorial Hospital and Nursing Home in Luna County and Alta Vista Regional Medical Center in San Miguel County.February 2, 2015; U.S. Attorney, Northern District of AlabamaFormer Non-Profit Health Clinics CEO Arrested on 112-Count Indictment
BIRMINGHAM - Federal agents this morning arrested JONATHAN WADE DUNNING, former chief executive officer of two non-profit health clinics for the poor and homeless, based on a 112-count superseding indictment returned by a federal grand jury last week, announced U.S. Attorney Joyce White Vance, Federal Bureau of Investigation Special Agent in Charge Roger C. Stanton, Internal Revenue Service-Criminal Investigation Division Special Agent in Charge Veronica Hyman-Pillot, and U.S. Department of Health and Human Services, Office of Inspector General, Atlanta Regional Office Special Agent in Charge Derrick L. Jackson.February 2, 2015; U.S. Attorney, Southern District of New YorkNew York City Employee Sentenced In Manhattan Federal Court For Million-Dollar Medicaid Fraud
Preet Bharara, United States Attorney for the Southern District of New York, announced today that AKIM MURRAY was sentenced in Manhattan federal court to 63 months in prison for orchestrating a substantial Medicaid fraud. MURRAY, a former employee of the Medicaid Reimbursement Unit of the New York City Human Resources Administration ("HRA"), was sentenced today by U.S. District Judge Richard M. Berman. MURRAY pled guilty in September 2014 to one count of conspiracy to commit health care fraud for abusing his access as an HRA employee in order to have dozens of checks amounting to over a million dollars issued to his friends and criminal associates, who in turn gave him a substantial cut of the proceeds.February 2, 2015; U.S. Attorney, Eastern District of TexasNigerian Sentenced for East Texas Health Care Fraud Violations
TYLER, Texas - A 44-year-old woman, formerly of Port Harcourt, Nigeria, has been sentenced to federal prison for a health care fraud scheme in the Eastern District of Texas, announced U.S. Attorney John M. Bales today. Vivian Yusuf pleaded guilty on Sep. 17, 2014, to conspiracy to commit health care fraud and was sentenced to 87 months in federal prison today by U.S. District Judge Michael Schneider.
January 2015

January 29, 2015; U.S. Attorney; Western District of KentuckyLouisville Physician Pays $515,408.85 For Treating Patients With Misbranded Drugs And Fraudulently Charging Medicare
LOUISVILLE, Ky. - A Louisville physician pleaded guilty this week in U.S. District Court to a criminal charge of treating patients with misbranded medications and was sentenced to a term of one year probation and ordered to pay restitution in the amount of $176,915.55 by U.S. Magistrate Judge Colin H. Lindsay, announced Acting United States Attorney John E. Kuhn, Jr.January 29, 2015; U.S. Attorney; District of MontanaFederal Jury Convicts Former Finance Manager of the Rocky Boy Health Clinic
GREAT FALLS - The former Finance Manager of the Rocky Boy Health Board Clinic in Box Elder, Theodora Ann Morsette, 60, was convicted of three felony counts of embezzlement and theft for taking over $156,000 in federal monies provided to the tribe for the operation and services of the Clinic. Judge Brian Morris of Great Falls set sentencing for April 20, 2015.January 29, 2015; U.S. Department of Justice Four Florida Residents Sentenced to Federal Prison for Roles in $6 Million Miami Home Health Care Fraud Scheme
Four South Florida residents were sentenced today in connection with a long-running $6.2 million Medicare fraud scheme involving Professional Medical Home Health LLC (Professional Home Health), a Miami home health care agency that purported to provide home health and therapy services. Two of the defendants were also sentenced in connection with their conduct in similar schemes at other Miami home health care agencies.January 29, 2015; U.S. Attorney; District of New JerseyDoctor Sentenced to 16 Months in Prison for taking Bribes in Test-Referral scheme with New Jersey clinical lab
NEWARK, N.J. - An internist with a practice in Montclair, New Jersey, was sentenced today to 16 months in prison for accepting bribes in exchange for test referrals as part of a long-running scheme operated by Biodiagnostic Laboratory Services LLC (BLS), of Parsippany, New Jersey, its president and numerous associates, U.S. Attorney Paul J. Fishman announced.January 29, 2015; U.S. Attorney; District of New JerseyDoctor Admits Taking Bribes in Test-Referral Scheme with New Jersey Clinical Lab
NEWARK, N.J. - A Monmouth County doctor with practices in Colts Neck, New Jersey, and Staten Island, New York, today admitted accepting bribes in exchange for test referrals as part of a long-running and elaborate scheme operated by Biodiagnostic Laboratory Services LLC (BLS), of Parsippany, New Jersey, its president and numerous associates, U.S. Attorney Paul J. Fishman announced.January 29, 2015;U.S. Attorney; Eastern District of PennsylvaniaPennsylvania Doctor And Receptionist Charged With Running "Pill Mill"
PHILADELPHIA - William J. O'Brien III, 49, and Angela Rongione, 29, both of Philadelphia, were charged by indictment, unsealed today, with running a "pill mill" from O'Brien's medical offices in Philadelphia and Levittown, PA, announced United States Attorney Zane David Memeger. Both defendants are charged with one count of conspiracy to distribute controlled substances. O'Brien, a doctor of osteopathic medicine, is also charged with 26 counts of illegally distributing oxycodone, a Schedule II controlled substance, and Xanax, a Schedule IV controlled substance, outside the usual course of professional practice and for no legitimate medical purpose.January 29, 2015; U.S. Attorney; District of MarylandBrothers Plead Guilty To Conspiracy To Distribute Over $6.6 Million In Contraband Cigarettes
Baltimore, Maryland - Elmar Rakhamimov, a/k/a "Eric Rakhamimov," age 42, of Owings Mills, Maryland, and his brother, Salim Yusufov, age 43, of Reisterstown, Maryland, pleaded guilty today to a conspiracy to traffic over $6.6 million in contraband cigarettes. Rakhamimov also pleaded guilty to trafficking in contraband cigarettes and distribution of oxycodone. Yusufov also pleaded guilty to health care fraud and to receipt and delivery of misbranded drugs.January 27, 2015; U.S. Attorney; Southern District of IllinoisDoctor from Effingham, Illinois Convicted of Illegal Dispensation of Controlled Substances
NAEEM MAHMOOD KOHLI, 60, of Effingham, Illinois, was convicted of seven counts of illegal dispensation of a Schedule II Controlled Substance following a 17-day jury trial held in federal district court, the United States Attorney for the Southern District of Illinois, Stephen R. Wigginton, announced today.January 27, 2015; U.S. Attorney; Eastern District of LouisianaNorth Carolina Couple Sentenced to Pay $342,447 in Restitution for Participating in Health Care Kickback Scheme
U.S. Attorney Kenneth A. Polite announced that CRYSTAL FINDLEY MCDONALD, and her husband, COREY MCDONALD (the "MCDONALDs"), ages 32 and 43, respectively, were sentenced after previously pleading guilty to a one-count Bill of Information for conspiracy to defraud the United States and to pay and receive illegal remuneration.January 27, 2015; U.S. Attorney; Western District of MissouriFormer Waldo Chiropractor Sentenced for $3 Million Medicare Fraud
KANSAS CITY, Mo. - Tammy Dickinson, United States Attorney for the Western District of Missouri, announced that the former owner of a Kansas City, Mo., clinic was sentenced in federal court today for a $3 million Medicare fraud scheme.January 26, 2015; U.S. Attorney; Eastern District of KentuckyFloyd County Ambulance Services Company to Pay U.S. Government $948,000 to Settle False Claims Act Violations
LEXINGTON, KY -An ambulance services company in Floyd County agreed to pay the U.S. Government $948,000 to settle civil allegations that it billed federal health care programs for medically unnecessary services over the course of several years.January 26, 2015; U.S. Department of JusticeOwner of Miami Home Health Company Sentenced to 106 Months in Prison for $30 Million Health Care Fraud Scheme
The owner and operator of a Miami home health care agency was sentenced today to 106 months in prison for his participation in a $30 million Medicare fraud scheme.January 23, 2015; U.S. Attorney; Eastern District of MissouriTurkish Man Sentenced for Smuggling Adulturated and Misbranded Cancer Drugs
St. Louis, MO - SABAHADDIN AKMAN, the owner and manager of a Turkish drug wholesaler, was sentenced to 30 months imprisonment and fined $150,000 for smuggling misbranded and adulterated cancer treatment drugs into the United States, including multiple shipments of Altuzan® (the Turkish version of Avastin®) that he sent from Turkey to Chesterfield, Missouri. Akman also paid a forfeiture of $150,000 before sentencing.January 22, 2015; U.S. Attorney; U.S. Department of JusticeMan pled guilty to health care fraud and issuing illegal prescriptions for controlled substances
Syracuse, New York - United States Attorney Richard S. Hartunian announced today that a physician who formerly ran offices in Central New York has pled guilty to health care fraud and issuing illegal prescriptions for controlled substances.January 21, 2015; U.S. Attorney; Western District of KentuckyKentuckiana Physician Charged With Prescribing Pain Medications That Resulted In The Deaths Of Five Patients
LOUISVILLE, Ky. - A Kentuckiana physician was charged today by a federal grand jury with prescribing pain medications that resulted in the deaths of five patients, health care fraud, and unlawful distribution or dispensing of controlled substances announce Acting United States Attorney John E. Kuhn, Jr.January 21, 2015; U.S. Attorney; District of New JerseyPhysician Admits To Billing Medicare And Medicaid For Phantom Physical Therapy Services
NEWARK, N.J. - A doctor with offices in Newark, Union City, Paterson and Passaic today admitted his role in a three-year scheme to bill Medicare for services that were not provided and services provided by unlicensed and unsupervised providers, U.S. Attorney Paul J. Fishman announced.January 21, 2015; U.S. Attorney; Southern District of New YorkFormer Operator Of NYC Health Clinics Pleads Guilty In Manhattan Federal Court To $12 Million Medicare Fraud Scheme
Preet Bharara, the United States Attorney for the Southern District of New York, Scott Lampert, Special Agent-in-Charge of the New York Regional Office of the United States Department of Health and Human Services Office of Inspector General ("HHS-OIG"), Thomas E. Bishop, the Acting Special Agent-in-Charge of the New York Office of the Internal Revenue Service, Criminal Investigation ("IRS-CI"), and George Venizelos, the Assistant Director-in-Charge of the New York Field Office of the Federal Bureau of Investigation ("FBI"), announced that JORGE JUVIER pled guilty today in Manhattan federal court to participating in a scheme to defraud Medicare out of more than $12 million through the use of fraudulent HIV/AIDS clinics in New York City.January 20, 2015; U.S. Attorney; District of MassachusettsSouth Shore Physicians Hospital Organization to Pay $1.775 Million for Alleged Kickbacks for Patient Referrals
BOSTON - The South Shore Physician Hospital Organization (SSPHO) in South Weymouth has agreed to pay $1.775 million to settle allegations of operating a recruitment grant program through which it paid kickbacks to its physician members in exchange for patient referrals. The United States and the Commonwealth will share in this recovery.January 20, 2015; U.S. Attorney; Northern District of TexasFort Worth Chiropractor Sentenced in Heath Care Fraud Case
FORT WORTH, Texas - The owner/operator of a chiropractic clinic in Fort Worth, Texas, was sentenced this morning on a federal felony conviction stemming from her submission of false reimbursement claims to Medicare and Medicaid, announced Acting U.S. Attorney John Parker of the Northern District of Texas.January 20, 2015; U.S. Attorney; Eastern District of LouisianaBogalusa Chiropractor Pleads Guilty To Health Care Fraud
U.S. Attorney Kenneth A. Polite announced that DAVID LEE KILLEN, age 43, a resident of Covington, pled guilty today to a one-count Bill of Information for health care fraud. KILLEN admitted to fraudulently billing health care insurance plans for chiropractic and other services that were not rendered or were otherwise unauthorized.January 16, 2015; U.S. Department of JusticeCommonwealth of Pennsylvania to Pay $48.8 Million to Resolve Federal Government's Claims that it Provided Benefits to Ineligible Aliens
The commonwealth of Pennsylvania will pay $48.8 million to resolve the federal government's claims that it provided benefits to ineligible aliens in violation of federal law, the Justice Department announced today. The benefits at issue were provided under three programs: Medicaid, Temporary Assistance for Needy Families (TANF) and the Supplemental Nutrition Assistance Program (SNAP), formerly known as food stamps.January 16, 2015; U.S. Attorney; District of ConnecticutRidgefield Physician Pleads Guilty to Health Care Fraud
Deirdre M. Daly, United States Attorney for the District of Connecticut, announced that DAVID LESTER JOHNSTON, 46, of Ridgefield, pleaded guilty today in Hartford federal court to committing health care fraud.January 15, 2015; U.S. Attorney; District of MarylandPharmacy Store Employee Sentenced To Prison For Scheme To Defraud Health Care Benefit Programs
Baltimore, Maryland - U.S. District Judge George L. Russell III sentenced Jigar Patel, age 27, of Columbia, Maryland, today to 13 months in prison, followed by three years of supervised release, for a scheme to defraud Medicaid, Medicare and the Federal Employees Health Benefits Program by submitting false claims for prescription refills. As a result of the scheme, the loss to the health care benefit programs to date is between $2.5 million and $7 million. Judge Russell ordered Jigar Patel to pay restitution of $102,066.25.January 14, 2015; U.S. Department of Justice Michigan Physician Sentenced to 15 Months in Prison for her Role in a $2.1 Million Medicare Fraud Scheme
A Michigan physician involved in a $2.1 million home health care fraud scheme was sentenced today to 15 months in prison.January 14, 2015; U.S. Attorney; District of South CarolinaCharleston Doctors and Medical Clinic Settle Allegations of Fraud
Columbia, South Carolina ---- United States Attorney Bill Nettles announced today that the United States Attorney's Office for the District of South Carolina, settled claims of health care fraud with Nason Medical, out of Charleston, South Carolina, and two of its owners, Dr. Baron S. Nason and Robert T. Hamilton. The United States contended that Nason Medical submitted numerous false claims to Medicare, Medicaid and TRICARE.January 13, 2015; U.S. Attorney; Eastern District of MissouriLocal Podiatrist Pleads Guilty to Health Care Fraud Charges
ST. LOUIS, MO-Lawrence B. Iken, DPM, and his company each pled guilty to charges involving the submission of false documents and reimbursement claims related to podiatric services purportedly provided by Dr. Iken, from 2006 through July 2014. As part of his plea, Dr. Iken has agreed to a money judgment of $999,170, which represents the amount of reimbursement that he and his company received for the health care claims.January 12, 2015; U.S. Attorney; Southern District of TexasDoctor and Pharmacist Charged Distributing 1.6 Million Doses of Oxycodone
HOUSTON - Richard Arthur Evans, M.D., 70, and David D. Devido, R.Ph., 76, both of Houston, have been charged in a 24-count indictment alleging a conspiracy to commit distribution of controlled substances, mail fraud, health care fraud and money laundering, announced U.S. Attorney Kenneth Magidson along with Special Agent in Charge Joseph Arabit of the Drug Enforcement Administration (DEA) and Special Agent in Charge Lucy Cruz of Internal Revenue Service - Criminal Investigation (IRS-CI).January 12, 2014; U.S. Department of Justice Physician Owners of Mental Health Clinic Sentenced for $97 Million Medicare Fraud Scheme
The two physician owners of a Houston-area mental health clinic were sentenced today to 148 months and 120 months respectively for their roles in a $97 million Medicare fraud scheme. A group home owner who sent residents to the clinic in exchange for kickbacks was also sentenced to 54 months in prison for her role.January 9, 2015; U.S. Department of JusticeDaiichi Sankyo Inc. Agrees to Pay $39 Million to Settle Kickback Allegations Under the False Claims Act
Daiichi Sankyo Inc., a global pharmaceutical company with its U.S. headquarters in New Jersey, has agreed to pay the United States and state Medicaid programs $39 million to resolve allegations that it violated the False Claims Act by paying kickbacks to induce physicians to prescribe Daiichi drugs, including Azor, Benicar, Tribenzor and Welchol, the Justice Department announced today.January 9, 2015; U.S. Department of JusticeOwner of Miami Home Health Company Pleads Guilty for Role in $32 Million Medicare Fraud Scheme
A Miami owner of a home health care company pleaded guilty today in connection with a $32 million Medicare fraud scheme.January 9, 2015; U.S. Attorney; Northern District of GeorgiaOwner of Allergy Lab Sentenced for Faking Allergy Test Results
ATLANTA - Rahsaan Jackson Garth has been sentenced to federal prison for committing health-care fraud by faking the results of allergy tests that patients' doctors had ordered.January 9, 2015; U.S. Attorney; Eastern District of WisconsinMedical College of Wisconsin, Inc. Pays $840,000 to Settle Alleged False Claims for Neurosurgeries
United States Attorney James L. Santelle of the Eastern District of Wisconsin announced today that the Medical College of Wisconsin, Inc. (MCW) has paid the federal government $840,000 to resolve allegations that it violated the False Claims Act. MCW is alleged to have knowingly billed federal healthcare programs for neurosurgeries involving residents who did not receive the required level of supervision from teaching physicians.January 7, 2015; U.S. Attorney; Southern District of CaliforniaAnsun Biopharma to Pay More Than $2 Million for Overbilling the U.S.
United States Attorney for the Southern District of California Laura E. Duffy announced that a local biopharmaceutical company, Ansun Biopharma, Inc., entered into criminal and civil settlements with the Department of Justice that will require it to make approximately $2 million in payments to the United States. These settlements resolve a criminal and related civil investigation against Ansun for submitting false and fraudulent claims on grants and a contract with the National Institutes of Health ("NIH").January 8, 2015; U.S. Attorney; Southern District of New YorkStaten Island Physician's Assistant Pleads Guilty In Manhattan Federal Court To Massive Oxycodone Distribution Conspiracy
Preet Bharara, the United States Attorney for the Southern District of New York, announced today that LEONARD MARCHETTA, a physician's assistant, pled guilty in Manhattan federal court to conspiring to distribute a massive quantity of oxycodone out of a Staten Island-based medical clinic he oversaw. During a period of approximately three years, in exchange for cash payments, MARCHETTA wrote medically unnecessary prescriptions for more than 125,000 30-milligram oxycodone pills to individuals claiming to be "patients," and on a number of occasions MARCHETTA issued prescriptions in the names of fictitious individuals or individuals whom he had never seen. MARCHETTA was charged in September 2014, and pled guilty today before U.S. District Judge P. Kevin Castel.January 8, 2015; U.S. Attorney; Western District of North CarolinaFormer Clinic Owner Sentenced for Role in $3.4 Million Medicaid Fraud Scheme
CHARLOTTE, NC-Ronnie Lorenzo Robinson, 37, of Charlotte, was sentenced today to 30 months in prison for his role in a $3.4 million Medicaid fraud scheme involving sham mental and behavioral health services, announced Anne M. Tompkins, U.S. Attorney for the Western District of North Carolina. Chief U.S. District Judge Frank D. Whitney also ordered Robinson to serve three years under court supervision and to pay $3,153,074 in restitution to Medicaid.January 5, 2015; U.S. Department of JusticeGovernment Intervenes in Lawsuit Against Florida Cardiologist Alleging Unnecessary Peripheral Artery Interventions and Payment of Kickbacks
The government has intervened in two lawsuits against a Florida cardiologist, Dr. Asad Qamar, and his physician group, the Institute for Cardiovascular Excellence PLLC (ICE), alleging that Qamar and ICE billed Medicare for medically unnecessary peripheral artery interventions and paid kickbacks to patients by waiving Medicare copayments irrespective of financial hardship, the Justice Department announced today.January 5, 2015; U.S. Attorney; District of New JerseyNorth Jersey Doctor Sentenced to One Year of House Arrest and Three Years' Probation
NEWARK, N.J. - A doctor with a practice in Paterson, New Jersey, was sentenced today to three years' probation, which includes one year of house arrest with electronic monitoring, for accepting more than $200,000 in bribes from Parsippany, New Jersey-based Biodiagnostic Laboratory Services LLC (BLS) as part of a long-running scheme operated by the lab, its president, and numerous associates, U.S. Attorney Paul J. Fishman announced.

December 8, 2014

Florida - Miami-Area Certified Nursing Assistant Sentenced to 150 Months in Prison for Role in $200 Million Medicare Fraud Scheme
Miami, Florida - A Miami licensed nursing assistant was sentenced today to serve 150 months in prison for participating in a $200 million Medicare fraud scheme involving fraudulent billings by American Therapeutic Corporation (ATC), a mental health company headquartered in Miami.


December 2, 2014

Florida - Principal in $28.3 Million Medicare Fraud Scheme Sentenced to 11 Years in Prison
Tampa, Florida - A Florida owner and operator of multiple physical therapy rehabilitation facilities was sentenced in federal court in Tampa today to serve 11 years in prison for his role in organizing a $28.3 million Medicare fraud scheme involving physical and occupational therapy services.

http://www.stopmedicarefraud.gov/newsroom/index.html

By Katie Lobosco @KatieLobosco

The FBI arrested 46 doctors and nurses across the country this week in the largest Medicare fraud bust ever.

In total, 243 people were arrested in 17 cities for allegedly billing Medicare for $712 million worth of patient care that was never given or unnecessary.

In one of the most egregious cases, owners of a mental health facility in Miami billed tens of millions of dollars for psychotherapy sessions based on treatment that was little more than moving patients to different locations, said Attorney General Loretta Lynch.

Four people are charged for mass-marketing a talking glucose monitor and sending the devices to Medicare patients across the country who didn't need or request them. They billed Medicare for the devices and received more than $22 million.

In some cases health care providers paid kickbacks to fraudsters who could get their hands on Medicare patients' personal information.

They would then use that info to bill Medicare for bogus care.

Sometimes fraudsters, known to the Feds as "patient recruiters," will go to places like homeless shelters and soup kitchens and offer money to those who would share their Medicare patient numbers, a Department of Justice spokesman said.

Related: Administration can't help if Court kills Obamacare

A Los Angeles doctor is charged for allegedly billing $23 million for 1,000 power wheelchairs and home health services that were not medically necessary and often not provided. And in a Florida case, a health care provider received $1.6 million from Medicare for prescription drugs that were never purchased and never dispensed, said Lynch.

The FBI analyzed billing data to find areas in the country where there is a high potential for fraud.

"In these cases, we followed the money and found criminals who were attracted to doctors offices, clinics, hospitals and nursing homes in search of what they viewed as an ATM," said FBI Director James B. Comey.

The DOJ's Medicare Fraud Strike Force team led the investigations. Since 2007, it has charged 2,300 people who have falsely billed the Medicare program for more than $7 billion. In recent years, the team has expanded from two cities to nine, thanks to an additional $350 million in funding from the Affordable Care Act.

http://money.cnn.com/2015/06/19/pf/m...fraud-doctors/

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https://www.fbi.gov/news/stories/201...fraud-takedown

Health Care Fraud Takedown 243 Arrested, Charged with $712 Million in False Medicare Billings 06/18/15 More than 240 individuals—including doctors, nurses, and other licensed professionals—were arrested this week for their alleged participation in Medicare fraud schemes involving approximately $712 million in false billings. The arrests, which began Tuesday, were part of a coordinated operation in 17 cities by Medicare Fraud Strike Force teams, which include personnel from the FBI, the Department of Health and Human Services (HHS), the Department of Justice (DOJ), and local law enforcement. The Strike Force’s mission is to combat health care fraud, waste, and abuse. At a press conference today at DOJ Headquarters in Washington, D.C., officials said the arrests constituted the largest-ever health care fraud takedown in terms of both loss amount and arrests. “These are extraordinary figures,” said Attorney General Loretta Lynch. “They billed for equipment that wasn’t provided, for care that wasn’t needed, and for services that weren’t rendered.” The charges are based on a variety of alleged fraud schemes involving medical treatments and services. According to court documents, the schemes included submitting claims to Medicare for treatments that were medically unnecessary and often not provided. In many of the cases, Medicare beneficiaries and other co-conspirators were allegedly paid cash kickbacks for supplying beneficiary information so providers could submit fraudulent bills to Medicare. Forty-four of the defendants were charged in schemes related to Medicare Part D, the prescription drug benefit program, which is the fastest growing component of Medicare and a growing target for criminals. “There is a lot of money there, so there are a lot of criminals,” said FBI Director James B. Comey. He described how investigations leveraged technology to collect and analyze data, and rapid response teams to surge where the data showed the schemes were operating. “In these cases, we followed the money and found criminals who were attracted to doctors offices, clinics, hospitals, and nursing homes in search of what they viewed as an ATM.” Since their inception in 2007, Strike Force teams in the nine cites where they operate have charged more than 2,300 defendants who collectively falsely billed Medicare more than $7 billion. Today’s announcement marked the first time that districts outside Strike Force locations have participated in a national takedown; those districts accounted for 82 of the arrests this week. Here’s a look at some of the cases: In Miami, 73 were charged in schemes involving about $263 million in false billings for pharmacy, home health care, and mental health services. In Houston and McAllen, 22 were charged in cases involving more than $38 million. In one case, the defendant coached beneficiaries on what to tell doctors to make them appear eligible for Medicare services and then received payment for those who qualified. The defendant was paid more than $4 million in fraudulent claims. In New Orleans, 11 people were charged in connection with home health care and psychotherapy schemes. In one case, four defendants from two companies sent talking glucose monitors across the country to Medicare beneficiaries regardless of whether they were needed or requested. The companies billed Medicare $38 million and were paid $22 million. “We will not stop here,” said HHS Secretary Sylvia Mathews Burwell. “We will work tirelessly to prevent these programs from becoming targets and fight fraud wherever we find it.” More than 900 law enforcement officials participated in the three-day sweep. Those arrested include 46 licensed medical professionals, including 19 doctors. Since 2007, the Medicare Fraud Strike Force has prosecuted more than 200 doctors and more than 400 medical professionals. In fiscal year 2014, DOJ and HHS health care fraud and prevention efforts recovered nearly $3.3 billion. Over the past five years, DOJ specifically has recovered more than $15 billion in cases involving health care fraud. The average prison sentence in Strike Force cases in fiscal year 2014 was more than four years, though some prosecutions in recent years resulted have in sentences of 50 years. Resources: - Press release - More on the Medicare Fraud Strike Force - More on the FBI’s efforts to combat health care fraud - FBI, This Week podcast: The Medicare Fraud Strike Force https://www.fbi.gov/news/stories/201...fraud-takedown

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