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Criminal and Civil Enforcement

February 2019

February 21, 2019; U.S. Attorney; Western District of Missouri
Jury Convicts Former Dental Clinic Owners of $1 Million Health Care, Payroll Tax Fraud
SPRINGFIELD, Mo. - U.S. Attorney Tim Garrison and Missouri Attorney General Eric Schmitt announced today that a Marshfield, Mo., couple has been convicted by a federal trial jury of multiple fraud schemes totaling more than $1 million that involved Medicaid payments to their dental clinics, failing to pay over payroll taxes and collecting unemployment benefits they were not entitled to receive.
February 21, 2019; U.S. Attorney; District of Massachusetts
Newton Physician to Pay $680,000 to Resolve Allegations of Medicare and Medicaid Fraud
BOSTON - The U.S. Attorney's Office announced today that Dr. Hooshang Poor, a Newton geriatric medicine physician, has agreed to pay $680,000 to resolve allegations that he violated the False Claims Act by submitting inflated claims to Medicare and the Massachusetts Medicaid program (MassHealth) for care rendered to nursing home patients.
February 20, 2019; U.S. Department of Justice
Miami Medical Clinic Owner Pleads Guilty to Health Care Fraud Scheme
A Miami, Florida-area medical clinic owner pleaded guilty today for her role in a scheme to defraud Medicare by submitting fraudulent billings from the clinic and by supplying patients to three home health agencies that submitted fraudulent bills for home health services.
February 19, 2019; U.S. Department of Justice
United States Joins False Claims Act Lawsuit Against Arriva Medical LLC and Alere Inc.
The United States has intervened in a False Claims Act case alleging that Arriva Medical LLC (Arriva) and its parent Alere Inc. (Alere) submitted or caused false claims to the Medicare program for medically unnecessary glucometers and paid kickbacks to Medicare beneficiaries in the form of free glucometers and copayment waivers, the Justice Department announced today. Additionally, the government has informed the court that it is adding Ted Albin, a reimbursement consultant for Arriva, as an additional defendant in the action.
February 19, 2019; U.S. Attorney; Northern District of Oklahoma
Tulsa Doctor Will Pay $84,666 for Allegedly Engaging in an Illegal Kickback Scheme
TULSA, Okla. -A Tulsa doctor has agreed to pay the government $84,666.42 for allegedly accepting illegal kickback payments from OK Compounding, LLC, announced U.S. Attorney Trent Shores.
February 19, 2019; U.S. Attorney; Southern District of Florida
Stuart Physician Convicted of 23 Counts of Health Care Fraud
On February 19, 2019, a doctor who previously worked in Stuart, Florida, was convicted by a federal jury of committing repeated acts of health care fraud.
February 15, 2019; U.S. Department of Justice Medicare Fraud Strike Force Case
Michigan Patient Recruiter Pleads Guilty in $1.2 Million Kickback Scheme
A Michigan woman pleaded guilty today for her role as a patient recruiter in a scheme involving approximately $1.2 million in fraudulent Medicare claims for home health care procured through the payment of kickbacks.
February 14, 2019; U.S. Department of Justice
Florida Compounding Pharmacy and Its Owners to Pay at Least $775,000 to Resolve False Claims Act Allegations
The Department of Justice announced today that Vital Life Institute LLC (formerly known as AgeVital Pharmacy LLC), located in Sarasota, Florida, and owners Jenny and William Wilkins have agreed to pay at least $775,000 to resolve claims that they violated the False Claims Act by engaging in an illegal kickback scheme to induce the referral of compounded drug prescriptions for TRICARE and Medicare beneficiaries. AgeVital and the Wilkinses have agreed to pay additional amounts in the event certain contingencies are triggered.
February 14, 2019; U.S. Department of Justice Medicare Fraud Strike Force Case
Baton Rouge Doctor and His Medical Billing Supervisor Plead Guilty to Fraudulent Billing Scheme
A Baton Rouge, Louisiana-based doctor pleaded guilty yesterday and his medical billing supervisor pleaded guilty today for their roles in a scheme to defraud Medicare and other health care insurers.
February 14, 2019; U.S. Attorney; Eastern District of Pennsylvania
Prime Healthcare Services and CEO, Dr. Prem Reddy, to Pay $1.25 Million to Settle False Claims Act Allegations
PHILADELPHIA - U.S. Attorney William M. McSwain announced today that Prime Healthcare Services, Inc. ("Prime") and Prime's Founder and Chief Executive Officer, Dr. Prem Reddy, have agreed to pay the United States $1.25 million to settle allegations that two Prime hospitals in Pennsylvania - Roxborough Memorial Hospital in Philadelphia and Lower Bucks Hospital in Bristol - knowingly submitted false claims to Medicare by engaging in the following conduct: (1) admitting patients to the hospital for overnight stays who required only less costly, outpatient care and (2) billing for more expensive patient diagnoses than the patients had (the latter practice known as "up-coding").
February 13, 2019; U.S. Attorney; Western District of Virginia
Former Blacksburg Doctor Sentenced on Federal Drug Charges
Roanoke, VIRGINIA - The former owner of the Virginia Vein Institute in Blacksburg was sentenced yesterday to 20 months in federal prison resulting from his conviction on nearly 70 federal drug charges for illegally obtaining 3,200 oxycodone pills, United States Attorney Thomas T. Cullen and the Virginia Attorney General's Office announced.
February 12, 2019; U.S. Attorney; Southern District of Mississippi
Laurel-Based Physicians Group and Neurologist Agree to Pay Almost One Million Dollars to Resolve False Claims Act Allegations
Settlement Stems from Alleged Medicare Overpayments to Doctors
Jackson, Miss. - Jefferson Medical Associates, a now dissolved, multi-specialty medical practice group in Laurel, and Dr. Aremmia Tanious, have agreed to pay the United States $817,635.06 to resolve claims under the False Claims Act arising from Medicare overpayments to Jefferson Medical Associates and Dr. Tanious, announced U.S. Attorney Mike Hurst.
February 12, 2019; U.S. Attorney; Northern District of New York
Owner of North Country Medical Transportation Company Pleads Guilty to Health Care Fraud, Paying Kickbacks
ALBANY, NEW YORK - Arshad Nazir, age 54, of Ticonderoga, New York, pled guilty today to conspiring to defraud Medicaid, and conspiring to pay bribes and kickbacks to Medicaid beneficiaries who used his medical transportation service. He admitted to causing at least $550,000 in losses, and to paying at least $95,000 in bribes and kickbacks.
February 11, 2019; U.S. Department of Justice
Genetic Testing Company Agrees to Pay $1.99 Million to Resolve Allegations of False Claims to Medicare for Medically Unnecessary Tests
The Justice Department announced today that GenomeDx Biosciences Corp. (GenomeDx) has agreed to pay $1.99 million to resolve allegations that it violated the False Claims Act, 31 U.S.C. 3729 et seq., by submitting claims to Medicare for the Decipher® post-operative genetic test for prostate cancer patients. GenomeDx is a genetic testing laboratory headquartered in Vancouver, British Columbia, with operations based in San Diego.
February 11, 2019; U.S. Attorney; Eastern District of Kentucky
Williamsburg Pharmacist Convicted of Unlawful Drug Distribution
LONDON, Ky. - Kimberly Jones, a Williamsburg pharmacist, was convicted last week, by a federal jury sitting in London, on seven counts of unlawful distribution of controlled substances.
February 8, 2019; U.S. Attorney; Northern District of Oklahoma
Marketer Agrees to Pay Nearly $340,000 for Allegedly Engaging in an Illegal Kickback Scheme with OK Compounding
TULSA, Okla. - James Paul Adams, 35, of Cypress, Texas, also known as Beau Adams, owner of the Texas marketing company One Source Healthcare Organization, LLC, agreed to pay the government $339,412.50 for allegedly accepting illegal kickback payments from OK Compounding, LLC, announced U.S. Attorney Trent Shores.
February 8, 2019; U.S. Attorney; Middle District of Florida
Dunedin Psychologist Pleads Guilty To Obstruction Of A Medicare Audit
Tampa, Florida - Dr. Charles Gerardi (76, Dunedin) has pleaded guilty to obstructing a Medicare audit. He faces a maximum penalty of 5 years in federal prison. A sentencing date has not yet been set.
February 8, 2019; U.S. Attorney; District of South Carolina
Sumter Women Convicted of Healthcare Fraud for Over-Charging Government by Millions of Dollars
Columbia, SC - United States Attorney Sherri A. Lydon announced today that Angela Breitweiser Keith, age 53, and Ann Davis Eldridge, age 58, both of Sumter, South Carolina, pleaded guilty in federal court to one count of false statements to defraud Medicaid.
February 7, 2019; U.S. Attorney; Southern District of Florida
Two South Florida Doctors Arrested on Charges of Unlawfully Dispensing Opioids
Two South Florida doctors were arrested on charges related to the unlawful dispensing of opioids.
February 6, 2019; U.S. Department of Justice
Electronic Health Records Vendor to Pay $57.25 Million to Settle False Claims Act Allegations
Greenway Health LLC (Greenway), a Tampa, Florida-based developer of electronic health records (EHR) software, will pay $57.25 million to resolve allegations in a complaint filed by the United States under the False Claims Act alleging that Greenway caused its users to submit false claims to the government by misrepresenting the capabilities of its EHR product "Prime Suite" and providing unlawful remuneration to users to induce them to recommend Prime Suite, the Justice Department announced today.
February 6, 2019; U.S. Attorney; District of Massachusetts
Physician Sentenced to Prison for False Billing Scheme
BOSTON - A physician at the now-defunct New England Pain Management Associates Inc. was sentenced today in federal court in Boston for conspiring to falsify patient medical records in order to obtain payments from Medicare and commercial insurers for medical services that were not performed.
February 6, 2019; U.S. Attorney; Western District of Pennsylvania
Suspended Nurse Practitioner Indicted for Illegal Prescriptions
PITTSBURGH, PA - A suspended nurse practitioner has been indicted by a federal grand jury in Pittsburgh on charges of dispensing and distributing controlled substances and conspiring to distribute and dispense controlled substances, United States Attorney Scott W. Brady announced today.
February 6, 2019; U.S. Attorney; Western District of Pennsylvania
Johnstown Opioid Treatment Center Owner Indicted For Unlawfully Dispensing Controlled Substances, Money Laundering
PITTSBURGH, PA. - The owner and operator of SKS Associates, Inc. (SKS) has been indicted by a federal grand jury in Pittsburgh on charges of conspiracy to unlawfully distribute controlled substances, using or maintaining a drug involved premises, conspiracy to commit health care fraud and money laundering, United States Attorney Scott W. Brady announced today.
February 6, 2019; U.S. Attorney; Eastern District of Pennsylvania
Fourteen Individuals Charged for Operating "Pill Mills" and Illegally Prescribing Drugs to Hundreds of Patients in Multiple Locations in the Philadelphia Area
PHILADELPHIA, PA - United States Attorney William M. McSwain announced two indictments charging 14 people with a multitude of crimes, including conspiracy to dispense and distribute controlled substances outside the course of professional practice and without a legitimate medical purpose; distribution of oxycodone; health care fraud; and maintaining a drug-involved premises. These charges are the result of coordinated law enforcement effort across multiple federal, state, and local agencies. U.S. Attorney McSwain announced these charges as part of a press conference held today to highlight the Eastern District of Pennsylvania's recent efforts to combat the opioid crisis in the District.
February 6, 2019; U.S. Attorney; Northern District of Georgia
Union General Hospital to pay $5 million to resolve alleged False Claims Act violations
ATLANTA - Union General Hospital ("UGH"), located in Blairsville, Georgia, has agreed to pay $5 million to resolve allegations that it violated the False Claims Act by engaging in improper financial relationships with referring physicians.
February 5, 2019; U.S. Attorney; Middle District of Pennsylvania
York Man Pleads Guilty To Health Care Fraud
HARRISBURG - The United States Attorney's Office for the Middle District of Pennsylvania announced that Nagy Mohamed Abdelhamed, age 68, of York, Pennsylvania, pleaded guilty before U.S. District Court Judge John E. Jones to health care fraud for his fraudulent receipt of Medicaid and SNAP (Supplemental Nutritional Assistance Program, formerly known as Food Stamp) benefits.
February 5, 2019; U.S. Attorney; Middle District of Florida
Clermont Eye Doctors Agree To Pay Over $157,000 To Settle False Claims Act Liability For Improperly Billing Medicare
Orlando, FL - United States Attorney Maria Chapa Lopez announces today that Dr. Craig D. Fishman and Dr. Jeffrey A. Sheridan have agreed to pay the United States a combined total of $157,312.32 to resolve allegations that they violated the False Claims Act by knowingly billing the government for mutually exclusive eyelid repair surgeries. Dr. Fishman and Dr. Sheridan are ophthalmologists who operate Fishman & Sheridan Eye Care Specialists.
February 4, 2018; U.S. Attorney; Eastern District of Pennsylvania
Pentec Health, Inc. to Pay $17 Million to Settle False Claims Act Allegations
PHILADELPHIA - U.S. Attorney William M. McSwain announced that Pentec Health, Inc. ("Pentec") has agreed to pay the United States $17 million to settle allegations that Pentec submitted false claims to Medicare and other government healthcare programs.
February 1, 2019; U.S. Attorney; District of Arizona
Youth Care Worker Sentenced to 19 Years in Prison for Sexually Abusing Unaccompanied Minors in Southwest Key Facility
PHOENIX - On Jan. 14, 2019, Levian D. Pacheco, 25, of Phoenix, Ariz, was sentenced by U.S. District Judge Steven P. Logan to 19 years' imprisonment, followed by lifetime supervised release. Pacheco was previously convicted by a federal jury of seven counts of abusive sexual contact with a ward and three counts of sexual abuse of a ward. The statutory maximum sentence for sexual abuse of a ward is 15 years in prison and the statutory maximum for abusive sexual contact with a ward is 2 years in prison. U.S. District Court Judge Logan ordered several of Pacheco's counts to run consecutively.
February 1, 2019; U.S. Attorney; Southern District of Ohio
Columbus Home Health Care Provider Sentenced for Fraud
COLUMBUS, Ohio - The co-owner of Alpha Star Health Care Inc. was sentenced today in federal court to 18 months in prison for running home health care fraud and tax fraud schemes.

January 2019

January 31, 2019; U.S. Attorney; Western District of Pennsylvania
Criminal Complaint Filed Against Suspended Nurse Practitioner for Illegal Prescriptions
PITTSBURGH - Larry J. Goissie, Jr., 34, of Pittsburgh, Pa., has been charged by federal criminal complaint with illegal distribution of Schedule II controlled substances, United States Attorney Scott W. Brady announced today.
January 31, 2019; U.S. Attorney; Southern District of Texas
UT Health Science Center Pays More than $2.3 Million to Resolve Allegations
HOUSTON - The University of Texas Health Science Center (UTHSC) at Houston has paid $2,396,769.76 to resolve allegations that its Human Genetics Center misappropriated grant funds the National Institutes of Health (NIH) provided for research related to the impact of genomic variation on individual health and the health of families and populations, announced U.S. Attorney Ryan K. Patrick. A component of UTHealth, UTHSCH is one of the largest research institutions in the United States.
January 30, 2019; U.S. Department of Justice
Pathology Laboratory Agrees to Pay $63.5 Million for Providing Illegal Inducements to Referring Physicians
Pathology laboratory company Inform Diagnostics has agreed to pay $63.5 million to settle allegations that it violated the False Claims Act by engaging in improper financial relationships with referring physicians, the Justice Department announced today. Inform Diagnostics, formerly known as Miraca Life Sciences Inc., is headquartered in Irving, Texas, and was a subsidiary of Miraca Holdings Inc., a Japanese company, during the period relevant to the case. In 2017, majority ownership of the company changed, and the company was renamed.
January 30, 2019; U.S. Attorney; Middle District of Florida
Clearwater Doctor Sentenced To Prison For Health Care Fraud
Tampa, Florida - U.S. District Judge James S. Moody Jr. today sentenced Jayam Krishna Iyer (66, Clearwater) to six months in federal prison for committing health care fraud, ordered Iyer to forfeit over $52,000 in health care fraud proceeds, and order her to pay restitution to the Medicare and Medicaid programs.
January 29, 2019; U.S. Department of Justice
Two South Texas Doctors Sentenced to Prison for Roles in Separate Multi-Million Dollar Medicare Fraud Schemes
Two Houston, Texas physicians were sentenced to 25 and three-year prison terms for their roles in separate schemes to defraud Medicare out of payments for medical services.
January 29, 2019; U.S. Attorney; Western District of Tennessee
WellBound of Memphis will pay $3,246,000 to the United States and the State of Tennessee for services rendered to patients at its Memphis facility that were in violation of the Anti-Kickback statute
Memphis, TN - WellBound of Memphis will pay $3,246,000 to the United States and the State of Tennessee to resolve allegations of false claims to Medicare, Tricare and Tenncare for services rendered to home dialysis patients at its Memphis facility. D. Michael Dunavant, United States Attorney for the Western District of Tennessee announced today.
January 28, 2018; U.S. Attorney; Middle District of Florida
Orlando Skilled Nursing Facility, Physician, And Related Providers Agree To Pay $1.5 Million To Resolve Allegations Of Illegal Kickback And Patient Referral Scheme
Orlando, FL - United States Attorney Maria Chapa Lopez announces that on January 9, 2019, Conway Lakes NC, LLC; its former Administrator, Matthew File; its management company, Clear Choice Health Care, LLC; Clear Choice's part-owner and President, Jeffrey Cleveland; Clear Choice's part-owner and Senior Vice President, Geoffrey Fraser; and an Orlando-area orthopedic surgeon, Dr. Kenneth Krumins, agreed to pay $1.5 million to resolve allegations that they engaged in a kickback scheme related to the referral of Medicare and TRICARE patients.
January 28, 2019; U.S. Attorney; Southern District of Georgia
Doctor charged for prescribing narcotics to non patients, ordered detained until trial
SAVANNAH, Ga: A physician with clinics in Pooler, Ga., and Braselton, Ga., has been indicted for illegally prescribing drugs to non-patients and ordered held in custody pending trial in federal court.
January 28, 2019; U.S. Attorney; Western District of New York
Orchard Park Pain Doctor Pleads Guilty To Using Patient Names Fraudulently To Obtain Controlled Substances
BUFFALO, N.Y. - U.S. Attorney James P. Kennedy, Jr. announced today that Dr. Paul Biddle, 54, of Amherst, NY, pleaded guilty before U.S. District Judge Elizabeth A. Wolford to identity theft and possession of unlawful hydromorphone HCL. The charges carry a maximum penalty of five years in prison.
January 23, 2019; U.S. Department of Justice
Walgreen Co. Agrees to Pay $3.5 Million to Settle Allegations Under the False Claims Act
United States Attorney Matthew D. Krueger announced today that Walgreen Co. ("Walgreens") has agreed to pay $3.5 million to the United States and the State of Wisconsin to settle allegations that Walgreens violated the False Claims Act by submitting claims to Medicaid for stimulant medications without complying with Medicaid rules designed to ensure that stimulants are dispensed for appropriate medical treatment.
January 22, 2019; U.S. Attorney; Southern District of New York
Manhattan U.S. Attorney Announces $269.2 Million Recovery From Walgreens In Two Civil Healthcare Fraud Settlements
Geoffrey S. Berman, the United States Attorney for the Southern District of New York, Gregory E. Demske, Chief Counsel to the Inspector General of the U.S. Department of Health and Human Services ("HHS-OIG"), Scott J. Lampert, Special Agent in Charge of HHS-OIG's New York Regional Office, William F. Sweeney Jr., the Assistant Director-in-Charge of the New York Office of the Federal Bureau of Investigation ("FBI"), Leigh-Alistair Barzey, Special Agent-in-Charge of the Defense Criminal Investigative Service ("DCIS") Northeast Field Office, Michael C. Mikulka, Special Agent-in-Charge, New York Region, U.S. Department of Labor Office of Inspector General ("DOL-OIG"), Matthew Modafferi, Special Agent in Charge, U.S. Postal Service, Office of Inspector General, Northeast Area Field Office ("USPS-OIG"), and Thomas W. South, Deputy Assistant Inspector General for Investigations, U.S. Office of Personnel Management, Office of the Inspector General ("OPM-OIG"), announced today that the United States filed and settled two healthcare fraud lawsuits against national pharmacy chain WALGREENS BOOTS ALLIANCE, INC. ("WALGREENS"), pursuant to which WALGREENS must pay the United States and state governments a total of $269.2 million.