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Criminal and Civil Enforcement

February 2018

February 14, 2018; U.S. Attorney; District of Montana
Former Chief Financial Officer of Rocky Boy Health Clinic Sentenced to Prison
GREAT FALLS - The United States Attorney's Office announced that on February 14, 2018, U.S. District Judge Brian Morris, sentenced Kathy Ann Sutherland, 61, of Box Elder, Montana, to 12 months and 1 day of imprisonment and two years of supervised release for the crime of Wire Fraud. Sutherland must also pay $111,902.50 in restitution and a $100 special assessment.
February 13, 2018; U.S. Department of Justice Medicare Fraud Strike Force Case
Detroit Doctor Sentenced to Six Years in Prison for Role in $10.4 Million Health Care Fraud Scheme
A Detroit, Michigan-area doctor was sentenced to 72 months in prison today for his role in a $10.4 million conspiracy to defraud the Medicare program.
February 13, 2018; U.S. Attorney; District of Nevada
Las Vegas Doctor Arrested And Charged With 29-Counts Of Unlawful Distribution Of Fentanyl And Health Care Fraud
LAS VEGAS, Nev. - A pain management doctor practicing in Las Vegas was arrested today and charged with 29-counts of unlawful distribution of fentanyl and for committing health care fraud, announced Attorney General Jeff Sessions, U.S. Attorney Dayle Elieson of the District of Nevada, Assistant Special Agent in Charge Dan Neill for the DEA's Las Vegas field office, Special Agent in Charge Aaron C. Rouse for the FBI's Las Vegas Division, and Special Agent in Charge Christian J. Schrank for the Office of Inspector General of the U.S. Department of Health and Human Services Office Los Angeles Region.
February 12, 2018; U.S. Attorney; Southern District of Florida
Broward Doctor and Staff Arrested for Running a Pill Mill
Dr. Andres Mencia, 64, of Ft. Lauderdale, Oscar Luis Ventura-Rodriguez, 41, of Ft. Lauderdale, Nadira Sampath-Grant, 51, of Margate, and John Mensah, 50, of Miami, were arrested for their involvement in a scheme where they billed Medicare and Medicaid for medical consultations during which in actuality, they issued prescriptions for opioids and other drugs in exchange for cash payments, in violation of 21 U.S.C. 846 and 841(a)(1), 18 U.S.C. 2, 18 U.S.C. 1347 and 18 U.S.C. 1349.
February 8, 2018; U.S. Attorney; District of Minnesota
Health Care Business Owners Sentenced To Prison For Multi-Million Dollar Fraud And Tax Conspiracy
United States Attorney Gregory G. Brooker today announced the sentencing of three defendants for their involvement in a years-long, multi-million dollar heath care fraud and tax conspiracy. THURLEE BELFREY, 52, ROYLEE BELFREY, 52, and LANORE BELFREY, 43, each entered guilty pleas on September 14, 2017, and were sentenced yesterday before Senior U.S. District Judge Ann D. Montgomery in Minneapolis, Minn.
February 8, 2018; U.S. Attorney; Western District of Pennsylvania
Hospice Company and Owner Agree to Pay $1.24 Million to Settle Two False Claims Act Whistleblower Lawsuits
PITTSBURGH - A privately owned for-profit hospice company and its owner and Chief Executive Officer agreed to pay the United States $1,240,000 to resolve allegations that the company had fraudulently billed Medicare and Medicaid for hospice services for patients who were ineligible for hospice, United States Attorney Scott W. Brady announced today.
February 8, 2018; U.S. Attorney; Northern District of New York
Queensbury Oncologist and Spouse to Pay $500,000 for Submitting False Claims to Medicare for the Administration of Unapproved Cancer Drugs
ALBANY, NEW YORK - Dr. Vincent Koh and his wife and office manager, Milly Koh, have agreed to pay $500,000 for violating the False Claims Act by knowingly submitting false claims to Medicare for unapproved chemotherapy drugs, announced United States Attorney Grant C. Jaquith. On November 20, 2017, the Kohs pled guilty to receiving and delivering misbranded drugs, a misdemeanor, and are scheduled to be sentenced on March 20, 2018 by United States Magistrate Judge Daniel J. Stewart.
February 7, 2018; U.S. Department of Justice
New York Doctor Sentenced to 13 Years in Prison for Multi-Million Dollar Health Care Fraud
A New York surgeon who practiced at hospitals in Brooklyn and Long Island was sentenced today to 156 months in prison for his role in a scheme that involved the submission of millions of dollars in false and fraudulent claims to Medicare.
February 6, 2018; U.S. Attorney; Eastern District of Michigan
Former Doctor Sentenced to 75 Months in Prison for Illegally Prescribing Opiates and Committing Health Care Fraud
Rodney Moret of Madison Heights, Michigan was sentenced today to 75 months' imprisonment for participating in conspiracies to distribute prescription pills illegally and to defraud Medicare, U.S. Attorney Matthew Schneider announced. His crimes include over $15 million of prescriptions drugs, and an additional $6 million in health care fraud.
February 5, 2018; U.S. Attorney; Western District of Kentucky
Bowling Green Physician Guilty Of Conspiring To Unlawfully Distribute And Dispense Controlled Substances And Health Care Fraud
BOWLING GREEN, Ky. - United States Attorney Russell M. Coleman today announced the guilty plea by former Warren County, Kentucky, physician Charles Fred Gott to multiple charges of unlawful distribution and dispensing of controlled substances and health care fraud, in United States District Court, before United States District Judge Greg N. Stivers.
February 2, 2018; U.S. Attorney; Western District of Tennessee
Memphis Operator, LLC d/b/a Spring Gate Rehabilitation and Healthcare Center will pay $500,000 to the United States and the State of Tennessee for services rendered to residents of Spring Gate that were materially substandard and worthless
Memphis, TN - Memphis Operator, LLC d/b/a Spring Gate Rehabilitation and Healthcare Center will pay $500,000 to the United States and the State of Tennessee to resolve allegations of false claims to Medicare and Tenncare for services rendered to residents of Spring Gate that were materially substandard, worthless and were provided in violation of certain essential requirements that the United States expects skilled nursing facilities to meet.

January 2018

January 31, 2018; U.S. Attorney; Eastern District New York
Brooklyn-Based Home Health Care Service and Its President Agree to Pay Over $6.4 Million to Settle False Claims Act Suit Alleging Improper Billing Practices
Home Family Care, Inc. (HFC), a Brooklyn-based company that provides home health care services, and Alexander Kiselev, the co-owner and President of HFC, have entered into a civil settlement agreement under which they have agreed to pay $6,415,000 to resolve allegations that they violated the federal and state False Claims Acts by falsely billing Medicaid for home health care services that HFC did not provide to Medicaid recipients. HFC's former Vice President, Michael Gurevich, entered into a separate settlement regarding the same allegations. The settlement agreements were approved by United States District Judge Sterling Johnson, Jr.
January 30, 2018; U.S. Attorney; Middle District of Florida
Tampa's Largest Ambulance Providers Agree To Pay $5.5 Million To Resolve False Claims Act Allegations Regarding Medically Unnecessary Ambulance Transports
Tampa, FL - United States Attorney Maria Chapa Lopez announces that AmeriCare Ambulance Service, Inc. and its sister company, AmeriCare ALS, Inc. (collectively, AmeriCare), have agreed to pay approximately $5.5 million to resolve allegations that they defrauded Medicare by billing for medically unnecessary ambulance transportation services.
January 29, 2018; U.S. Attorney; District of Delaware
United States Obtains $16.2 Million Judgment Against MRI Provider For Submitting False Claims
Wilmington, Del. - David C. Weiss, Acting U.S. Attorney for the District of Delaware, announced today that the U.S. District Court for the District of Delaware entered judgment in the amount of $16,223,091.38 against Orthopaedic and Neuro Imaging LLC (ONI) for submitting false claims for Medicare reimbursement. Under the terms of the judgment, ONI's owner, Richard Pfarr, is jointly and severally liable for $6,125,947.13.
January 25, 2018; U.S. Attorney; Northern District of Texas
Laboratory and Owner of Lab Management Services Company to Pay $3.77 Million to Resolve Kickback and Medical Necessity Claims
DALLAS - Primex Clinical Laboratories, LLC has agreed to pay $3,500,000 to resolve allegations that it violated the False Claims Act by paying kickbacks in exchange for laboratory referrals for patient pharmacogenetic testing. In a related settlement, Mitch Edland, the Chief Executive Officer and owner of DNA Stat, LLC, has agreed to pay $270,000 to resolve similar allegations. Both settlements were announced today by U.S. Attorney Erin Nealy Cox of the Northern District of Texas.
January 24, 2018; U.S. Department of Justice
Tennessee Chiropractor Pays More Than $1.45 Million to Resolve False Claims Act Allegations
A Lenior City, Tennessee, chiropractor has paid $1.45 million, plus interest, to resolve False Claims Act violations, announced U.S. Attorney General Jeff Sessions and U.S. Attorney Don Cochran of the Middle District of Tennessee. The settlement also calls for a Cookeville, Tennessee, pain clinic nurse practitioner to pay $32,000 and surrender her DEA registration to settle allegations that she violated the Controlled Substances Act.
January 24, 2018; U.S. Attorney; Northern District of Ohio
Moreland Hills physicians indicted on charges of performing unnecessary medical tests and procedures, overbilling insurance providers and illegally distributing opioids and other drugs
A Moreland Hills couple was charged in a 24-count indictment with ordering and performing unnecessary tests and procedures to defraud insurance providers, as well as illegally distributing opioids and other drugs, law enforcement officials said.
January 24, 2018; U.S. Attorney; District of New Jersey
Pharmacy Employee Charged In $1.5 Million Health Care Fraud Conspiracy
NEWARK, N.J. - A Marlboro, New Jersey, man was charged today for his role in a conspiracy to falsely bill public and private insurance providers for medications that were never dispensed to patients, U.S. Attorney Craig Carpenito announced.
January 23, 2018; U.S. Department of Justice
Two California Urologists Agree to Pay More than $1 Million to Settle False Claims Act Allegations Related to Radiation Therapy Referrals
Drs. Aytac Apaydin and Stephen Worsham, urologists based in Northern California, will pay $1.085 million to resolve allegations that they submitted and caused the submission of false claims to Medicare for image guided radiation therapy (IGRT) that was referred and billed in violation of the physician self-referral law (commonly known as the "Stark Law") and the Anti-Kickback Statute, the Department of Justice announced. Drs. Apaydin and Worsham own and operate Salinas Valley Urology Associates (SVUA) in Salinas, California. They also owned Advance Radiation Oncology Center (AROC), located in Salinas, California, which dissolved in 2016. IGRT is used to treat patients who are diagnosed with cancer, including prostate cancer patients.
January 19, 2018; U.S. Department of Justice
Scripps Health to Pay $1.5 Million to Settle Claims for Services Rendered by Unauthorized Physical Therapists
Scripps Health (Scripps), a health care system based in San Diego, California, has agreed to pay $1.5 million to resolve allegations that it violated the False Claims Act by charging federal health care programs for physical therapy services that were rendered by therapists who did not have billing privileges for these programs and were not supervised by an authorized provider, the Justice Department announced today.
January 18, 2018; U.S. Department of Justice Medicare Fraud Strike Force Case
Michigan Doctor Sentenced to Prison for $1.7 Million Health Care Fraud Scheme
A Detroit, Michigan-area doctor was sentenced to 24 months in prison today for his role in a $1.7 million health care fraud scheme that involved billing Medicare for physician home visits that were medically unnecessary and/or were billed under unwarranted treatment codes that resulted in inappropriately high payments.
January 18, 2018; U.S. Attorney; District of New Jersey
Morris County, New Jersey, Doctor Admits Illegally Prescribing Oxycodone And Defrauding Medicare, Medicaid Out Of $30,000
NEWARK, N.J. - A Long Valley, New Jersey, man today admitted writing illegal prescriptions for oxycodone and conspiring to bill Medicare and Medicaid for certain allergy tests without performing the required patient examinations, U.S. Attorney Craig Carpenito announced.
January 16, 2018; U.S. Attorney; Northern District of Georgia
Eye care provider convicted of Medicare and Medicaid fraud
GAINESVILLE, Ga. - Matilda Lynn Prince has been convicted by a federal jury of twenty-nine counts of health care fraud for filing fraudulent claims with Medicare and the Georgia Medicaid program for optometry and ophthalmology services that were never provided to patients.
January 10, 2018; U.S. Department of Justice
Texas Mayor and Owners of Health Care Company Charged With Health Care Fraud, Money Laundering and Obstruction
Four individuals, including a Texas mayor who was a licensed physician and medical director, and three owners of a health care company, were charged in an indictment unsealed today for their roles in a $150 million health care fraud and money laundering scheme. Three of the defendants were also charged with counts relating to obstructing justice and providing false statements.
January 10, 2018; U.S. Department of Justice
Dental Management Company Benevis and Its Affiliated Kool Smiles Dental Clinics to Pay $23.9 Million to Settle False Claims Act Allegations Relating to Medically Unnecessary Pediatric Dental Services
The Justice Department announced today that it has settled False Claims Act allegations against dental management company Benevis LLC (formerly known as NCDR LLC) and more than 130 of its affiliated Kool Smiles dental clinics for which Benevis provides business management and administrative services. Under the agreement, Benevis and the Kool Smiles clinics will pay the United States and participating states a total of $23.9 million, plus interest, to resolve allegations that they knowingly submitted false claims for payment to state Medicaid programs for medically unnecessary dental services performed on children insured by Medicaid.
January 9, 2018; U.S. Attorney; Eastern District of Michigan
Livonia Doctor and Patient Recruiters Charged in $18 Million Illegal Distribution of Prescription Drugs and Health Care Fraud Scheme
An indictment was unsealed today charging Dr. Zongli Chang, M.D. and seven other individuals with conspiracy to illegally distribute prescription drugs, U.S. Attorney Matthew Schneider announced today. Chang is also charged with health care fraud.
January 9, 2018; U.S. Attorney; Northern District of West Virginia
Two West Virginia physicians and a business partner indicted for illegally distributing drugs
CLARKSBURG, WEST VIRGINIA - Two physicians operating offices in West Virginia, along with a business partner, were indicted by a grand jury today on charges of illegally distributing controlled substances, United States Attorney Bill Powell announced.
January 9, 2018; U.S. Attorney; Western District of Virginia
Danville Doctor Sentenced on Healthcare Fraud, Tax Evasion Charges
Danville, VIRGINIA - A Danville doctor, who billed various insurers for services he never administered to patients, even after he was warned about the practice, was sentenced today in the United States District Court for the Western District of Virginia in Danville on healthcare fraud and tax evasion charges, United States Attorney Rick A. Mountcastle announced.
January 8, 2017; U.S. Attorney; District of Wyoming
Powell, Wyoming Psychologist Sentenced to Three Years in Prison for Health Care Fraud
Gibson Buckley Condie, 57, of Powell, Wyoming, was sentenced on January 8, 2018, to serve three years in prison for felony health care fraud involving mental health services falsely billed to Wyoming Medicaid, announced United States Attorney Mark A. Klaassen. Condie was also ordered to pay approximately $2.28 million in restitution to the Wyoming Department of Health and the United States Department of Health and Human Services, and forfeit certain assets traceable to the proceeds of his fraud.
January 4, 2018; U.S. Department of Justice Medicare Fraud Strike Force Case
New Orleans Area Woman Sentenced to More Than Four Years in Prison for Role in Approximately $2 Million Home Health Kickback and Identity Theft Scheme
A New Orleans woman was sentenced today to 51 months in prison for her involvement in a $2 million home health kickback scheme carried out through a New Orleans area home health agency.

December 2017

December 22, 2017; U.S. Department of Justice
Kmart Corporation to Pay U.S. $32.3 Million to Resolve False Claims Act Allegations for Overbilling Federal Health Programs for Generic Prescription Drugs
Kmart Corporation, a wholly owned subsidiary of Sears Holdings Corporation (SHC), has agreed to pay $32.3 million to the United States to settle allegations that in-store pharmacies in Kmart stores failed to report discounted prescription drug prices to Medicare Part D, Medicaid, and TRICARE, the health program for uniformed service members and their families, the Justice Department announced today.
December 21, 2017; U.S. Attorney; Eastern District of New York
Medical Doctor Indicted for Causing Patient's Overdose Death In Staten Island
A second superseding indictment was unsealed today in federal court in Brooklyn charging medical doctor Martin Tesher with unlawfully prescribing oxycodone and fentanyl to a patient, Nicholas Benedetto, without legitimate medical purpose, which resulted in Benedetto's overdose death on March 5, 2016 in Staten Island. Dr. Tesher was previously indicted for unlawfully prescribing thousands of oxycodone pills to patients without a legitimate medical purpose. Dr. Tesher's arraignment on the second superseding indictment is scheduled for this afternoon before United States Magistrate Judge Steven M. Gold.
December 21, 2017; U.S. Attorney; Eastern District of Virginia
Former Owner of Sleep Study Clinics Pleads Guilty to Fraud, Tax Charges
ALEXANDRIA, Va. - The former owner of 1st Class Sleep Diagnostic Center and 1st Class Medical, pleaded guilty today to conspiracy to commit health care and wire fraud, and conspiracy to defraud the United States.
December 21, 2017; U.S. Attorney; District of Vermont
Dominion Diagnostics pays $815,000 to the United States and State of Vermont to resolve allegations of False Claims Act violations
The United States Attorney's Office for the District of Vermont announced today that Dominion Diagnostics, Inc. has paid $815,000 in total to the United States and the State of Vermont to resolve civil claims that Dominion Diagnostics violated the federal False Claims Act, 31 U.S.C. � 3729, and the Vermont False Claims Act, 32 V.S.A. � 630, by knowingly presenting, or causing to be presented, false claims for payment to Medicare and Medicaid. The money will be divided between the federal Medicare, federal Medicaid, and Vermont Medicaid programs to which Dominion Diagnostics submitted the alleged false claims.
December 20, 2017; U.S. Attorney; District of Maryland
Baltimore Man Indicted For Witness Retaliation and Tampering Resulting in the Death of a Baltimore Woman
Baltimore, Maryland - A federal grand jury in Baltimore, Maryland returned a six count indictment against Davon Carter, age 37, of Baltimore, Maryland. The indictment was unsealed today following the initial appearance of Carter in federal court. Four of the counts relate to the murder of Latrina Ashburne, age 41, on May 27, 2016. For these charges Carter faces a possible death sentence or mandatory life in prison. Carter is also charged with being a felon in possession of ammunition the day of the murder as well as possession with intent to distribute marijuana. Those charges carry a maximum term of 10 years in prison.
December 20, 2017; U.S. Department of Justice
Drug Maker United Therapeutics Agrees to Pay $210 Million to Resolve False Claims Act Liability for Paying Kickbacks
Pharmaceutical company United Therapeutics Corporation (UT), based in Silver Spring, Maryland, has agreed to pay $210 million to resolve claims that it used a foundation as a conduit to pay the copays of Medicare patients taking UT's pulmonary arterial hypertension drugs, in violation of the False Claims Act, the Justice Department announced today.
December 19, 2017; U.S. Department of Justice
Two Physician Groups Pay Over $33 Million to Resolve Claims Involving HMA Hospitals
The Justice Department today announced settlements with two physician groups, EmCare Inc. (EmCare) and Physician's Alliance Ltd (PAL), for allegedly receiving illegal remuneration in exchange for patient referrals to hospitals owned by the now-defunct Health Management Associates (HMA).
December 19, 2017; U.S. Attorney; Western District of North Carolina
EmCare, Inc. to Pay $29.8 Million To Resolve False Claims Act Allegations
CHARLOTTE, N.C. - The Department of Justice today announced a settlement with Dallas based EmCare, Inc. a subdivision of Envision Healthcare Corporation that provides physicians to hospitals to staff their Emergency Departments (EDs). EmCare agreed to pay $29.8 million to resolve claims that, from 2008 to 2012, EmCare received remuneration from non-defunct Health Management Associates (HMA) to increase Medicare admissions at HMA Hospitals by recommending admission for patients whose medical care should have been billed as outpatient or observation services. These recommendations allegedly caused the medically unnecessary admission of Medicare beneficiaries.
December 19, 2017; U.S. Attorney; Eastern District of New York
Senior Executives of Medical Drug Repackager Sentenced for Defrauding Healthcare Providers
Earlier today, in federal court in Brooklyn, Gerald Tighe and Stephen Kalinoski, were sentenced by United States District Court Judge I. Leo Glasser to six months' home confinement, four years' probation, and 300 hours of community service, for wire fraud conspiracy in connection with their operation of Med Prep Consulting, Inc. (Med Prep), a now-defunct Tinton Falls, New Jersey-based medical drug repackager and compounding pharmacy, which sold adulterated and contaminated drug products to healthcare providers across the country. As part of their sentences, Kalinoski will forfeit $140,000 of criminal proceeds to the government. The amount of forfeiture owed by Tighe and the amount of restitution both defendants must pay to Yale-New Haven Hospital, which discovered it had received drug products from Med Prep contaminated with mold, will be determined by the Court at a later date. The defendants pleaded guilty to the charges on July 14, 2017.
December 18, 2017; U.S. Attorney; Southern District of Florida
Glades Drugs Agrees to Pay the United States $300,000 to Settle Allegations of Fraudulent Claims to Medicare and TRICARE
Glades Drugs, Inc., a pharmacy located in Palm Beach County, Florida has agreed to pay the United States $300,000, to settle allegations that it violated the False Claims Act by waiving or failing to collect required copayments from Medicare and TRICARE beneficiaries.
December 18, 2017; U.S. Department of Justice
Three Major New York Diagnostic Testing Facility Owners Charged for Their Roles in Alleged Multi-Million Dollar Health Care Fraud Scheme
Three owners of independent diagnostic testing facilities in Brooklyn, New York, were charged in an indictment unsealed today for their roles in an allegedly fraudulent scheme that involved submitting over $44 million in claims to Medicare and private insurers, which included government-sponsored managed care organizations.
December 18, 2017; U.S. Attorney; District of New Hampshire
Resident Of Webster, New York Pleads Guilty To Health Care Fraud
CONCORD, N.H. - Acting United States Attorney John Farley announced today that Judith Morale (formerly known as Judith Remo), 54, currently a resident of Webster, New York, has pleaded guilty to health care fraud.
December 18, 2017; U.S. Attorney; District of New Jersey
Cherry Hill Doctor And Son Sentenced To Prison For Defrauding Medicare
CAMDEN, N.J. - A doctor and his chiropractor son were sentenced to prison today for conspiring to defraud Medicare by using unqualified people to give physical therapy to Medicare recipients, Acting U.S. Attorney William E. Fitzpatrick announced.
December 18, 2017; U.S. Attorney; Western District of Virginia
Dillwyn Couple Indicted on Federal Health Care Fraud Charges
Charlottesville, VIRGINIA - A federal grand jury, sitting in the United States District Court for the Western District of Virginia in Charlottesville, have indicted a husband and wife and charged them with a variety of crimes related to health care fraud, United States Attorney Rick A. Mountcastle announced.
December 15, 2017; U.S. Attorney; Western District of Pennsylvania
New Castle Doctor Charged with Distributing Medications Outside the Course of Professional Practice
PITTSBURGH - On Dec. 13, 2017, a resident of New Castle, Pa., was indicted by a federal grand jury in Pittsburgh on charges of violating federal narcotics laws, Acting United States Attorney Soo C. Song announced today.
December 15, 2017; U.S. Department of Justice Medicare Fraud Strike Force Case
Former Florida State Health Care Administration Official Sentenced to More Than Four Years in Prison for Accepting Bribes
A former employee of Florida's Agency for Health Care Administration (AHCA) was sentenced today to 57 months in prison for accepting bribes in exchange for providing confidential information about health care facilities that received Medicare and Medicaid funds.
December 14, 2017; U.S. Department of Justice
DaVita Rx Agrees to Pay $63.7 Million to Resolve False Claims Act Allegations
DaVita Rx LLC, a nationwide pharmacy that specializes in serving patients with severe kidney disease, agreed to pay a total of $63.7 million to resolve False Claims Act allegations relating to improper billing practices and unlawful financial inducements to federal healthcare program beneficiaries, the Justice Department announced today. DaVita Rx is based in Coppell, Texas.
December 14, 2017; U.S. Attorney; Southern District of Mississippi
Mental Health Facility to Pay Almost $7 Million to Resolve Fraud Allegations
Jackson, Miss - Region 8 Mental Health Services has agreed to pay the United States government in excess of $6.93 million under the False Claims Act to resolve allegations that it was paid for services that it either did not provide or that were not provided by qualified individuals as part of its preschool Day Treatment program, announced United States Attorney Mike Hurst and Derrick Jackson, Special Agent in Charge, Department of Health and Human Services, Office of Inspector General. Today's announcement is believed to be the largest False Claims Act healthcare settlement in the history of the State of Mississippi.
December 13, 2017; U.S. Attorney; District of Columbia
Owner of Durable Medical Equipment Company Sentenced to Two Years in Prison for Health Care Fraud
WASHINGTON - Emeka H. Chijioke, 41, formerly of Atlanta, Ga., and Nigeria, was sentenced today to two years in prison on a federal charge stemming from a scheme in which he defrauded the District of Columbia's Medicaid program out of more than $500,000.
December 12, 2017; U.S. Department of Justice
21st Century Oncology to Pay $26 Million to Settle False Claims Act Allegations
21st Century Oncology Inc. and certain of its subsidiaries and affiliates have agreed to pay $26 million to the government to resolve a self-disclosure relating to the submission of false attestations regarding the company's use of electronic health records software and separate allegations that they violated the False Claims Act by submitting, or causing the submission of, claims for certain services provided pursuant to referrals from physicians with whom they had improper financial relationships.
December 12, 2017; U.S. Attorney; District of Nevada
Nevada Cardiologist Arrested For Unlawful Distribution of Prescription Opioids And Health Care Fraud
RENO, Nev. - An Elko, Nevada cardiologist was arrested today on 39-charges of unlawful distribution of prescription opioids and Medicare and Medicaid fraud, announced Attorney General Jeff Sessions, Acting U.S. Attorney Steven W. Myhre for the District of Nevada, Special Agent in Charge Aaron C. Rouse for the FBI's Las Vegas office, Special Agent in Charge David J. Downing for the DEA's Los Angeles field office, and Special Agent in Charge Christian Schrank for the Office of Inspector General of the U.S. Department of Health and Human Services Office Los Angeles Region.
December 12, 2017; U.S. Attorney; Eastern District of Texas
East Texas Imaging Companies and Owners Resolve Swapping and Medicare Fraud Allegations
PLANO, Texas - Multiple mobile imaging companies, along with their owners Dennis Whitsell and Jonathan Graham Lane, will pay the United States $300,000 after improperly billing Medicare for transportation charges related to portable x-ray services, announced Acting United States Attorney Brit Featherston. One of the companies also entered into a deferred prosecution agreement with the United States to resolve swapping allegations, which implicated the Anti-Kickback Statute.
December 11, 2017; U.S. Attorney; Middle District of Alabama
Another Montgomery "Pill Mill" Doctor Pleads Guilty to Drug Distribution and Money Laundering Charges
Montgomery, Ala. - On Friday, December 8, 2017, Dr. Shepherd A. Odom, 78, of Alexander City, Alabama, pleaded guilty to charges of drug distribution and conspiracy to commit money laundering, announced United States Attorney Louis V. Franklin, Sr. Dr. Odom's guilty plea was a part of the ongoing investigation and prosecution of those involved in operating a "pill mill" through the Family Practice medical office located at 4143 Atlanta Highway in Montgomery, Alabama.
December 8, 2017; U.S. Department of Justice Medicare Fraud Strike Force Case
Owner of Home Health Agency Sentenced in Absentia to 80 Years in Prison for Involvement in $13 Million Medicare Fraud Conspiracy and for Filing Fraudulent Tax Returns
The owner of a Houston home health agency was sentenced today to 80 years in prison for his role in a $13 million Medicare fraud scheme and for filing false tax returns.
December 8, 2017; U.S. Attorney; District of Connecticut
Substance Abuse Treatment Provider and CEO Pay More Than $800,000 to Settle Improper Billing Allegations
United States Attorney John H. Durham and Connecticut Attorney General George Jepsen today announced that APT FOUNDATION, INC. and its Chief Executive Officer, LYNN MADDEN, have entered into a civil settlement agreement with the federal and state governments in which they will pay $883,859 to resolve allegations that they caused overpayments to be paid by the Connecticut Medicaid Program.
December 7, 2017; U.S. Attorney; Eastern District of Missouri
Local Chiropractor and Wife, and One Police Officer Plead Guilty to Federal Charges
St. Louis, MO - Police Officer Terri Owens of the St. Louis Metropolitan Police Department (SLMPD); Dr. Mitchell Davis, a St. Louis chiropractor; and his wife Galina Davis, all pled guilty today to federal charges arising out of a scheme to obtain un-redacted accident reports for use in Dr. Davis's practice.
December 7, 2017; U.S. Attorney; Southern District of West Virginia
Charleston dentist sentenced to five years in federal prison for health care fraud
CHARLESTON, W.Va. - A Charleston dentist who falsely billed West Virginia Medicaid and West Virginia Medicaid Managed Care Organizations (MCOs) for more than $700,000 was sentenced today to five years in federal prison, announced United States Attorney Carol Casto. Antoine Skaff, 58, previously pleaded guilty to health care fraud. Skaff also previously entered into a civil settlement with the U.S. Attorney's Office, the Office of Inspector General for the U.S. Department of Health and Human Services, the West Virginia Department of Health and Human Resources (DHHR), DHHR's Bureau for Medical Services, and the West Virginia Medicaid Fraud Control Unit, in which he agreed to pay treble damages of $2.2 million, or three times the loss suffered by West Virginia Medicaid.
December 7, 2017; U.S. Attorney; Northern District of Texas
Federal Grand Jury Charges Grand Prairie Husband and Wife for Medicare Fraud
DALLAS - On December 6, 2017, a husband and wife were indicted on charges that they submitted false and fraudulent claims for home health services and defrauded Medicare of more than $3.4 million, announced U.S. Attorney Erin Nealy Cox of the Northern District of Texas.
December 6, 2017; U.S. Department of Justice Medicare Fraud Strike Force Case
Former Owners of Sleep Study Clinics in Northern Virginia and Maryland Charged With Health Care Fraud and Tax Evasion
An indictment was unsealed today charging two individuals with leading a multi-million dollar health care fraud and tax evasion scheme.
December 6, 2017; U.S. Attorney; District of New Jersey
Passaic County, New Jersey, Man Sentenced to 37 Months in Prison for Taking Bribes for Referring Tests to New Jersey Clinical Lab
NEWARK, N.J. - An internal medicine doctor with a practice in West New York, 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, N.J., its president and numerous associates, Acting U.S. Attorney William E. Fitzpatrick announced.
December 5, 2017; U.S. Attorney; Middle District of Alabama
One Physician and Three Nurse Practitioners Charged for Participating in the Operation of a Montgomery "Pill Mill"
Montgomery, Ala. - On Tuesday, December 5, 2017, four individuals were arrested after being indicted by a federal grand jury for their role in operating a "pill mill," out of a Montgomery, Alabama medical office, announced United States Attorney Louis V. Franklin, Sr. A "pill mill" is a medical clinic that is dispensing controlled substances inappropriately, unlawfully, and for non-medical reasons.
December 4, 2017; U.S. Attorney; Northern District of Texas
Dallas-Based Physician-Owned Hospital to Pay $7.5 Million to Settle Allegations of Paying Kickbacks to Physicians in Exchange for Surgical Referrals
WASHINGTON - Pine Creek Medical Center LLC ("Pine Creek"), a physician-owned hospital serving the Dallas/Fort Worth area, has agreed to pay $7.5 million to resolve claims that it violated the False Claims Act by paying physicians kickbacks in the form of marketing services in exchange for surgical referrals, the Department of Justice announced today.
December 4, 2017; U.S. Department of Justice
Owner of Michigan Home Health Agency Convicted in $1.6 Million Healthcare Fraud Scheme
A federal jury found a Detroit home health agency owner guilty today for her role in a scheme involving approximately $1.6 million in fraudulent Medicare claims for home health services that were procured through the payment of kickbacks, and that were medically unnecessary and not provided.
December 1, 2017; U.S. Attorney; Middle District of Florida
Podiatrists Plead Guilty To Fraud
Jacksonville, Florida - Acting United States Attorney W. Stephen Muldrow announces that William Danzeisen (60, Ponte Vedra Beach), a licensed podiatrist, and Sachin Brahmbhatt (37, Jacksonville), an unlicensed podiatrist, have pleaded guilty to theft of government property. Each faces a maximum penalty of 10 years in federal prison. The sentencing hearings have been set for January 30, 2018.
December 1, 2017; U.S. Attorney; Middle District of Florida
Sarasota Physician Agrees To Pay $1.95 Million To Resolve False Claims Act Allegations Regarding Unnecessary Ultrasounds
Tampa, FL - Acting United States Attorney W. Stephen Muldrow announces that Dr. Arthur S. Portnow, the owner and operator of Arthur S. Portnow, P.A., d/b/a Apple Medical and Cardiovascular Group, d/b/a Apple Medical Group (collectively, Dr. Portnow) has agreed to pay $1.95 million to resolve allegations that he and his practice violated the False Claims Act by knowingly seeking reimbursement for medically unnecessary ultrasound tests that were performed on Medicare beneficiaries.
December 1, 2017; U.S. Attorney; District of Minnesota
Local Dermatologist Pays $850,000 To Settle False Claims Act Allegations
Acting United States Attorney Gregory G. Brooker today announced that Skin Care Doctors, P.A. and its founder and CEO, Michael J. Ebertz, M.D. have agreed to pay $850,000 to the United States to resolve allegations of false claims submitted for certain dermatology procedures in violation of the False Claims Act ("FCA").
December 1, 2017; U.S. Attorney; Middle District of Pennsylvania
Doctor Indicted On Heath Care Fraud And Opioid Diversion Charges
HARRISBURG - The United States Attorney's Office for the Middle District of Pennsylvania announced today that Charles J. Gartland, D.O., age 59, of Cochranville, Pennsylvania, was indicted on November 29, 2017, by a federal grand jury on health care fraud and opioid diversion charges.
December 1, 2017; U.S. Attorney; Western District of North Carolina
School Counselor Sentenced To Two Years In Prison For Defrauding North Carolina Medicaid
ASHEVILLE, N.C. - Joseph Frank Korzelius, 47, of Tryon, N.C. was sentenced yesterday to 24 months in prison for fraudulently billing Medicaid for more than $450,000 in false claims for mental and behavioral health services he did not provide, announced R. Andrew Murray, U.S. Attorney for the Western District of North Carolina. In addition to the prison term imposed, U.S. District Judge Martin Reidinger ordered Korzelius to serve three years of supervised release and to pay $436,229.08 as restitution to Vaya Health, the administrator of Medicaid funds in Western North Carolina.

November 2017

November 30, 2017; U.S. Attorney; District of South Carolina
Wellford Woman Pleads Guilty to Forging Prescriptions
Columbia, South Carolina ---- United States Attorney Beth Drake stated today that Felicia L. Prysock, age 41, of Wellford, South Carolina, pled guilty to Aggravated Identity Theft, a violation of Title 18, United States Code, � 1028A; and, Obtaining a Controlled Substance by Fraud, a violation of Title 21, United States Code, � 843(a)(3). Chief Judge Terry L. Wooten presided at the hearing and will sentence Prysock on February 27, 2018.
November 30, 2017; U.S. Attorney; Southern District of New York
Dentist And Others Charged In Medicaid Health Care Fraud Scheme At Upper Manhattan Dental Clinic
Joon H. Kim, the Acting United States Attorney for the Southern District of New York, and Scott J. Lampert, the 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"), announced the arrests of MEHMET DIKENGIL, ANNA JONES, and LUIS OMAR VARGAS for their participation in a scheme to defraud Medicaid of more than $400,000. DIKENGIL, the owner of Dental Express Broadway, P.C., a dental clinic located in upper Manhattan, employed JONES, an officer manager, and VARGAS, an unlicensed dental provider, in furtherance of the health care fraud, which involved billing Medicaid for dental services that were not provided to patients. DIKENGIL and VARGAS were arrested this morning in New Jersey. JONES was arrested this morning in Queens, New York. The defendants will be presented later today in Manhattan federal court before Chief Magistrate Judge Debra Freeman.
November 28, 2017; U.S. Attorney; Middle District of Alabama
Montgomery "Pill Mill" Doctor Pleads Guilty to Drug Distribution, Health Care Fraud, and Money Laundering Charges
Montgomery, Ala. - On Tuesday, November 28, 2017, Dr. Gilberto Sanchez, 56, of Cecil, Alabama, pleaded guilty to drug distribution conspiracy, health care fraud, and money laundering charges, announced United States Attorney Louis V. Franklin, Sr. from the Middle District of Alabama.
November 28, 2017; U.S. Attorney; Eastern District of California
CVC Heart Center to Pay $1.2 M to Settle Allegations of Billing Health Care Programs for Medically Unnecessary Nuclear Stress Tests
FRESNO, Calif. - Cardiovascular Consultants Heart Center (CVC Heart Center), a cardiology clinic with offices in Fresno and Clovis, and its shareholder physicians - Dr. Kevin Boran, Dr. Michael Gen, Dr. Rohit Sundrani, Dr. Donald Gregory, and Dr. William Hanks - will pay $1.2 million to resolve federal and state False Claims Act allegations that they improperly performed and billed federal and state health care programs for medically unnecessary cardiovascular diagnostic procedures, U.S. Attorney Phillip A. Talbert announced.
November 28, 2017; U.S. Attorney; Central District of California Medicare Fraud Strike Force Case
Former Employees of Southern California Ambulance Company and Dialysis Center Plead Guilty to Medicare Fraud Charges
WASHINGTON - A former employee of a Southern California ambulance company and a former employee of a Los Angeles dialysis treatment center both pleaded guilty today to fraud charges for their roles in a fraud scheme that resulted in more than $6.6 million in fraudulent claims to Medicare. Three other individuals charged in the case previously pleaded guilty.
November 28, 2017; U.S. Attorney; Southern District of New York
Acting Manhattan U.S. Attorney Announces Criminal And Civil Charges Against Prominent Researcher For Theft Of Government Funds And Other Offenses
Joon H. Kim, the Acting United States Attorney for the Southern District of New York, and Scott J. Lampert, the Special Agent in Charge of the New York Office of the U.S. Department of Health and Human Services' Office of Inspector General ("HHS-OIG"), announced today the filing of criminal and civil charges against ALEXANDER NEUMEISTER ("NEUMEISTER"), a prominent researcher into neurological disorders who, at all times relevant to the charges, was a professor of psychology at a New York City medical school (the "School").
November 27, 2017; U.S. Department of Justice
Former Employees of Southern California Ambulance Company and Dialysis Center Plead Guilty to Medicare Fraud Charges
A former employee of a Southern California ambulance company and a former employee of a Los Angeles dialysis treatment center both pleaded guilty today to fraud charges for their roles in a fraud scheme that resulted in more than $6.6 million in fraudulent claims to Medicare. Three other individuals charged in the case previously pleaded guilty.
November 22, 2017; U.S. Department of Justice
Former General Counsel of Company That Operates Health Maintenance Organizations in Several States Sentenced to Prison for Role in $35 Million Health Care Fraud Scheme
The former general counsel of a company that operates health maintenance organizations in several states was sentenced to six months in prison today for his role in a $35 million health care fraud scheme.
November 21, 2017; U.S. Department of Justice Medicare Fraud Strike Force Case
Miami-Area Man Pleads Guilty for Role in $63 Million Health Care Fraud Scheme
A Miami-area, Florida man pleaded guilty today for his role in a $63 million health care fraud scheme involving a now-defunct community mental health center located in Miami that purported to provide partial hospitalization program (PHP) services to individuals suffering from mental illness.
November 21, 2017; U.S. Department of Justice
Owner of Two Miami Home Health Agencies Sentenced to More Than Six Years in Prison for Role in $74 Million Medicare Fraud Conspiracy
The owner and operator of two defunct Miami home health agencies was sentenced today to 80 months in prison for her role in a $74 million conspiracy to defraud the Medicare program.
November 20, 2017; U.S. Department of Justice Medicare Fraud Strike Force Case
Operator of Purported Durable Medical Equipment Providers Pleads Guilty to Health Care Fraud Charges for Role in Durable Medical Equipment Fraud Scheme
An operator of multiple purported durable medical equipment (DME) companies pleaded guilty today to fraud charges for her role in a scheme to defraud Healthfirst, a non-profit, New York-based health maintenance organization that administers Medicare Advantage plans and New York Medicaid Managed Care plans.
November 20, 2017; U.S. Attorney; Central District of Illinois
Decatur Woman to Serve 18 Months in Prison for Defrauding Home Services Program
URBANA, Ill., -- A Decatur, Ill., woman, Charissie Davis, was sentenced this afternoon to serve 18 months in federal prison for defrauding the Home Services Program, a Medicaid waiver program. The health care benefit program provides funding to pay personal assistants who aid qualifying disabled individuals in performing household tasks and personal care. With the permission of a doctor, the personal assistant may also perform certain health care procedures.
November 17, 2017; U.S. Attorney; Southern District of Georgia
Meadows Regional Medical Center, Inc. and Affiliates To Pay Up To $12.875 Million To Resolve Alleged False Claims Act Violations
SAVANNAH, GA: Meadows Regional Medical Center, Inc. ("Meadows") and others have agreed to pay the United States and Georgia a total of up to $12,875,000 to resolve allegations that they violated the False Claims Act. The United States and State of Georgia contended that Meadows and others violated and conspired to violate the False Claims Act by submitting claims referred by physicians with whom Meadows had improper compensation arrangements, in violation of the Stark Law and the Anti-Kickback Statute. As part of the settlement, Meadows has also entered into a corporate integrity agreement with the Department of Health and Human Services Office of Inspector General (HHS-OIG).
November 16, 2017; U.S. Attorney; Northern District of Georgia
Four charged in multi-state health care fraud conspiracy
ATLANTA - Matthew Harrell, Nikki Richardson, Tomeka Howard and Andrea Barrett have been indicted on multiple counts of conspiracy to commit healthcare fraud and aggravated identify theft related to fraudulent claims filed with the Georgia, Florida and Louisiana Medicaid programs.
November 16, 2017; U.S. Attorney; Eastern District of Missouri
Chicago Podiatrist Sentenced for Health Care Fraud Charges
St. Louis, MO - Dr. John Dailey was sentenced to 27 months in prison and ordered to pay $291,413 in restitution to the Centers for Medicare and Medicaid Services.
November 15, 2017; U.S. Department of Justice Medicare Fraud Strike Force Case
Owner and Manager of New York Medical Equipment Provider Charged for Their Roles in Alleged $3.5 Million Scheme to Defraud Government-Funded Health Plans
The owner and the manager of a purported durable medical equipment (DME) company in the Bronx, New York, were charged in an indictment unsealed today for their roles in an allegedly fraudulent scheme that involved submitting over $3.5 million in claims to private insurers, which included government-sponsored managed care organizations.
November 15, 2017; U.S. Attorney; District of New Jersey
Doctor And Wife From Wayne, New Jersey, Plead Guilty In Test-Referral Bribe Scheme With New Jersey Clinical Lab
NEWARK, N.J. - A cardiologist with a practice in Paterson, New Jersey, and his wife pleaded guilty today to their involvement in a test-referral bribe scheme operated by Biodiagnostic Laboratory Services LLC (BLS), of Parsippany, New Jersey, its president and numerous associates, Acting U.S. Attorney William E. Fitzpatrick announced.
November 15, 2017; U.S. Attorney; Western District of Louisiana
Shreveport mental health facility administrator sentenced to 26 months in prison for kickback scheme
SHREVEPORT, La. - Acting U.S. Attorney Alexander C. Van Hook announced that a Shreveport mental health facility administrator was sentenced Tuesday to 26 months in prison for taking part in a kickback scheme.
November 14, 2017; U.S. Attorney; Southern District of New York
Doctor And Four Executives Plead Guilty In $30 Million Scheme To Defraud Medicare And Medicaid
Joon H. Kim, the Acting United States Attorney for the Southern District of New York, announced today that five defendants have pleaded guilty in the past week to participating in a scheme to defraud Medicare and Medicaid through the operation of eight medical clinics and related health care providers in Brooklyn. The defendants pleading guilty are Dr. MUSTAK Y. VAID, medical supply company president MARINA BURMAN, clinic executives ASHER OLEG KATAEV, a/k/a "Oleg Kataev," and ALLA TSIRLIN, and IVAN VOYCHAK, who helped run two of the fraudulent clinics and a related ambulette company. The defendants were charged with participating in a $30 million health care fraud scheme. As part of the scheme, the defendants or their co-conspirators paid cash kickbacks to elderly patients (the "Paid Patients") insured by Medicare and/or Medicaid, and then billed Medicare and Medicaid for unnecessary medical services, tests, and supplies.
November 14, 2017; U.S. Attorney; Northern District of Alabama
NW Alabama Compounding Pharmacy Sales Representative Pleads Guilty in Prescription Fraud Conspiracy
BIRMINGHAM - A sales representative for a Haleyville, Ala.,-based compounding pharmacy pleaded guilty today in federal court to participating in a conspiracy to generate prescriptions, including for a $29,000 wound cream, and defraud health care insurers and prescription drug administrators out of tens of millions of dollars in 2015.
November 14, 2017; U.S. Attorney; District of New Jersey
Two Insurance Companies Agree To Pay More Than $2 Million To Resolve False Claims Act Allegations
NEWARK, N.J. - Two insurance companies that are part of one of the largest providers of automobile insurance in the United States have agreed to pay more than $2 million to resolve allegations that they violated the False Claims Act by causing Medicare and Medicaid to pay for claims for which the companies were responsible, Acting U.S. Attorney William E. Fitzpatrick announced today.
November 9, 2017; U.S. Attorney; Southern District of Florida
Doctor Sentenced in Multi-Million Dollar Health Care Fraud and Money Laundering Scheme Involving Sober Homes and Alcohol and Drug Addiction Treatment Centers
A doctor was sentenced to 48 months in prison, to be followed by one year of supervised release, and was ordered to pay restitution of $2,198,520.37 for his participation in a multi-million dollar health care fraud and money laundering scheme that involved the filing of fraudulent insurance claim forms and defrauded health care benefit programs.
November 9, 2017; U.S. Department of Justice Medicare Fraud Strike Force Case
New Orleans Woman Convicted for Role in $3.2 Million Medicare Kickback Scheme
A federal jury found a New Orleans woman guilty today for her role in an approximately $3.2 million Medicare fraud and kickback scheme.
November 8, 2017; U.S. Attorney; District of New Jersey
New York Doctor Sentenced To 33 Months In Prison For Role In Test-Referral Scheme With New Jersey Clinical Lab
NEWARK, N.J. - An internal medicine doctor practicing in Staten Island, New York, was sentenced today to 33 months in prison for taking bribes in connection with a long-running and elaborate test referral scheme operated by Biodiagnostic Laboratory Services LLC (BLS), of Parsippany, New Jersey, its president and numerous associates, Acting U.S. Attorney William E. Fitzpatrick announced.
November 7, 2017; U.S. Department of Justice Medicare Fraud Strike Force Case
Michigan Doctor and Owner of Medical Billing Company Sentenced to 15 Years in Prison for $26 Million Health Care Fraud Scheme
A Detroit-area doctor was sentenced to 180 months in prison today for his role in a $26 million health care fraud scheme that involved billing Medicare for nerve block injections that were never provided and efforts to circumvent Medicare's investigation of the fraudulent scheme. A co-conspirator who owned a medical billing company was previously sentenced to 10 years in prison.
November 6, 2017; U.S. Department of Justice
Owner of Florida Pharmacy Pleads Guilty in $100 Million Compounding Pharmacy Fraud Scheme; Real Properties, Cars and a 50-Foot Boat Will Be Forfeited
The president and owner of a Florida pharmacy that was at the center of a massive compounding pharmacy fraud scheme, which impacted private insurance companies, Medicare and TRICARE, pleaded guilty today for his role in the scheme. Seven other individuals have previously pleaded guilty in connection to the scheme. Various real properties, cars and a 50-foot boat will be forfeited as part of the guilty pleas.
November 2, 2017; U.S. Attorney; Eastern District of Louisiana
Two Californians Sentenced for Conspiracy to Commit Health Care Fraud
Acting U.S. Attorney Duane A. Evans announced that GEOFFREY RICKETTS, age 48, and SAMUEL KIM, age 42, both of Porter Ranch, California, were sentenced today after previously pleading guilty to conspiracy to commit health care fraud.
November 2, 2017; U.S. Attorney; Southern District of New York
Doctor And Nurse Practitioner Among Three Defendants Charged In Manhattan Federal Court For Oxycodone And Fentanyl Diversion Scheme
Joon H. Kim, the Acting United States Attorney for the Southern District of New York, James J. Hunt, the Special Agent in Charge of the New York Field Division of the Drug Enforcement Administration ("DEA"), James P. O'Neill, the Commissioner of the Police Department for the City of New York ("NYPD"), and Mark G. Peters, the Commissioner of the New York City Department of Investigation ("DOI"), today announced the arrests of ERNESTO LOPEZ, a New York-licensed doctor who wrote thousands of medically unnecessary prescriptions for oxycodone and fentanyl patches over an approximately three-year period, SHARON WASHINGTON-BHAMRE, a pediatric nurse practitioner who also wrote medically unnecessary prescriptions for oxycodone, and AUDRA BAKER, an employee at one of LOPEZ's medical offices who helped facilitate the diversion scheme. All three defendants are charged with conspiracy to distribute controlled substances and were arrested earlier this morning. The defendants will be presented in Manhattan federal court before U.S. Magistrate Judge Barbara C. Moses later today.
November 1, 2017; U.S. Attorney; District of Maine
Mercy Hospital Pays $1,514,000 to Settle False Claims Act Allegations
Portland, Maine: United States Attorney Halsey B. Frank today announced that Mercy Hospital ("Mercy"), of Portland, has entered into a civil settlement agreement with the United States and the State of Maine in which it will pay $1,514,000 to resolve allegations that it violated the federal and Maine False Claims Acts.
November 1, 2017; U.S. Attorney; Northern District of Illinois
U.S. and State of Illinois File Suit Against Owners of Suburban Youth Counseling Center for Allegedly Defrauding Medicaid out of Millions
CHICAGO - The United States and the State of Illinois have jointly filed a civil lawsuit accusing the owners of a Chicago-area youth counseling center of defrauding Medicaid out of millions of dollars through a fraudulent billing scheme.

October 2017

October 30, 2017; U.S. Department of Justice
Chemed Corp. and Vitas Hospice Services Agree to Pay $75 Million to Resolve False Claims Act Allegations Relating to Billing for Ineligible Patients and Inflated Levels of Care
Chemed Corporation and various wholly-owned subsidiaries, including Vitas Hospice Services LLC and Vitas Healthcare Corporation, have agreed to pay $75 million to resolve a government lawsuit alleging that defendants violated the False Claims Act (FCA) by submitting false claims for hospice services to Medicare. Chemed, which is based in Cincinnati, Ohio, acquired Vitas in 2004. Vitas is the largest for-profit hospice chain in the United States.
October 30, 2017; U.S. Attorney; Southern District of Florida
Fort Pierce Resident Sentenced in Federal Health Care Fraud Scheme
Miguel De Paula Arias, 53, of Fort Pierce, was sentenced to 161 months in prison on charges of health care fraud, false statements related to healthcare and aggravated identity theft.
October 30, 2017; U.S. Attorney; District of Maryland
Pain Management Physician Convicted On Charges Of Accepting Kickbacks And Submitting Fraudulent Bills For Anesthesia Services
Baltimore, Maryland - On October 27, 2017, following a thirteen-day trial, a federal jury convicted Atif Babar Malik, age 48, of Germantown, Maryland, on 26 felony counts arising from two criminal schemes that involved referring patients' urine toxicology specimens to a New Jersey diagnostic testing lab in return for $1.376 million in kickbacks and fraudulently billing for anesthesia services provided in connection with spinal nerve block injections. Malik was convicted on one count of conspiracy to violate the federal Anti-Kickback Act and the Travel Act; 12 counts of violating the Anti-Kickback Act; three counts of violating the Travel Act; six counts of health care fraud; and three counts of making false entries in patients' medical records.
October 27, 2017; U.S. Attorney; District of Wyoming
Powell, Wyoming Psychologist Pleads Guilty to Health Care Fraud
Gibson Buckley Condie, 57, of Powell, Wyoming, pled guilty in federal court on October 27, 2017, to health care fraud involving mental health services falsely billed to Wyoming Medicaid, announced Acting United States Attorney John R. Green. Condie, who is a licensed psychologist, had been indicted by a federal grand jury in May 2017 for an alleged scheme to defraud Medicaid. As part of a plea agreement with the United States, Condie has agreed to serve 3 years in prison, pay approximately $2.28 million in restitution to the Wyoming Department of Health and the United States Department of Health and Human Services, and forfeit certain assets traceable to the proceeds of his fraud.
October 27, 2017; U.S. Attorney; Northern District of Texas
Last Defendant Sentenced in Health Care Fraud Scheme
DALLAS - Cynthia Stiger, 52, of Dallas, Texas, who was convicted in April 2016 of one count of conspiracy to commit health care fraud, was sentenced yesterday by U.S. District Judge Sam A. Lindsay to 120 months in federal prison and ordered to pay $23,630,777.26 in restitution, joint and several with all codefendants to Medicare and Medicaid, announced U.S. Attorney John Parker of the Northern District of Texas.
October 26, 2017; U.S. Department of Justice
Pittsburgh-Area Doctor Charged With Unlawfully Distributing Opioids
A suburban Pittsburgh physician has been indicted by a federal grand jury in Pittsburgh on charges of conspiracy and unlawfully distributing controlled substances, Acting United States Attorney Soo C. Song announced today. The indictment of Andrzej Kazimierz Zielke, 62, is the first since Attorney General Jeff Sessions announced the formation of the Opioid and Abuse Detection Unit, a Department of Justice initiative that uses data to target and prosecute individuals that are contributing to the nation's opioid crisis.
October 26, 2017; U.S. Department of Justice
Founder and Owner of Pharmaceutical Company Insys Arrested and Charged with Racketeering
The founder and majority owner of Insys Therapeutics Inc., was arrested today and charged with leading a nationwide conspiracy to profit by using bribes and fraud to cause the illegal distribution of a Fentanyl spray intended for cancer patients experiencing breakthrough pain.
October 25, 2017; U.S. Attorney; District of Rhode Island
RI Doctor Admits to Healthcare Fraud, Accepting Kickbacks for Prescribing Highly Addictive Version of Fentanyl
WASHINGTON - Dr. Jerrold N. Rosenberg, 63 of North Providence and Jamestown, R.I., the operator of a now-defunct pain management practice in Rhode Island, pleaded guilty in U.S. District Court in Providence, R.I., today to conspiring to solicit and receive kickbacks in connection with his prescribing of the drug Subsys, a fast-acting, powerful, and highly-addictive version of the opioid drug Fentanyl that is administered as an under-the-tongue spray, and to committing healthcare fraud.
October 25, 2017; U.S. Attorney; District of New Jersey
New York Doctor Convicted Of Taking Bribes In Test-Referral Scheme With New Jersey Clinical Lab
NEWARK, N.J. - A doctor practicing in Staten Island, New York, was convicted at trial 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, Acting U.S. Attorney William E. Fitzpatrick announced.
October 24, 2017; U.S. Department of Justice
Nurse Practitioner and Physician Indicted in Compounding Pharmacy Fraud Schemes
A Mississippi-based nurse practitioner was charged in an indictment unsealed today for her role in a multi-million dollar scheme to defraud TRICARE, the health care benefit program serving U.S. military, veterans and their respective family members. A Mississippi-based physician was charged in a separate indictment filed last week for his role in a similar scheme.
October 24, 2017; U.S. Attorney; District of Columbia
Court Orders Home Health Care Company to Pay United States Nearly $2 Million in Damages in False Claims Case
WASHINGTON - A federal judge has entered a verdict in favor of the United States and against Dynamic Visions, Inc., and awarded the government $1.98 million in a False Claims Act case, in which the United States demonstrated that employees of the home health care company repeatedly and routinely falsified records to obtain funds from Medicaid.
October 24, 2017; U.S. Attorney; Northern District of Alabama
U.S. Attorney Charges NW Alabama Compounding Pharmacy Sales Representative in Prescription Fraud Conspiracy
BIRMINGHAM - The U.S. Attorney's Office today charged a fourth sales representative for a Haleyville, Ala.,-based compounding pharmacy for participating in a conspiracy to generate prescriptions and defraud health care insurers and prescription drug administrators out of tens of millions of dollars in 2015.
October 23, 2017; U.S. Attorney; District of New Jersey
Head of Camden Nonprofit Sentenced to 70 Months in Prison for Defrauding Medicaid and Embezzling over $1.5 Million
CAMDEN, N.J. - The executive director of a nonprofit provider of mental health services to Camden's poorest residents was sentenced today to 70 months in prison for defrauding New Jersey Medicaid by using unqualified people to treat Medicaid recipients and taking money from the nonprofit, Acting U.S. Attorney William E. Fitzpatrick announced.
October 19, 2017; U.S. Attorney; Southern District of Texas
Huntsville Nursing Home Pays the United States and the State of Texas $5 Million to Settle Claims Alleging Poor Quality of Care
HOUSTON - Health Services Management Inc. (HSM) has paid the United States $5 million to resolve claims that the company billed the Medicare and Medicaid programs for worthless services and for services that were never provided, announced Acting U.S. Attorney Abe Martinez. HSM is based in Murfreesboro, Tennessee, and owns and operates nursing homes throughout Texas and the United States. The claims resolved by the settlement are allegations only with no determination of liability.
October 18, 2017; U.S. Attorney; Middle District of Florida
Two Behavioral Health Clinic Operators Plead Guilty To Conspiracy To Commit Over $1 Million In Health Care Fraud
Jacksonville, FL - Acting United States Attorney W. Stephen Muldrow announces that Shawn Thorpe (30) and Ruben McLain (46), both of Winston Salem, North Carolina, have pleaded guilty to conspiracy to commit healthcare fraud. Each faces a maximum penalty of five years in prison and a fine of up to $250,000. A sentencing date has not yet been set.
October 17, 2017; U.S. Attorney; Northern District of Illinois
U.S. Files Lawsuit Against Husband-And-Wife Owners of Suburban Health Care Company for Allegedly Defrauding Medicare out of Millions of Dollars
CHICAGO - The United States today filed a civil lawsuit against the husband-and-wife owners of a suburban Chicago health care company for allegedly falsely billing Medicare for millions of dollars in unnecessary or nonexistent services.
October 17, 2017; U.S. Attorney; District of New Jersey
Doctor Admits Billing Medicare, Other Insurers $3 Million For Therapy Services Performed By Unqualified Personnel
NEWARK, N.J. - A doctor with offices in Paterson, New Jersey, Passaic, New Jersey, and Elizabeth, New Jersey, today admitted defrauding Medicare and private insurance companies out of $3 million by billing for more than 150,000 physical therapy sessions that were performed by unlicensed and unqualified personnel, Acting U.S. Attorney William Fitzpatrick announced.
October 17, 2017; U.S. Attorney; Western District of Pennsylvania
MedFast Pharmacist Sentenced to Probation, Community Service for Fraud Scheme
PITTSBURGH - A resident of Beaver County, Pennsylvania, has been sentenced in federal court to two years probation and 150 hours of community service on her conviction of conspiracy, Acting United States Attorney Soo C. Song announced today.
October 16, 2017; U.S. Attorney; District of New Jersey
Three New York Doctors Sentenced To Prison For Taking Bribes In Test-Referral Scheme With New Jersey Clinical Lab
NEWARK, N.J. - Three doctors were each sentenced today to over two years in prison for taking bribes in connection with a long-running and elaborate test referral scheme operated by Biodiagnostic Laboratory Services LLC (BLS), of Parsippany, New Jersey, its president and numerous associates, Acting U.S. Attorney William E. Fitzpatrick announced.
October 13, 2017; U.S. Attorney; Middle District of Florida
Jacksonville Cardiovascular Practice Agrees To Pay More Than $440,000 To Resolve False Claims Act Allegations For Failing To Reimburse Government Health Care Programs
Jacksonville, FL - Acting United States Attorney W. Stephen Muldrow announces that First Coast Cardiovascular Institute, P.A. ("FCCI") has agreed to pay $448,821.58 to resolve allegations that it violated the False Claims Act by knowingly delaying repayment of more than $175,000 in overpayments owed to Medicare, Medicaid, TRICARE, and the Department of Veterans Affairs.
October 13, 2017; U.S. Attorney; Eastern District of Louisiana
Marrero Woman Sentenced to One Year Imprisonment for Healthcare Fraud
Acting U.S. Attorney Duane A. Evans announced that MONICA SYLVEST, age 52, of Marrero, was sentenced today after previously pleading guilty to health care fraud.
October 11, 2017; U.S. Attorney; Eastern District of North Carolina
North Carolina Pharmacist Sentenced to Prison For Medicare and Medicaid Fraud
GREENVILLE - The United States Attorney's Office for the Eastern District of North Carolina announced that yesterday in federal court, JUSTIN LAWRENCE DANIEL, 35, of Fayetteville, North Carolina, was sentenced to 12 months and a day in federal prison and 3 years of supervised release following his prior guilty plea to Health Care Fraud Conspiracy. DANIEL was also ordered to make restitution of $1,961,176.56 to the Medicare program and $479,923.50 to the North Carolina Medicaid program.
October 6, 2017; U.S. Attorney; Eastern District of Missouri
Former CEO of Benchmark Healthcare Sentenced on Health Care Fraud Charges
St. Louis, MO - John Mac Sells, 53, of St. Peters, Missouri, was sentenced today to 41 months in prison and ordered to pay $667,201.85 in restitution.
October 4, 2017; U.S. Attorney; Southern District of Texas
Four Area Hospitals to Pay Millions to Resolve Ambulance Swapping Allegations
HOUSTON - Four Houston-area hospitals have agreed to pay $8.6 million to settle allegations they received kickbacks from various ambulance companies in exchange for rights to the hospitals' more lucrative Medicare and Medicaid transport referrals. The hospitals are all affiliated with Hospital Corporation of America (HCA), which is based in Nashville, Tennessee, and include Bayshore Medical Center, Clear Lake Regional Medical Center, West Houston Medical Center and East Houston Regional Medical Center.
October 3, 2017; U.S. Department of Justice
Doctor Pleads Guilty to Health Care Fraud Conspiracy for Role in $19 Million Detroit Area Medicare Fraud Scheme
A physician pleaded guilty today to conspiracy to commit health care fraud for his role in an approximately $19 million Medicare fraud scheme involving three Detroit area providers.
October 3, 2017; U.S. Attorney; Northern District of New York
Syracuse Area Medical Practice to Pay Nearly $2 Million to Resolve False Claims Act Exposure
SYRACUSE, NEW YORK - New York Anesthesiology Medical Specialties, P.C. d/b/a New York Spine and Wellness Center (New York Spine & Wellness) agreed today to pay $1,941,850.29 to resolve claims that it improperly billed for moderate sedation services, announced Acting United States Attorney Grant C. Jaquith and New York State Attorney General Eric T. Schneiderman.
October 2, 2017; U.S. Attorney; Central District of California
Owner-Operator of Burbank Clinic that Prescribed Unnecessary Services and Submitted Fraudulent Claims as Part of Scheme to Defraud Medicare Sentenced to 37 Months in Federal Prison
LOS ANGELES - The owner-operator of a Burbank medical clinic was sentenced today to 37 months in federal prison on federal healthcare fraud charges for participating in a scheme to defraud Medicare by prescribing unnecessary services and equipment, which often were not even provided.

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