Skip Navigation Change Font Size

Criminal and Civil Enforcement

February 2014

February 28, 2014; U.S. Attorney; Northern District of Indiana
Plea: Conspiracy to Submit False Claims to Medicare
Anthony Bitterling, 40, of Winimac, Indiana, a defendant in the case US v Hoosier EMS Inc. et al., pled guilty before District Judge Joseph Van Bokkelen to the felony offense of conspiring with other individuals to submit fraudulent claims to Medicare in connection with ambulance transportation. Sentencing has been set for 5/8/14. This charge was filed as a result of an investigation by the Federal Bureau of Investigation, the Medicare Fraud Control Unit, and the US Department of Health and Human Services. This case is being prosecuted by Assistant United States Attorneys Diane Berkowitz and Thomas McGrath.
February 28, 2014; U.S. Attorney; Northern District of New York
A Physician and Employee of a Former Utica and Fulton Area Medical Practice Indicted
United States Attorney Richard S. Hartunian announced the indictment of a physician and employee of a former Utica and Fulton area medical practice. Mahesh Kuthuru, M.D., age 43, and Bonnie Meislin, age 42, were indicted by a federal grand jury in Syracuse on February 26, 2014.
February 27, 2014; U.S. Attorney; District of Puerto Rico
Four Individuals Indicted And Arrested For Health Care Fraud
SAN JUAN, P.R. - Yesterday, February 26, a Federal grand jury returned a fourteen count-indictment against four individuals for health care fraud and causing the misbranding and adulteration of prescription medications with intent to mislead and defraud, announced Rosa Emilia Rodríguez-Vélez, United States Attorney for the District of Puerto Rico. The defendants are facing a forfeiture allegation of $225,929.21.
February 27, 2014; U.S. Attorney; District of South Dakota
Kyle Man Charged with Health Care Fraud
United States Attorney Brendan V. Johnson announced that a Kyle, South Dakota, man has been indicted by a federal grand jury for Theft in Connection with Health Care, Health Care Fraud, False Statements Relating to Health Care Matters and Acquiring Controlled Substances by Fraud. Dean L. Hodges, age 59, was indicted on February 19, 2014. He appeared before U.S. Magistrate Judge Veronica L. Duffy on February 24, 2014, and pled not guilty to the Indictment.
February 27, 2014; U.S. Attorney; District of South Dakota
Pine Ridge Woman Charged With Health Care Fraud
United States Attorney Brendan V. Johnson announced that a Pine Ridge, South Dakota, woman has been indicted by a federal grand jury for False Statements Relating to Health Care Matters and Attempt to Obtain Controlled Substance by Fraud. Jamie Wounded Arrow, age 26, was indicted on February 19, 2014. She appeared before U.S. Magistrate Judge Veronica L. Duffy on February 24, 2014, and pled not guilty to the Indictment.
February 27, 2014; U.S. Department of Justice
Omnicare to Pay Government $4.19 Million to Resolve False Claims Act Allegations of Kickbacks
Omnicare Inc., an Ohio-based long-term care pharmacy, has agreed to pay the government $4.19 million to settle allegations that it engaged in a kickback scheme in violation of the False Claims Act, the Justice Department announced today. Omnicare provides pharmaceuticals and services to long-term care facilities and residents and other senior populations.
February 27, 2014; U.S. Department of Justice
Owner of Fake Michigan Psychotherapy Clinic Sentenced for Role in Medicare Fraud Scheme
The owner of two Flint, Mich., adult day care centers was sentenced today for his leadership role in a $3.2 million Medicare fraud scheme. Glenn English, 53, was sentenced by United States District Judge Victoria A. Roberts in the Eastern District of Michigan to serve 96 months in prison. In addition to his prison term, English was sentenced to serve three years of supervised release and was ordered to pay $988,529 in restitution.
February 26, 2014; U.S. Attorney; District of New Jersey
Doctor Admits Taking Bribes in Test-Referral Scheme with New Jersey Clinical Lab
Newark, N.J. - An internist with a practice in Montclair, N.J., admitted today accepting bribes in exchange for test referrals as part of a long-running scheme operated by Biodiagnostic Laboratory Services LLC, of Parsippany, N.J., its president and numerous associates, U.S. Attorney Paul J. Fishman announced. Charles Goldberg, 60, of West Orange, N.J., pleaded guilty before U.S. District Judge Stanley R. Chesler in Newark federal court to an information charging him with one count of accepting bribes.
February 26, 2014; U.S. Attorney; District of Utah
Salt Lake City Psychologist Charged With Health Care Fraud In Indictment Returned By Grand Jury
Salt Lake City - A federal grand jury returned an indictment Wednesday charging Charles Fredrick McCusker, age 62, of Salt Lake City, a licensed Utah psychologist, with health care fraud and mail fraud in connection with a health care fraud scheme the indictment alleges caused federal and private benefit programs to pay more than $1.3 million for services not provided to patients. The indictment alleges the conduct occurred from around 2007 to around August 2013
February 25, 2014; U.S. Attorney; District of Massachusetts
Concord Doctor Pleads Guilty for Role in $27 Million Home Health Care Scam
BOSTON - The former medical director of a Waltham-based home health agency pleaded guilty today for his role in a home health fraud scheme which cost Medicare over $27 million. Dr. Spencer Wilking, 65, of Concord, pleaded guilty today before U.S. District Judge Joseph L. Tauro to health care fraud. Sentencing is scheduled for May 20, 2014. The statutory maximum penalty for the crime is 10 years in prison, three years of supervised release, a fine of $250,000 or twice the gross loss to the Medicare program or twice the gross gain to Wilking (whichever is greater), restitution to Medicare, forfeiture of any proceeds of the offense, and exclusion from the Medicare program.
February 25, 2014; U.S. Department of Justice
Diagnostic Imaging Group to Pay $15.5 Million for Allegedly Submitting False Claims to Federal and State Health Care Programs
WASHINGTON - Diagnostic Imaging Group (DIG) has agreed to pay a total of $15.5 million to resolve allegations that its diagnostic testing facility falsely billed federal and state health care programs for tests that were not performed or not medically necessary and by paying kickbacks to physicians. Assistant Attorney General for the Justice Department's Civil Division Stuart F. Delery, U.S. Attorney for the District of New Jersey Paul J. Fishman and U.S. Attorney for the Eastern District of New York Loretta E. Lynch announced the settlement today.
February 25, 2014; U.S. Attorney; Middle District of Florida
United States Settles False Claims Act Lawsuit against Florida Pain Clinic and Its Owner
Tampa, Florida - United States Attorney A. Lee Bentley, III announced today that a Florida-based physician, Dr. Steven Chun, has agreed to pay $750,000 to resolve allegations that he and his clinic billed Medicare for physician office visits that he did not perform. The United States alleges that, between 2006 and 2011, Dr. Chun owned and operated a clinic, first in Sarasota and then in Bradenton, called Sarasota Pain Associates. The United States alleges that, beginning in 2006, Dr. Chun billed Medicare for office visits at the highest levels possible, falsely claiming to have conducted comprehensive examinations of patients with complex problems. In fact, those patients visited Sarasota Pain Associates for scheduled procedures for which Dr. Chun was paid. In addition to getting paid for those procedures, Dr. Chun billed and was paid by Medicare for examinations that he did not in fact perform.
February 24, 2014; U.S. Attorney; District of Connecticut
Physical Therapist Arrested On Health Care Fraud Charges
Deirdre M. Daly, United States Attorney for the District of Connecticut, announced that Danielle Faux, 46, of Weston, was arrested today on federal health care fraud charges. On February 19, 2014, a federal grand jury sitting in Bridgeport returned an indictment charging Faux with 46 counts of health care fraud and one count of obstruction of a federal audit.
February 21, 2014; U.S. Attorney; Southern District of Iowa
Former Newton, Iowa Doctor Pleads Guilty of Health Care Fraud and Illegal Distribution of Controlled Substance
DES MOINES, IA - The United States Attorney for the Southern District of Iowa, Nicholas A. Klinefeldt, announces that Lafayette James Twyner, Jr., age 64, a former doctor in Newton, Iowa, pleaded guilty in United States District Court on February 21, 2014, to one count of health care fraud and one count of illegal distribution of a schedule III controlled substance resulting in death, announced United States Attorney Nicholas A. Klinefeldt. If approved by the district court at sentencing, the plea agreement calls for Twyner to serve a total of 8 years of incarceration, which will include 5 years in prison and 3 years of home and/or community confinement.
February 21, 2014; U.S. Attorney; Eastern District of Missouri
Local Doctor Sentenced For Making False Statement to Agent
St. Louis, MO - Dr. Erick Falconer was sentenced to five months in prison, followed by five months of home confinement, on charges of making a false statement to federal agents regarding his purchases of misbranded Botox® from a foreign unlicensed drug wholesaler, some of which had counterfeit exterior packaging. Additionally, as part of his plea agreement, Dr. Falconer previously forfeited $20,000 to the Government.
February 21, 2014; U.S. Attorney; District of South Carolina
Andrews Woman Sentenced in Health Care Fraud Case
Columbia, South Carolina - United States Attorney Bill Nettles stated that Queen Edwards Nesmith, age 53, of Andrews, South Carolina, was sentenced today in federal court in Charleston for Health Care Fraud, a violation of 18 U.S.C. § 1346, and Aggravated Identity Theft, a violation of 18 U.S.C. § 1028A. Senior United States District Judge Sol Blatt Jr. of Charleston sentenced Nesmith to 24 months imprisonment on each charge, for a total of 48 months, and ordered her to pay approximately $411,000 in restitution.
February 21, 2014; U.S. Attorney; Southern District of California
Alvarado Pharmacy and Its Owner Ordered To Repay Medicare over $1 Million
United States Attorney Laura E. Duffy announced today that Alvarado Medical Plaza Pharmacy, Inc. was sentenced by United States District Court Judge Janis L. Sammartino to repay Medicare over $1 million, and to pay a $10,000 fine, following its conviction of federal Health Care Fraud for billing Medicare for unapproved oncology drugs.
February 21, 2014; U.S. Department of Justice
Endo Pharmaceuticals and Endo Health Solutions to Pay $192.7 Million to Resolve Criminal and Civil Liability Relating to Marketing of Prescription Drug Lidoderm for Unapproved Uses
Pharmaceutical company Endo Health Solutions Inc. and its subsidiary Endo Pharmaceuticals Inc. (Endo) have agreed to pay $192.7 million to resolve criminal and civil liability arising from Endo's marketing of the prescription drug Lidoderm for uses not approved as safe and effective by the Food and Drug Administration (FDA), the Justice Department announced today. The resolution includes a deferred prosecution agreement and forfeiture totaling $20.8 million and civil false claims settlements with the federal government and the states and the District of Columbia totaling $171.9 million. Endo Pharmaceuticals Inc. is a Delaware corporation headquartered in Malvern, Pa.
February 21, 2014; U.S. Department of Justice
New Jersey Doctor Who Provided Spa Services Pleads Guilty in Medicare Fraud Scheme
Dr. Chang Ho Lee, 68, of Palisades Park, N.J., pleaded guilty today to health care fraud and agreed to forfeit more than $3.4 million in fraud proceeds. According to court documents, Lee, who is a medical doctor, and two others recruited patients by offering free lunches and recreational classes and provided them with spa services, such as massages and facials, then falsely billed Medicare for more than $13 million using those patients' Medicare numbers.
February 20, 2014; U.S. Attorney; District of Columbia
More Than 20 People Arrested Following Investigations into Widespread Health Care Fraud in D.C. Medicaid Program as Charges Unsealed in Largest Health Care Fraud Takedown in D.C. History
WASHINGTON-More than 20 people, including operators of home care agencies and nurse staffing agencies, office workers, and personal care assistants, were arrested today following investigations into fraudulent billing practices in the home health care industry.
February 20, 2014; U.S. Attorney; Southern District of Texas
Houston Physician Arrested in Health Care Fraud Conspiracy
HOUSTON - Dr. Enyibuaku Rita Uzoaga, 41, and Charles Harris, 53, have been indicted on charges of conspiracy to commit health care fraud and health care fraud, announced United States Attorney Kenneth Magidson. The seven-count indictment was returned Feb. 12, 2014, and unsealed this morning as Uzoaga surrendered to federal authorities. She is expected to make an initial appearance before U.S. Magistrate Judge George C. Hanks Jr. at 10:00 a.m. today.
February 20, 2014; U.S. Attorney; Northern District of Georgia
Atlanta Doctor Sentenced For Defrauding Medicare and IRS
ATLANTA - Lawrence Eppelbaum has been sentenced to 50 months in prison and fined $3.5 million following his trial conviction on health care fraud, tax fraud and money laundering charges.
February 20, 2014; U.S. Attorney; Northern District of Illinois
Physician Arrested for Allegedly Illegally Dispensing Oxycodone and Falsely Billing Medicare in Undercover Probe
CHICAGO - A southwest suburban physician was arrested yesterday on federal charges for allegedly conspiring to illegally dispense a prescription medication and health care fraud, federal law enforcement officials announced today. The defendant, Sathish Narayanappa Babu, the owner of Anik Life Sciences Medical Corp., allegedly conspired to illegally dispense oxycodone and fraudulently billed Medicare for services he purportedly provided.
February 19, 2014; U.S. Department of Justice
Washington-Based Medical Device Manufacturer to Pay up to $5.25 Million to Settle Allegations of Causing False Billing of Federal Health Care Programs
Medical device manufacturer EndoGastric Solutions Inc. has agreed to pay the government up to $5.25 million to resolve allegations that it violated the False Claims Act by misleading health care providers about how to bill federal health care programs for a procedure using a device manufactured by the company and by paying kickbacks, the Justice Department announced today. EndoGastric Solutions is located in Redmond, Wash.
February 19, 2014; U.S. Department of Justice
Government Intervenes in Lawsuit against Tenet Healthcare Corp. and Georgia Hospital Owned by Health Management Associates Inc. Alleging Payment of Kickbacks
The government has intervened in a False Claims Act lawsuit against Tenet Healthcare Corp. (Tenet) and four of its hospitals in Georgia and South Carolina, as well as a hospital in Monroe, Ga., owned by Health Management Associates Inc. (HMA), alleging that the hospitals paid kickbacks to obstetric clinics serving primarily undocumented Hispanic women in return for referral of those patients for labor and delivery at the hospitals. The hospitals then billed the Medicaid programs in Georgia and South Carolina for the services provided to the referred patients and, in some instances, also obtained additional Medicare reimbursement based on the influx of low-income patients. Tenet and HMA are two of the largest owner/operators of hospitals in the United States. HMA was acquired by Community Health Systems last month. The government also is intervening against the clinics and related entities known as Hispanic Medical Management d/b/a Clinica de la Mama.
February 19, 2014; U.S. Attorney; Eastern District of Texas
Former Shelby County Residents Guilty in Health Care Fraud Scheme
BEAUMONT, Texas - A Center, Texas couple now living in Elgin, Texas, has pleaded guilty to federal violations in a health care fraud scheme in the Eastern District of Texas, announced U.S. Attorney John M. Bales today.
February 19, 2014; U.S. Attorney; District of New Jersey
Monmouth County, N.J., Doctor Admits Stealing $1.1 Million
NEWARK, N.J. - A pain management doctor with a practice based in Red Bank, N.J., admitted today that he embezzled more than $1.1 million from a medical practice, U.S. Attorney Paul J. Fishman announced. Robert Muscio, 40, a resident of Colts Neck, N.J., pleaded guilty before U.S. District Judge Stanley R. Chesler in Newark federal court to one count of committing mail fraud to embezzle those monies.
February 18, 2014; U.S. Attorney; Central District of California
Three Found Guilty for Roles in $20 Million Health Care Fraud Scheme Involving Bogus Prescriptions for Expensive Anti-Psychotic Drugs
LOS ANGELES - Three people linked to a Glendale medical clinic - including a doctor who took money to let his name be used thousands times on bogus prescriptions - were found guilty today of federal fraud charges related to a $20 million scheme to defraud Medicare and Medi-Cal by, among other things, fraudulently prescribing expensive anti-psychotic medications and then re-billing the government for those drugs over and over.
February 18, 2014; U.S. Attorney; Southern District of Florida
Miami Physician Pleads Guilty in Medicare Fraud Scheme
Wifredo A. Ferrer, United States Attorney for the Southern District of Florida, Christopher B. Dennis, Special Agent in Charge, U.S. Department of Health and Human Services, Office of Inspector General, Michael B. Steinbach, Special Agent in Charge, Federal Bureau of Investigation, Miami Field Office, and Mark R. Trouville, Special Agent in Charge, U.S. Drug Enforcement Administration, Miami Field Division, announce today that Christopher Gregory Wayne, an osteopathic physician residing in Miami, pled guilty before U.S. District Judge Robert N. Scola, Jr., to a criminal information that charges him with health care fraud and conspiracy to violate the narcotics laws of the United States. Sentencing has been scheduled for May 16, 2014.
February 14, 2014; U.S. Attorney; District of Massachusetts
Former Lab Executive Sentenced for Tax-Related Crimes
BOSTON - The former chief operating officer of a Woburn drug testing laboratory was sentenced yesterday for federal tax related crimes. U.S. District Court Judge George A. O'Toole, Jr. sentenced Patrick Cavanaugh, 50, of Gloucester, to 18 months in prison and one year of supervised release. In 2013, Cavanaugh pleaded guilty to four counts of subscribing to false tax returns for the tax years 2005 through 2008.
February 18, 2014; U.S. Attorney; Southern District of Texas
Corpus Christi Doctor Convicted in Connection with Fraudulent Health Care Billing Scheme
Corpus Christi, Texas - Dr. Roque Joel Ramirez, 49, of Robstown, has entered a plea of guilty to mail fraud in connection with his scheme to defraud Medicare and Medicaid through fraudulent billings, announced United States Attorney Kenneth Magidson and Texas Attorney General Greg Abbott.
February 18, 2014; U.S. Attorney; District of Maryland
Three Medical Groups and A Medical Billing Company Agree To Pay $3,340,979 to Resolve Investigation into Medicare Overbilling Scheme
Baltimore, Maryland - Medical billing company Engage Medical, Inc., its owner Sanjay Puri and three medical practices that were its clients have agreed to pay a total of $3,340,979 to resolve claims that Engage Medical overbilled for nuclear stress tests. Engage Medical and Sanjay Puri have agreed to pay $544,500; Advanced Cardiology Center and its owners Pankaj Lal, M.D., Mubashar Choudry, M.D. and Moshin Ijaz, M.D. agreed to pay $1,894,549.50; Reva Gill, M.D. and Kenilworth Internists, P.A. agreed to pay $242,204; and Sureshkumar Muttath, M.D. agreed to pay $659,726.
February 14, 2014; U.S. Attorney; Southern District of Illinois
Alton Doctor Pleads Guilty To Health Care Fraud and Illegal Dispensation of Controlled Substances
Viwathna Bhuthimethee, 68, a medical doctor who operated the Walk In Clinic, located at 654 East Broadway Street in Alton, Illinois, pled guilty today in federal court to the fifteen counts of an indictment which charged health care fraud against the Illinois Medicaid program and illegal distribution of Schedule III controlled substances (Hydrocodone) and Schedule IV controlled substances (Xanax) by prescribing outside the usual course of professional conduct and without legitimate medical purpose, Stephen R. Wigginton, United States Attorney for the Southern District of Illinois, announced.
February 13, 2014; U.S. Attorney; Eastern District of Louisiana
Former Chiropractor, David Lee Killen, Indicted On Health Care Fraud And Aggravated Identity Theft Charges
David Lee Killen, age 42, a resident of Covington, Louisiana, was charged today in a thirty-count health care fraud and four-count aggravated identity theft indictment by a Federal Grand Jury for his submission of fraudulent claims to Medicare, Medicaid and private insurers, announced U.S. Attorney Kenneth Allen Polite, Jr.
February 13, 2014; Eastern District of Washington
Walla Walla Man Sentenced To Probation And Ordered To Pay Over $106,000 For Willfully Failing To Pay Child Support
Richland, Washington - Michael C. Ormsby, United States Attorney for the Eastern District of Washington, announced that Ty Warren Azeltine, 54, a resident of Walla Walla, was sentenced after having previously pleaded guilty in October, 2013 to Failure to Pay a Child Support Obligation, which is a misdemeanor offense. Senior United States District Court Judge Edward F. Shea sentenced Azeltine to a 30 month term of probation. Judge Shea ordered Azeltine to pay $106,725.23 in restitution, which represents the outstanding child support obligation owed. Judge Shea also ordered Azeltine to actively seek and maintain employment.
February 12, 2014; U.S. Attorney; Eastern District of Texas
Tyler County Woman Guilty of Health Care Fraud
BEAUMONT, Texas - A 31-year-old Woodville, Texas woman has pleaded guilty to federal violations in the Eastern District of Texas, announced U.S. Attorney John M. Bales. Kari Mannino pleaded guilty to conspiracy to commit health care fraud today before U.S. Magistrate Judge Keith F. Giblin.
February 12, 2014; U.S. Attorney; Western District of Missouri
Former KC Man Pleads Guilty To Fleeing U.S. To Avoid Paying Child Support - Project Save Our Children
Kansas City, Mo. - Tammy Dickinson, United States Attorney for the Western District of Missouri, announced today that a former Kansas City, Mo., man who has been living in Thailand pleaded guilty in federal court to fleeing the United States in 2007 to avoid paying child support.
February 12, 2014; U.S. Attorney; Eastern District of Missouri
Local In-Home Healthcare Provider Indicted On Bank Fraud Charges
St. Louis, MO - Tina Kuehl was indicted on bank fraud charges involving her fraudulent statements involving payment of a bank loan. In November 2013, Kuehl was also indicted by a federal grand jury on five counts of health care fraud and one count of making false statements to federal agents. The trial of these offenses is scheduled for May 5, 2014.
February 11, 2014; U.S. Attorney; Northern District of Illinois
Local Physician Indicted on Charges of Health Care Fraud
Rockford, IL-A suspended Rockford physician was indicted today by a federal grand jury on charges of healthcare fraud. Charles S. DeHann, 59, of Belvidere, Illinois, was charged with nine counts of engaging in a scheme to defraud Medicare.
February 11, 2014; U.S. Department of Justice
Durable Medical Equipment Clinic Owner Sentenced for His Role in $11 Million Health Care Fraud Scheme
The former owner of a defunct durable medical equipment (DME) clinic was sentenced today in Miami to serve 70 months in prison for his role in an $11 million health care fraud scheme involving World Class Medical Clinic Corp. Francisco Enrique Chavez, 36, of Miami, was sentenced by U.S. District Judge Patricia A. Seitz in the Southern District of Florida. In addition to his prison term, Chavez was sentenced to three years of supervised release and ordered to pay $1,713,959 in restitution.
February 10, 2014; U.S. Department of Justice
Government Settles False Claims Act Allegations against Kentucky Addiction Clinic, Clinical Lab and Two Doctors for $15.75 Million
SelfRefind, a chain of addiction treatment clinics, PremierTox LLC, a clinical laboratory that performs urine testing and Drs. Bryan Wood and Robin Peavler, the owners of SelfRefind and PremierTox, have agreed to pay $15.75 million to resolve allegations that they violated the False Claims Act by submitting claims to Medicare and Kentucky's Medicaid program for tests that were medically unnecessary, more expensive than those performed or billed in violation of the Stark Law, the Department of Justice announced today. SelfRefind provides addiction services to Medicare and Medicaid beneficiaries in 12 locations across Kentucky.
February 7, 2014; U.S. Attorney; District of Maryland
Prince Frederick Physician Admits To Illegal Drug Distribution and Health Care Fraud Scheme
Greenbelt, Maryland - Physician George Mathews, age 76, of Prince Frederick, Maryland, pleaded guilty today to the illegal distribution of drugs and health care fraud. According to his plea agreement, Mathews had medical offices in Prince Frederick and in Waldorf, Maryland. From January 2007 to July 2011, Mathews repeatedly wrote prescriptions for drugs that he knew were without any legitimate medical purpose. On a number of occasions, Mathews prescribed drugs after being made aware that his patients were either selling or abusing the prescribed drugs. In addition, numerous patients stated that Mathews performed little or no examination before writing the prescriptions.
February 7, 2014; U.S. Attorney; District of Maryland
Car Repair Shop Owner and His Son Admit To Drug Trafficking and Armed Commercial Burglaries
Baltimore, Maryland -Chad Paschall, age 28, of Baltimore, pleaded guilty today to conspiring to distribute oxycodone and two counts of conspiring to commit bank burglary. His father, David Paschall, age 54, of Catonsville, Maryland, pleaded guilty yesterday to the drug and burglary conspiracies.
February 6, 2014; U.S. Attorney; Eastern District of Texas
Houston Man Sentenced in Multi-State Health Care Fraud Scheme
SHERMAN, Texas - A 55-year-old Houston man has been sentenced to federal prison for his role in a multi-state health care fraud scheme in the Eastern District of Texas, announced U.S. Attorney John M. Bales today. Peter Pedro Egede pleaded guilty on Apr. 4, 2013, to health care fraud and was sentenced to 87 months in federal prison today by U.S. District Judge Marcia A. Crone. Egede was also ordered to pay restitution in the amount of $1,635,447.60 to the Medicare and Medicaid programs and a fine of $12,500.
February 6, 2014; U.S. Attorney; Eastern District of Texas
Former Hospital CFO Charged with Health Care Fraud
TYLER, Texas - The former Chief Financial Officer for Dr. Tariq Mahmood's Texas hospitals has been charged with health care fraud violations in the Eastern District of Texas, announced U.S. Attorney John M. Bales today. Joe White, 66, of Cameron, Texas, was indicted by a federal grand jury on Jan. 22, 2014, and charged with making false statements to the Centers for Medicare and Medicaid Services (CMS) and aggravated identity theft. White appeared for an arraignment hearing today before U.S. Magistrate Judge John D. Love.
February 6, 2014; U.S. Attorney; Northern District of Ohio
Salem Pharmacist Sentenced To Two Years in Prison for Health Care Fraud
A Salem, Ohio, pharmacist was sentenced to two years in prison and ordered to pay more than $300,000 in restitution after previously pleading guilty to health care fraud, said Steven M. Dettelbach, United States Attorney for the Northern District of Ohio and Ohio Attorney General Mike DeWine. Bruce E. Franken, 53, will also be on supervised release for three years upon his release from federal prison.
February 5, 2014; U.S. Attorney; Southern District of New York
Manhattan U.S. Attorney Announces Charges Against Owner Of Bronx Clinic And 23 Other Individuals Involved In Illegal Distribution Of More Than Five Million Oxycodone Pills
Preet Bharara, the United States Attorney for the Southern District of New York, Bridget G. Brennan, the Special Narcotics Prosecutor for the City of New York ("SNP"), James J. Hunt, the Acting Special Agent-in-Charge of the New York Field Division of the U.S. Drug Enforcement Administration ("DEA"), and William Bratton, the Police Commissioner of the City of New York ("NYPD"), announced today the unsealing of an Indictment against 24 defendants in connection with a massive drug distribution ring that operated out of a purported medical clinic with multiple locations in the Bronx, New York, known as "Astramed," and unlawfully distributed more than five million tablets of the prescription painkiller oxycodone over a three-year period. The participants in the distribution ring included doctors, clinic employees, and drug traffickers who oversaw crews of "patients" who they sent into the clinics in order to obtain medically unnecessary prescriptions. The prescriptions were then filled at pharmacies, and the resulting pills resold on the streets of New York and elsewhere.
February 5, 2014; U.S. Attorney; Southern District of Texas
Husband, Wife and Business Associate Charged with Health Care Fraud
HOUSTON - William Owuama, 55, Marla Owuama, 46, and Florida Holiday Island, 64, all of Houston, have been charged in an eight-count indictment alleging conspiracy to commit health care fraud, health care fraud and conspiracy to violate the federal anti-kickback statute, announced United States Attorney Kenneth Magidson.
February 5, 2014; U.S. Attorney; Northern District of Texas
Abilene Dentist Sentenced to 18 Months in Federal Prison and Ordered to Pay Nearly $58,000 in Restitution in Medicaid Fraud Scheme
ABILENE, Texas - Dr. Tuan Truong, aka "Terry Truong," of Abilene, a dentist who practiced pediatric dentistry at Kool Smiles in Abilene, was sentenced this afternoon, by U.S. District Judge Jorge A. Solis, to 18 months in federal prison. Truong pleaded guilty in August 2013 to an Information charging one count of making a false statement in connection with a health care matter. Truong was also ordered to pay $57,969 in restitution to Kool Smiles. Today's announcement was made by U.S. Attorney Sarah R. Saldaņa of the Northern District of Texas.
February 4, 2014; United States; District of New Jersey
New Jersey Doctor Convicted Of Taking Cash Kickbacks For Patient
Newark, N.J. - A doctor practicing in Newark was convicted at trial of receiving cash kickbacks for diagnostic testing referrals, becoming the 14th doctor and 16th defendant to be convicted in connection with the government's investigation of illegal payments made by an Orange, N.J., diagnostic testing facility, U.S. Attorney Paul J. Fishman announced today. Maryam Jafari, 43, was convicted of all three counts of a superseding indictment charging her with conspiracy and two counts of violating the federal health care anti-kickback statute after a three-week trial before U.S. District Judge Claire C. Cecchi in Newark federal court. The jury returned the guilty verdicts late Tuesday afternoon (Feb. 4, 2014) after two hours of deliberations.
February 4, 2014; U.S. Attorney; Western District of Louisiana
Madison Parish Hospital Administrator, Two Businessmen, Sentenced For Health Care Fraud
MONROE, La. - United States Attorney Stephanie A. Finley announced today that the former Madison Parish Hospital administrator and two of its vendors were sentenced Monday by U.S. District Judge Robert G. James for health care fraud. They pleaded guilty in October and November of 2013.
February 4, 2014; U.S. Attorney; Southern District of Texas
Speech Therapist and Office Manager Charged with Fraud
HOUSTON - Rebecca Lee Rabon, 44, and Tiffany Nicole Thompson, 31, both of Houston, have been charged in a 44-count indictment alleging conspiracy to commit health care fraud, health care fraud and aggravated identity theft, announced United States Attorney Kenneth Magidson along with Special Agent in Charge Janice Flores of the Defense Criminal Investigative Service (DCIS) - Southwest Field Office in Arlington.
February 3, 2014; U.S. Attorney; Northern District of Texas
Federal Jury Convicts Pharmacist, Physician's Office Manager and Three Drug Dealers in "Pill Mill" Operation
Dallas - A federal jury returned guilty verdicts late this afternoon against five individuals convicted for their roles in a pill mill conspiracy that operated in Dallas since 2010. The trial began Monday, January 27, 2013, in Dallas federal court before U.S. District Judge Barbara M. G. Lynn. Today's announcement was made by U.S. Attorney Sarah R. Saldaña of the Northern District of Texas.
February 3, 2014; U.S. Attorney; District of South Dakota
Rosebud Woman Charged With False Statements Relating to Health Care Matters and Attempt to Obtain Controlled Substance by Fraud
United States Attorney Brendan V. Johnson announced that a Rosebud, South Dakota, woman has been indicted by a federal grand jury for False Statements Relating to Health Care Matters and Attempt to Obtain Controlled Substance by Fraud. Letha Leroy, age 48, was indicted on January 15, 2014. She appeared before U.S. Magistrate Judge Mark A. Moreno on January 31, 2014, and pled not guilty to the Indictment.
February 3, 2014; U.S. Department of Justice
Leader of $28.3 Million Medicare Fraud Scheme Pleads Guilty
A Florida man who had been the owner and operator of multiple physical therapy rehabilitation facilities pleaded guilty today for his role in organizing and leading a $28.3 million Medicare fraud scheme involving physical and occupational therapy services. Luis Duluc, 53, formerly of southwest Florida, pleaded guilty in the U.S. District Court for the Middle District of Florida to conspiracy to commit health care fraud and making a false statement relating to health care matters. His sentencing date will be set by the court. He faces a maximum penalty of 15 years in prison.

January 2014

January 31, 2014; U.S. Department of Justice
Queens, N.Y., Doctor Sentenced for His Role in $15 Million Medicare Fraud Scheme
A Queens, N.Y., medical doctor was sentenced today to serve 12 months and a day in prison for his role in a scheme that fraudulently billed Medicare more than $15 million for, among other things, physical therapy and lesion removal services that were medically unnecessary and never provided. Hoi Yat Kam, 59, was sentenced by U.S. District Judge Edward R. Korman in the Eastern District of New York. In addition to his prison term, Kam was sentenced to serve three years of supervised release and to pay $2,217,656 in restitution.
January 31, 2014; U.S. Attorney; Western District of Michigan
Kentwood Pharmacy Owner and Thirteen Additional Employees Face Federal Charges
Grand Rapids, Michigan - U.S. Attorney Patrick Miles announced today that a federal grand jury returned a Second Superseding Indictment levelling additional charges against Kim Mulder, the CEO of Kentwood Pharmacy, and thirteen employees of the pharmacy. The indictment charges that Mulder conspired with Richard Clarke, Kentwood Pharmacy's Director of Sales, and Lawrence Harden, Kentwood Pharmacy's Chief Pharmacist, to return, restock and re-dispense drugs that were previously dispensed to nursing homes and adult foster care homes.
January 30, 2014; U.S. Department of Justice
Three Miami Residents Indicted for Alleged Roles in $190 Million Medicare Fraud Scheme
Three Miami residents have been indicted for their alleged participation in a $190 million Medicare fraud scheme. On Jan. 28, 2014, a federal grand jury in Miami returned a 10-count indictment charging Nelson Rojas, 43, Roger Bergman, 64, and Rodolfo Santaya, 54, for allegedly participating in a scheme to defraud Medicare by submitting false and fraudulent claims, from approximately December 2002 to October 2010.
January 30, 2014; U.S. Attorney; District of South Dakota
St. Francis Man Charged With False Statements and Fraud
United States Attorney Brendan V. Johnson announced that a St. Francis, South Dakota, man has been indicted by a federal grand jury for False Statements Relating to Health Care Matters and Attempt to Obtain Controlled Substance by Fraud.
January 30, 2014; U.S. Attorney; District of South Dakota
Idaho Man Sentenced for Failure to Pay Child Support
United States Attorney Brendan V. Johnson announced that a Post Falls, Idaho, man convicted of three counts of Failure to Pay Legal Child Support was sentenced on January 23, 2014, by Chief Judge Jeffrey L. Viken, U.S. District Court.
January 30, 2014; U. S. Attorney; Eastern District of Missouri
St. Charles Doctor Pleads Guilty To Medicare Fraud
St. Louis, MO - Dr. Khaled Hassan, St. Charles County, pled guilty to billing Medicare for "face to face" office visits performed on dates when he was actually traveling outside of the United States.
January 30, 2014; U.S. Attorney; Eastern District of California
Physician Practicing in Grass Valley and Yuba City Indicted for Illegal Prescription Practice
Sacramento, Calif. - A federal grand jury returned a six-count indictment today against Nicholas J. Capos Jr., 63, of Granite Bay, charging him with one count of conspiracy to distribute, dispense, and possess with intent to distribute oxycodone, and five counts of illegal distribution and dispensation of oxycodone, United States Attorney Benjamin B. Wagner announced.
January 29, 2014; U.S. Department of Justice
Kentucky Hospital Agrees to Pay Government $16.5 Million to Settle Allegations of Unnecessary Cardiac Procedures
Saint Joseph Health System Inc. has agreed to pay $16.5 million to resolve allegations that Saint Joseph Hospital violated the False Claims Act by submitting false claims to the Medicare and Kentucky Medicaid programs for a variety of medically unnecessary cardiac procedures, the Justice Department announced today. Saint Joseph Health System operates numerous hospitals statewide, including Saint Joseph Hospital, which is based in London, Ky.
January 29, 2014; U.S. Attorney; Southern District of Indiana
Hogsett Announces Charges against Indianapolis Man for Health Care Fraud
Joseph H. Hogsett, the United States Attorney, announced today that Ronald Reed, age 46, has been charged with conspiring to commit health care fraud in a scheme that involved the sale of electric wheelchairs and scooters and the potential loss of hundreds of thousands in taxpayer dollars. This comes as Hogsett's office has continued an effort to crack down on white collar fraud in Indiana's business community.
January 29, 2014; U.S. Attorney; Northern District of Ohio
Seven Ohio Oncologists Ordered To Pay $2.6 Million
Seven Ohio oncologists have been ordered to collectively pay nearly $2.6 million after pleading guilty to importing cancer medications that had not been approved by the Federal Drug Administration, said Steven M. Dettelbach, United States Attorney for the Northern District of Ohio.
January 28, 2014; U.S. Attorney; District of Maine
Scarborough Man Sentenced to 9 Years on Drug and Health Care Fraud Charges
Portland, Maine - United States Attorney Thomas E. Delahanty II announced that Adam Goodwin, 39, of Scarborough, Maine, was sentenced today in U.S. District Court by Judge George Singal to 9 years in prison and 3 years of supervised release for conspiracy to distribute oxycodone and health care fraud. Goodwin pled guilty to the charges on July 29, 2013.
January 28, 2014; U.S. Department of Justice
Patient Recruiter Pleads Guilty in Connection With $13 Million Health Care Fraud Scheme
Pavel Zborovskiy, 57, of Brooklyn, N.Y., pleaded guilty today to conspiracy to pay and receive illegal health care kickbacks in connection with a $13 million health care fraud and money laundering scheme. Zborovskiy pleaded guilty before U.S. District Judge Nina Gershon of the Eastern District of New York and is the sixth defendant to plead guilty in connection with the scheme. At sentencing on May 28, 2014, Zborovskiy faces a maximum penalty of five years in prison and a fine of more than $2.5 million.
January 28, 2014; U.S. Attorney; Eastern District of Kentucky
Saint Joseph London Hospital to Pay $16.5 Million to Settle False Claims Act Allegations of Unnecessary Heart Procedures
London, KY - Saint Joseph Health System, Inc., d/b/a Saint Joseph London Hospital ("Saint Joseph") has agreed to pay the U.S. Government $16.5 million to resolve civil allegations that it submitted false or fraudulent claims to the Medicare and Kentucky Medicaid programs for a variety of medically unnecessary heart procedures. According to the settlement agreement, the U.S. Government contends that from January 1, 2008 until August 31, 2011, several doctors working at the hospital performed numerous invasive cardiac procedures on Medicare and Medicaid patients who did not need them. The hospital then billed the federal programs for these unnecessary procedures, which include coronary stents, pacemakers, coronary artery bypass graft surgeries ("CABGS"), and diagnostic catheterizations.
January 27, 2014; U.S. Department of Justice
Medicare Fraud Strike Force Set Record Numbers for Health Care Fraud Prosecutions
The Justice Department's Medicare Fraud Strike Force has set record numbers for health care prosecutions in Fiscal Year 2013, demonstrating the targeted and coordinated approach remains strong as the strike force enters its eighth year of fighting fraud against the government's health care programs. In Fiscal Year 2013, the strike force set records in the number of cases filed (137), individuals charged (345), guilty pleas secured (234) and jury trial convictions (46). In addition, the defendants who were charged and sentenced are facing significant time in prison - an average of 52 months in prison for those sentenced in FY 2013, and an average of 47 months in prison for those sentenced since 2007.
January 27, 2014; U.S. Attorney; Northern District of Illinois
Illinois Hospice Executive Charged with Federal Health Care Fraud for Allegedly Falsely Elevating Level of Patients' Care
CHICAGO-An owner of an Illinois hospice company was charged with federal health care fraud for allegedly engaging in an extensive scheme to obtain higher Medicare and Medicaid payments by fraudulently elevating the level of hospice care for patients, many of whom resided at nursing homes he also controlled across the state. In many instances, the level of hospice care allegedly exceeded what was medically necessary or actually provided, including for some patients who did not have terminal illnesses or who were enrolled far longer?sometimes for several years?than the required life expectancy of six months or less.
January 24, 2014; U.S. Attorney; Northern District of Ohio
Solon Couple Indicted For $750,000 Health Care Fraud
A Solon couple was indicted on nine counts of health care fraud for defrauding Medicaid out of approximately $750,000 by providing ambulette rides to patients who did not use or need wheelchairs, said Steven M. Dettelbach, United States Attorney for the Northern District of Ohio, and Ohio Attorney General Mike DeWine.
January 24, 2014; U.S. Department of Justice
Disbarred Attorney Pleads Guilty for Role in $28.3 Million Medicare Fraud Scheme
A North Carolina woman has pleaded guilty for her involvement in a $28.3 million Medicare fraud scheme involving physical and occupational therapy services. Margarita M. Grishkoff, 59, of Charlotte, N.C., and formerly of southwest Florida, pleaded guilty today in the U.S. District Court for the Middle District of Florida to conspiracy to commit health care fraud. Her sentencing date will be set by the court. She faces a maximum penalty of 10 years in prison.
January 24, 2014; U.S. Department of Justice
Home Health Agency Owner Sentenced for Role in $11 Million Detroit Medicare Fraud Scheme
A home health agency owner who participated in a Medicare fraud scheme that totaled almost $11 million was sentenced in Detroit today to serve 120 months in prison. Chiradeep Gupta, 39, was sentenced by U.S. District Judge Denise Page Hood in the Eastern District of Michigan. In addition to his prison term, Gupta was sentenced to serve three years of supervised release and was ordered to pay more than $10 million in restitution, jointly and severally with his co-defendants.
January 24, 2014; U.S. Department of Justice
Tennessee and Virginia Orthopedic Clinics to Pay $1.85 Million to Settle Allegations of Billing Medicare for Reimported Products
WASHINGTON - Two orthopedic clinics will pay a combined $1.85 million to resolve state and federal False Claims Act allegations that they knowingly billed state and federal health care programs for reimported osteoarthritis medications, known as viscosupplements, the Department of Justice announced today. Tennessee Orthopaedic Clinics P.C., headquartered in Knoxville, Tenn., will pay $1.3 million, and Appalachian Orthopaedic Clinics P.C., headquartered in Kingsport, Tenn., will pay $550,000.
January 24, 2014; U.S. Attorney; District of New Jersey
Pharmacist Admits Multiple Sales Of Oxycodone Without A Prescription, Agrees To Forfeit $1.5 Million
Newark, N.J. - The former pharmacist-in-charge of West Orange Pharmacy today admitted to illegally distributing hundreds of tablets of oxycontin in exchange for thousands of dollars in cash, U.S. Attorney Paul J. Fishman announced.
January 23, 2014; U.S. Attorney; Western District of Kentucky
Owners of Durable Medical Equipment Companies Sentenced To 54 Months in Prison for Their Roles in a Multi-Million Dollar Health Care Fraud Scheme
Louisville, KY - The former owners of two, now defunct durable medical equipment companies were sentenced to 54 months in prison, and ordered to pay $1,940,043.84 in restitution, by U.S. District Judge John G. Heyburn II, for conspiracy, health care fraud, submitting false claims and wire fraud announced David J. Hale, United State Attorney for the Western District of Kentucky.
January 23, 2014; U.S. Department of Justice
Owner of Houston Medical Equipment Companies Indicted for $3.4 Million Medicare Fraud Scheme
Huey P. Williams Jr., the owner and operator of two durable medical equipment (DME) companies, was arrested yesterday for his alleged role in a $3.4 million Medicare fraud scheme. The indictment charges Williams, 44, of Katy, Texas, with one count of health care fraud, which carries a maximum penalty of 10 years in prison upon conviction. Williams is expected to make his initial appearance in U.S. District Court for the Southern District of Texas in Houston.
January 23, 2014; U.S. Department of Justice
Home Health Agency Owner and Director of Nursing Indicted
The operator and director of nursing of a home health agency based in Richmond, Texas, was arrested yesterday for her alleged role in a Medicare fraud scheme and a conspiracy to structure bank withdrawals. The owner and operator of the same home health agency was also arrested yesterday for his alleged role in the conspiracy to structure bank withdrawals.
January 21, 2014; U.S. Attorney; Middle District of Pennsylvania
Millcreek Township School District Agrees to Pay Government $350,000 to Resolve Allegation of Improper Medicaid Reimbursement
The United States Attorney's Office for the Middle District of Pennsylvania announced that Millcreek Township School District has agreed to pay the United States $350,000 to resolve allegations that it submitted improper claims to the Medicaid-funded School Based Access Program. Millcreek Township School District is the public school system for students residing in Millcreek Township, Pennsylvania, a suburb of Erie.
January 17, 2014; U.S. Attorney; District of South Dakota
Kadoka Man Sentenced For Destruction of Government Property
United States Attorney Brendan V. Johnson announced that a Kadoka, South Dakota, man convicted of Destruction of Government Property was sentenced on January 13, 2014, by Chief Judge Jeffrey L. Viken, U.S. District Court.
January 17, 2014; U.S. Department of Justice
Nationwide Contract Therapy Providers to Pay $30 Million to Resolve False Claims Act Allegations
Contract therapy providers RehabCare Group Inc., RehabCare Group East Inc. and Rehab Systems of Missouri and management company Health Systems Inc. have agreed to pay $30 million to resolve claims that they violated the False Claims Act by engaging in a kickback scheme related to the referral of nursing home business, the Justice Department announced today. Additionally, as part of this settlement, the entities have agreed to restructure their business arrangement.
January 17, 2014; U.S. Department of Justice
Miami Patient Recruiter Pleads Guilty for Role in $190 Million Medicare Fraud Scheme
A patient recruiter for a fraudulent Miami-area mental health company, American Therapeutic Corporation (ATC), pleaded guilty today for her participation in a $190 million Medicare fraud scheme. Miami resident Mayelin Santoyo, 28, pleaded guilty before U.S. District Judge K. Michael Moore in the Southern District of Florida to one count of conspiracy to receive health care kickbacks. Sentencing has been scheduled for March 28, 2014.
January 17, 2014; U.S. Attorney; Middle District of Tennessee
Former Owners of Murfreesboro Ambulance Service Sentenced To Federal Prison for Defrauding Medicare
Woody Medlock, Sr., 70, and his wife, Kathy Medlock, 58, of Murfreesboro, Tennessee, former owners of Murfreesboro Ambulance Service, were sentenced yesterday to federal prison for Medicare fraud and aggravated identity theft, announced David Rivera, U.S. Attorney for the Middle District of Tennessee.
January 17, 2014; U.S. Attorney; District of South Dakota
Idaho Man Found Guilty Of Failure to Pay Legal Child Support
United States Attorney Brendan V. Johnson announced that David E. Cox, age 47, of Post Falls, Idaho, was found guilty by a federal jury in Rapid City, South Dakota, of 3 counts of Failure to Pay Legal Child Support.
January 16, 2014; U.S. Attorney; District of Kansas
Manhattan Physician Pleads Guilty To Unlawfully Prescribing Prescription Drugs
TOPEKA, KAN. - A Manhattan, Kan., physician pleaded guilty today to unlawfully prescribing prescription drugs, U.S. Attorney Barry Grissom said. Michael P. Schuster, 54, Manhattan, Kan., pleaded guilty to one count of conspiracy to distribute controlled substances.
January 15, 2014; U.S. Attorney; Eastern District of Pennsylvania
Brotherly Love Ambulance EMT Pleads Guilty to Health Care Fraud Scheme
PHILADELPHIA - Neel Jackson, 35, of Philadelphia, PA, pleaded guilty today to health care fraud in connection with a scheme involving Brotherly Love Ambulance, Inc. A sentencing hearing is scheduled for April 17, 2014.
January 13, 2014; U.S. Attorney; Central District of California
San Fernando Valley Woman Pleads Guilty to Federal Charges in $25 Million Health Care Fraud Case
Los Angeles-A North Hollywood woman who worked in the health care industry pleaded guilty today to federal charges for orchestrating a scheme that submitted nearly $25 million in fraudulent bills to Medicare for services and supplies, including power wheelchairs and diagnostic tests that were medically unnecessary and sometimes were never provided.
January 13, 2014; U.S. Attorney; Eastern District of New York
United States Settles Action against New York City Department of Education for Submitting False Claims to Medicaid for Psychological Services to Special Education Students
Loretta E. Lynch, United States Attorney for the Eastern District of New York, today announced that the United States has entered into a settlement with the City of New York in the case of Ohlmeyer ex rel. United States of America v. City of New York, a whistleblower action brought pursuant to the qui tam provisions of the federal False Claims Act, 31 U.S.C. Sections 3729-33 (the FCA). In its civil complaint, the United States alleged that the City of New York Department of Education (DOE) submitted false claims to Medicaid for psychological counseling services to special education students in the New York City public schools. The settlement calls for the City to pay $1,375,000 to the United States.
January 13, 2014; U.S. Department of Justice
Government Intervenes In Lawsuits against Health Management Associates Inc. Hospital Chain Alleging Unnecessary Inpatient Admissions and Payment of Kickbacks
WASHINGTON - The government has intervened in eight False Claims Act lawsuits against Health Management Associates Inc. (HMA) alleging that HMA billed federal health care programs for medically unnecessary inpatient admissions from the emergency departments at HMA hospitals and paid remuneration to physicians in exchange for patient referrals, the Justice Department announced today. The government also has joined in the allegations in one of these lawsuits that Gary Newsome, HMA's former CEO, directed HMA's corporate practice of pressuring emergency department physicians and hospital administrators to raise inpatient admission rates, regardless of medical necessity. HMA operates 71 hospitals in 15 states: Alabama, Arkansas, Florida, Georgia, Kentucky, Mississippi, Missouri, North Carolina, Oklahoma, Pennsylvania, South Carolina, Tennessee, Texas, Washington and West Virginia.
January 10, 2014; U.S. Department of Justice
Former HealthEssentials Solutions Inc. Executives To Pay More Than $1 Million To Resolve Allegations Of Submitting False Claims To Federal Health Care Program
WASHINGTON - Michael R. Barr, former chief executive officer of Louisville, Kentucky-based HealthEssentials Solutions Inc., has paid $1 million to resolve allegations that he knowingly caused HealthEssentials to submit false claims to Medicare between 1999 and 2004, the Justice Department announced today. Norman J. Pfaadt, HealthEssentials' former chief financial officer, also agreed to pay $20,000 to resolve similar allegations. HealthEssentials provided primary medical care to patients in nursing facilities, assisted living facilities and other settings from 1998 until it filed for bankruptcy and ceased operations in 2005.
January 10, 2014; U.S. Attorney; Southern District of Texas
McAllen Area Ambulance Company Owner Charged with Multiple Health Care Fraud Allegations
McAllen, Texas ? The owner of a McAllen area ambulance transportation company has turned himself into federal authorities following the return of a federal indictment alleging a scheme to defraud Medicare and Texas Medicaid through fraudulent billings, announced United States Attorney Kenneth Magidson and Texas Attorney General Greg Abbott.
January 10, 2014; U.S. Attorney; Southern District of Illinois
Centreville Woman Sentenced For Health Care Fraud
Stephen R. Wigginton, United States Attorney for the Southern District of Illinois, announced today that Valerie W. Johnson, 56, of Centreville, Illinois, was sentenced in United States District Court in East St. Louis, Illinois on one count of Health Care Fraud.
January 9, 2014; U.S. Attorney; District of New Jersey
Pharmacist Charged With Paying More Than $50,000 in Kickbacks to Doctor for Prescription Referrals
Newark, N.J. - A pharmacist with a compounding pharmacy in Lakewood, N.J., was arrested today and charged with paying more than $50,000 to a Toms River, N.J., physician to induce the doctor to make prescription referrals to the pharmacy, U.S. Attorney Paul J. Fishman announced. Vladimir Kleyman, 42, of Lakewood, N.J., the president and pharmacist in charge of Prescriptions R US - a compounding pharmacy in Lakewood - was charged with violating the Anti-Kickback Statute by using a middle-man to provide repeated cash payments - totaling at least tens of thousands of dollars - to a N.J. physician over the course of several months.
January 9, 2014; U.S. Department of Justice
Justice Department Collects More Than $8 Billion in Civil and Criminal Cases in Fiscal Year 2013
Attorney General Eric Holder today announced that the Justice Department collected at least $8 billion in civil and criminal actions in the fiscal year ending Sept. 30, 2013. The statistics indicate that in FY 2013, approximately $5.9 billion was collected by the department's litigating divisions and the U.S. Attorneys' offices in individually and jointly handled civil actions. The largest civil collections were from affirmative civil enforcement cases, in which the United States recovered government money lost to fraud or other misconduct and collected fines imposed on individuals and/or corporations for violations of federal health, safety, civil rights or environmental laws. This number includes approximately $3.2 billion related to health care fraud and more than $430 million related to environmental cases. In addition, civil debts were collected on behalf of several federal agencies, including the Department of Housing and Urban Development, the Department of Health and Human Services, the Internal Revenue Service, the Small Business Administration and the Department of Education.
January 9, 2014; U.S. Department of Justice
CareFusion to Pay the Government $40.1 Million to Resolve Allegations That Include More Than $11 Million in Kickbacks to One Doctor
CareFusion Corp. has agreed to pay the government $40.1 million to settle allegations that it violated the False Claims Act by paying kickbacks and promoting its products for uses that were not approved by the Food and Drug Administration, the Justice Department announced today. CareFusion, a California-based medical technology company, develops, manufactures and sells pharmaceutical products, including products sold under the trade name ChloraPrep.
January 9, 2014; U.S. Attorney; Eastern District of California
Southern California Doctor Sentenced to over 3 Years in Prison for Medicare Fraud Scheme
Sacramento, Calif. - Dr. Emilio Louis Cruz III, 61, of Carson, Calif., was sentenced today by United States District Judge Morrison C. England Jr. to three years and two months in prison and ordered to pay $601,581 in restitution for his role in a conspiracy to commit Medicare fraud, United States Attorney Benjamin B. Wagner announced.
January 9, 2014; U.S. Attorney; Eastern District of Pennsylvania
Brotherly Love Ambulance EMT Charged In Health Care Fraud Scheme
Philadelphia - Neel Jackson, 35, of Philadelphia, PA, was charged today by Information with Health Care Fraud and aiding and abetting health care fraud, announced United States Attorney Zane David Memeger. In July 2010, Feda Kuran, who is charged elsewhere and has pleaded guilty, began operating Brotherly Love Ambulance, Inc. with a co-schemer. According to the Information, Jackson, an Emergency Medical Technician (EMT) employed by Brotherly Love, transported patients by ambulance when those patients could have been transported safely by other means and were, therefore, not eligible for ambulance service under Medicare and Medicaid requirements.
January 8, 2014; U.S. Attorney; Southern District of New York
Manhattan U.S. Attorney Simultaneously Files Additional Healthcare Fraud Claims Against Novartis Pharmaceuticals Corp. And Settles Lawsuit against Bioscrip, Inc., In Connection With a Multimillion-Dollar Kickback Scheme Involving a Prescription Drug
Preet Bharara, the United States Attorney for the Southern District of New York, and Ronald T. Hosko, the Assistant Director of the Federal Bureau of Investigation, Criminal Investigative Division ("FBI"), announced today that the United States has filed additional civil healthcare fraud claims in Manhattan federal court against NOVARTIS PHARMACEUTICALS CORP. ("NOVARTIS") and BIOSCRIP, INC. ("BIOSCRIP"). The Government's Amended Complaint seeks treble damages and civil penalties under the False Claims Act against NOVARTIS and BIOSCRIP for NOVARTIS providing kickbacks, in the form of patient referrals and in the guise of rebates, to BIOSCRIP in exchange for BIOSCRIP recommending refills to Exjade patients. The lawsuit alleges that, as a result of this kickback scheme, Medicare and Medicaid have paid tens of millions of dollars in reimbursements based on false, kickback-tainted claims for Exjade shipped by BIOSCRIP.
January 7, 2014; U.S. Attorney: Eastern District of Washington
United States Department Of Justice And The State Of Washington Announce Successful Health Care Fraud Settlement With Dr. Abhijit Deshpande And Pinnacle Health Care
Spokane - Michael C. Ormsby, United States Attorney for the Eastern District of Washington, announced that the United States and the State of Washington have reached a civil settlement on behalf of the United States Department of Health and Human Services which administers the Medicare program and the Washington State Health Care Authority which administers the Medicaid program in the amount of $89, 965.38 for claims that Dr. Abhijit Deshpande and his clinics, the Yakima Sleep Center in Yakima, Washington, and the Pinnacle Sleep & Wake Disorder Center in Kennewick, Washington, both operating under the umbrella of his business Pinnacle Health Care, incorrectly overbilled the federal and state health care programs between January 1, 2009 through August 31, 2011.
January 7, 2014; U.S. Department of Justice
United States Government Settles False Claims Act Allegations against Florida Vein Clinic and
Its Owner

A Florida-based physician, Dr. Ravi Sharma, has agreed to pay $400,000 to resolve allegations that he and his clinics violated the False Claims Act by knowingly billing Medicare for vein injections and physician office visits performed by unqualified personnel, the Justice Department announced today.
January 7, 2014; U.S. Department of Justice
Medical Clinic Owner and Other Patient Recruiters Plead Guilty in Miami for Roles in $8 Million Health Care Fraud Scheme
Several patient recruiters, including a medical clinic owner, pleaded guilty today in connection with a health care fraud scheme involving Flores Home Health Care Inc., a defunct home health care company. At a hearing held before U.S. District Judge Ursula Ungaro of the Southern District of Florida, Lerida Labrada, 59, of Miami, pleaded guilty to conspiracy to commit health care fraud, which carries a maximum penalty of 10 years in prison, and Mayra Flores, 49, and German Martinez, 36, both of Miami, pleaded guilty to conspiracy to defraud the United States and receive health care kickbacks, which carries a maximum penalty of five years in prison. Sentencing has been scheduled for March 14, 2014.
January 7, 2014; U.S. Department of Justice
Medical Clinic Owner Pleads Guilty in Miami for Role in Multiple Health Care Fraud Schemes Totaling Over $20 Million
The owner and operator of a Miami medical clinic pleaded guilty today in connection with multiple health care fraud schemes involving the defunct clinic Merfi Corp. Isabel Medina, 49, of Miami, pleaded guilty before U.S. District Judge Ursula Ungaro of the Southern District of Florida to conspiracy to commit health care fraud, which carries a maximum penalty of 10 years in prison. Sentencing has been scheduled for March 14, 2014.
January 6, 2014; U.S. Attorney; Eastern District of Pennsylvania
Medical Center Agrees To $2 Million Settlement of Voluntary Disclosure
The United States announces that it has settled claims under the False Claims Act with St. Mary Medical Center (SMMC) for improperly administering certain physician income guarantee agreements. SMMC voluntarily disclosed the allegations and has agreed to pay $2,339,224.70 to resolve the matter.
January 7, 2014; U.S. Attorney; Northern District of Texas
Man Convicted at Trial for Role in Nearly $3 Million Health Care Fraud Scheme Involving the Operation of Euless Healthcare Corp. Sentenced to 72 Months in Federal Prison
Dallas-Godwin Umotong, 58, was sentenced by U.S District Judge David C. Godbey to 72 months in federal prison and ordered to pay $880,000 in restitution following his conviction at trial in April 2013 on charges stemming from his involvement in the operation of Euless Healthcare Corporation (EHC) and Medic Healthcare Incorporated (Medic). Umotong is the last of six defendants sentenced in the conspiracy. Judge Godbey ordered that Umotong, a resident of Houston, surrender to the Bureau of Prisons in March. Today's announcement was made by U.S. Attorney Sarah R. Saldaña of the Northern District of Texas.
January 7, 2014; U.S. Attorney; Western District of North Carolina
Former Clinic Owner Pleads Guilty To $3.4 Million Medicaid Fraud Scheme
Charlotte, N.C. - A Charlotte man pleaded guilty today for his involvement in a health care fraud scheme that attempted to defraud Medicaid of at least $3.4 million for sham mental and behavioral health services, announced Anne M. Tompkins, U.S. Attorney for the Western District of North Carolina. Ronnie Lorenzo Robinson, 36, of Charlotte, pleaded guilty today before U.S. Magistrate Judge David S. Cayer to two counts of health care fraud. At today's plea hearing, Robinson admitted that from in or about 2007 to in or about 2011, he engaged in a scheme to defraud Medicaid of at least $3.4 million in fraudulent reimbursement payments from false claims submitted to Medicaid.
January 6, 2014; U.S. Attorney; District of Columbia
Total Care Services to Pay $187,500 to Resolve False Claims Allegations Company, a D.C. Medicaid Provider, Was Accused of Billing for Services without Proper Documentation
WASHINGTON - Total Care Services and its owner have agreed to pay $187,500 to resolve allegations that they violated the False Claims Act by knowingly billing Medicaid for patient services for which they had no, insufficient, or inaccurate documentation.
January 6, 2014; U.S. Attorney; District of New Jersey
Doctor Admits Taking Bribes in Test-Referrals Scheme with New Jersey Clinical Lab
Newark, N.J. - A doctor with a family medicine practice in New Jersey admitted today to accepting bribes in exchange for test referrals as part of a long-running scheme operated by Biodiagnostic Laboratory Services LLC (BLS), of Parsippany, N.J., its president and numerous associates, New Jersey U.S. Attorney Paul J. Fishman announced. Joel Fischgrund, 60, of Livingston, N.J., pleaded guilty today before U.S. District Judge Stanley R. Chesler in Newark federal court to one count of accepting bribes.

Top

Return to Enforcement Actions

I'm Looking For

Let's start by choosing a topic

Exclusions Database Report Fraud
Newsletter Sign Up Envelop Graphic

Stay up to date on the latest OIG news and opinions

Office of Inspector General, U.S. Department of Health and Human Services | 330 Independence Avenue, SW, Washington, DC 20201