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Criminal and Civil Enforcement

January 2020

January 27, 2020; U.S. Department of Justice
Electronic Health Records Vendor to Pay $145 Million to Resolve Criminal and Civil Investigations. Practice Fusion Inc. Admits to Kickback Scheme Aimed at Increasing Opioid Prescriptions.
Practice Fusion Inc. (Practice Fusion), a San Francisco-based health information technology developer, will pay $145 million to resolve criminal and civil investigations relating to its electronic health records (EHR) software, the Department of Justice announced today.
January 27, 2020; Southern District of West Virginia
HOPE Clinic Physician Pleads Guilty
BECKLEY, W.Va. - A North Carolina physician pled guilty to a drug crime, announced United States Attorney Mike Stuart. Roswell Tempest Lowry, M.D., 85, pled guilty to interstate travel in aid of a racketeering enterprise.
January 27, 2020; Southern District of New York
Manhattan Doctor Sentenced To Nearly Five Years In Prison For Accepting Bribes And Kickbacks In Exchange For Prescribing Fentanyl Drug.
Geoffrey S. Berman, the United States Attorney for the Southern District of New York, announced today that ALEXANDRU BURDUCEA, a doctor who practiced in Manhattan, was sentenced today in Manhattan federal court to 57 months in prison for conspiring to violate the Anti-Kickback Statute, in connection with a scheme to prescribe Subsys, a potent fentanyl-based spray, in exchange for bribes and kickbacks from Subsys's manufacturer, Insys Therapeutics. BURDUCEA pled guilty on February 14, 2019, and was sentenced by United States District Judge Kimba M. Wood.
January 24, 2020; U.S. Department of Justice
Columbus Pain Clinic and Owner Agree to Pay $650,000 to Resolve Allegations of Unnecessary Procedures
Comprehensive Pain Management Institute and its owner, Leon Margolin, M.D., have agreed to pay the United States $650,000 to resolve False Claims Act allegations that they knowingly billed Medicare for nerve conduction studies and alcohol/substance abuse assessments and interventions (SBIRT) that were medically unnecessary or not provided as billed, the Justice Department announced today. Margolin is a pain management physician in Columbus, Ohio.
January 24, 2020; District of Connecticut
Waterbury Licensed Professional Counselor Pays $39K to Settle False Claims Allegations
John H. Durham, United States Attorney for the District of Connecticut, today announced that CHANNA SONTAG, LPC, and her business, CHILDREN'S BEHAVIORAL THERAPY LLC, have entered into a civil settlement agreement with the federal and state governments and will pay more than $39,000 to resolve allegations that they violated the federal and state False Claims Acts.
January 24, 2020; Eastern District of Tennessee
Family Physician Pays $285,000 To Settle False Claims Act Allegations Of Billing Services At Inflated Rate
Knoxville, Tenn. - Family physician Dr. Chang-Wen Chen and his practice Chang-Wen Chen, M.D., P.C. paid $285,000 to resolve allegations that they violated the False Claims Act by improperly charging government health care programs the physician's rate for services that were provided by nurse practitioners. The allegations challenged billings submitted to Medicare, Medicaid ("TennCare") and TRICARE from 2013 through 2019.
January 23, 2020; U.S. Attorney; Southern District of California
San Diego's Arch Health Pays $2.9 Million to Resolve False Claims Act Allegations
SAN DIEGO - Arch Health Partners, Inc. ("Arch Health") has agreed to pay the United States $2,910,370 to resolve allegations that it violated the False Claims Act by submitting false claims to Medicare. Arch Health is a San Diego-based medical organization that contracts with physician groups to provide care through the Palomar Health system.
January 22, 2020; U.S. Attorney; District of Massachusetts
Former CEO of Insys Therapeutics Sentenced for Racketeering Scheme
BOSTON - The former CEO and President of Insys Therapeutics was sentenced today in federal court in Boston for bribing practitioners to prescribe Subsys, a fentanyl-based pain medication, often when medically unnecessary.
January 22, 2020; U.S. Attorney; Northern District of Ohio
Braking Point Recovery Center Owner Sentenced to 7 1/2 Years in Prison for Health Care Fraud and Drug Crimes
Ryan P. Sheridan, 39, the owner and operator of Braking Point Recovery Center, which operated in the Youngstown and Columbus areas, was sentenced to 7 ½ years in prison for crimes related to a health care fraud conspiracy where Medicaid was billed $48 million for drug and alcohol recovery services, much of which were not provided, not medically necessary, lacked proper documentation, or had other issues that made them ineligible for reimbursement.
January 21, 2020; U.S. Department of Justice
Patient Services Inc. Agrees to Pay $3 Million for Allegedly Serving as a Conduit for Pharmaceutical Companies to Illegally Pay Patient Copayments
Patient Services Inc. (PSI), a foundation based in Midlothian, Virginia, has agreed to pay $3 million to resolve allegations that it violated the False Claims Act by acting as a conduit to enable certain pharmaceutical companies to provide kickbacks to Medicare patients taking the companies' drugs by paying the patients' copayments, the Department of Justice announced today. The amount of the settlement announced today was determined based on analysis of PSI's ability to pay after review of its financial condition.
January 21, 2020; U.S. Department of Justice
Patient Services Inc. Agrees to Pay $3 Million for Allegedly Serving as a Conduit for Pharmaceutical Companies to Illegally Pay Patient Copayments
Patient Services Inc. (PSI), a foundation based in Midlothian, Virginia, has agreed to pay $3 million to resolve allegations that it violated the False Claims Act by acting as a conduit to enable certain pharmaceutical companies to provide kickbacks to Medicare patients taking the companies' drugs by paying the patients' copayments, the Department of Justice announced today. The amount of the settlement announced today was determined based on analysis of PSI's ability to pay after review of its financial condition.
January 21, 2020; U.S. Department of Justice
Pennsylvania Doctor Pleads Guilty to Unlawfully Distributing Oxycodone to His Patients
A Pennsylvania doctor pleaded guilty today to unlawfully distributing oxycodone to his patients.
January 21, 2020; U.S. Attorney; Southern District of California
"Pill Mill" Doctor Pleads Guilty to Opioid Distribution, Admits Signing Prescriptions for Dead and Jailed Patients
SAN DIEGO - Egisto Salerno, a medical doctor practicing in San Diego, pleaded guilty to opioid distribution in federal court today, admitting that he signed bogus prescriptions for multiple deceased or incarcerated patients.
January 21, 2020; U.S. Department of Justice
Patient Services Inc. Agrees to Pay $3 Million for Allegedly Serving as a Conduit for Pharmaceutical Companies to Illegally Pay Patient Copayments
Patient Services Inc. (PSI), a foundation based in Midlothian, Virginia, has agreed to pay $3 million to resolve allegations that it violated the False Claims Act by acting as a conduit to enable certain pharmaceutical companies to provide kickbacks to Medicare patients taking the companies' drugs by paying the patients' copayments, the Department of Justice announced today. The amount of the settlement announced today was determined based on analysis of PSI's ability to pay after review of its financial condition.
January 21, 2020; U.S. Attorney; District of Massachusetts
Fourth Foundation Resolves Allegations that it Conspired with Pharmaceutical Companies to Pay Kickbacks to Medicare Patients
BOSTON - The U.S. Attorney's Office announced today that Patient Services, Inc. ("PSI"), a foundation based in Midlothian, Va., has agreed to pay $3 million to resolve allegations that it violated the False Claims Act by enabling certain pharmaceutical companies to pay kickbacks to Medicare patients taking the companies' drugs.
January 21, 2020; U.S. Attorney; Southern District of Florida
Three South Florida Residents Sentenced to Prison for Their Roles in $21 Million Sober Homes Fraud Scheme
MIAMI, FL - Three former co-owners and clinical directors of a group of purported substance abuse treatment centers and sober homes were sentenced to prison today for their roles in a conspiracy to commit health care fraud and wire fraud that resulted in an actual loss of more than $3.8 million, and through which the conspirators sought to obtain more than $21 million.
January 21, 2020; U.S. Attorney; Eastern District of New York
Medical Doctor Settles Civil Fraud Allegations in Adult Homes Investigation
Dr. Rajendra Bhayani, an otolaryngologist, has agreed to pay the United States $1,109,000 to resolve civil allegations that he and his practice - New York Otolaryngology & Aesthetic Surgery, P.C. in Brooklyn and Queens - paid kickbacks and submitted false claims to federal healthcare programs for services provided to residents in adult homes in violation of the False Claims Act.
January 17, 2020; U.S. Attorney; District of South Carolina
ResMed Corp. to Pay the United States $37.5 Million to Settle Allegations Under the False Claims Act
Columbia, South Carolina --- Acting United States Attorney A. Lance Crick announced today that ResMed Corp., a manufacturer of durable medical equipment (DME) for sleep apnea and other sleep-related disorders, has agreed to pay more than $37.5 million to resolve allegations under the False Claims Act for paying kickbacks to DME suppliers, sleep labs, and other health care providers.
January 16, 2020; U.S. Attorney; Eastern District of Virginia
Psychiatrist Sentenced to Prison for Healthcare Fraud Scheme
NORFOLK, Va. - A Virginia Beach doctor was sentenced today to 27 months in prison for defrauding Medicare, Medicaid, and Tricare, and other health care benefits programs out of hundreds of thousands of dollars.
January 16, 2020; U.S. Attorney; Northern District of Iowa
Northern Iowa Doctor Sentenced to Federal Prison for Making False Statements and Will Pay More Than $315,000 to Resolve False Claims Act Allegations Relating to Nursing Facility Residents
Dr. Joseph X. Latella, a primary care doctor in Webster City, Iowa, was sentenced today to two months in prison and to pay a fine after previously pleading guilty to making false statements related to health care matters. Dr. Latella has also agreed to pay $316,438.96 to resolve False Claims Act allegations relating to claims he submitted for routine visits for nursing facility residents between January 1, 2014, and November 30, 2018. The United States alleged that Dr. Latella submitted claims to Medicare and Medicaid for the most intensive and expensive claim code for such visits when, in fact, he was not performing services sufficient to justify use of that code.
January 16, 2020; U.S. Attorney; Eastern District of Louisiana
Metairie Woman Pleads Guilty to Conspiracy to Obtain Oxycodone by Fraud and to Distribute Oxycodone
NEW ORLEANS - U.S. Attorney Peter G. Strasser announced that CHRISTIE LYNN BROWNING, age 42, a resident of Metairie, Louisiana pled guilty on January 15, 2020 to a dual object conspiracy to obtain possession of oxycodone by fraud and to unlawfully distribute oxycodone.
January 16, 2020; U.S. Attorney; District of Massachusetts
Two Dentists and Office Manager Indicted for Medicaid Fraud Scheme
One defendant also indicted for tax evasion and aggravated identity theft
BOSTON - A federal grand jury in Boston has indicted a Worcester dentist, a Chelmsford dentist, and a Worcester office manager for their participation in a scheme to defraud the Massachusetts Medicaid program, commonly known as MassHealth.
January 15, 2020; U.S. Department of Justice
Texas Doctor Found Guilty for Role in $325 Million Health Care Fraud Scheme Involving False Diagnoses of Life-Long Diseases
A federal jury found a Texas rheumatologist guilty today for his role in a $325 million health care fraud scheme in which he falsely diagnosed patients with life-long diseases and treated them with toxic medications on the basis of that false diagnosis.
January 15, 2020; U.S. Attorney; Eastern District of New York
ResMed Corp. to Pay the United States $37.5 Million for Allegedly Causing the Filing of False Claims Related to the Sale of Equipment for Sleep Apnea and Other Sleep-Related Disorders
WASHINGTON - The Department of Justice announced today that ResMed Corp., a manufacturer of durable medical equipment (DME) based in San Diego, California, has agreed to pay more than $37.5 million to resolve alleged False Claims Act violations for paying kickbacks to DME suppliers, sleep labs and other health care providers.
January 15, 2020; U.S. Attorney; Eastern District of Wisconsin
TMJ & Orofacial Pain Treatment Centers of Wisconsin Agree to Pay $1 Million to Resolve False Claims Act Allegations
United States Attorney Matthew D. Krueger announced today that L.M.G., Inc., which does business as TMJ & Orofacial Pain Treatment Centers of Wisconsin, agreed to pay $1,000,000 to the United States to resolve allegations that TMJ & Orofacial Pain Treatment Centers of Wisconsin submitted false claims to Medicare and TRICARE for oral appliances used to treat temporomandibular joint disorder.
January 14, 2020; U.S. Attorney; Middle District of Tennessee
Mid-State Physician Charged In $7 Million Healthcare Fraud Conspiracy
NASHVILLE, Tenn. - January 14, 2020 - James L. Crabb, M.D., 78, of Loretto, Tennessee, is facing federal charges for his role in a $7 million healthcare fraud conspiracy, announced U.S. Attorney Don Cochran for the Middle District of Tennessee. Crabb was charged in a criminal Information on December 20, 2019, and appeared before a U.S. Magistrate Judge yesterday.
January 14, 2020; U.S. Attorney; Western District of Pennsylvania
Pittsburgh Resident Pleads Guilty to Conspiracy and Health Care Fraud
PITTSBURGH, Pa. - A resident of Pittsburgh, Pennsylvania, pleaded guilty in federal court yesterday to one count each of conspiracy to defraud the Pennsylvania Medicaid program and health care fraud, United States Attorney Scott W. Brady announced today.
January 13, 2020; U.S. Attorney; Eastern District of Michigan
Metro Detroit Psychologist Sentenced to 51 Months for Health Care Fraud and Money Laundering
A psychologist with multiple clinic locations throughout Metro Detroit, will spend 51 months in prison for the commission of health care fraud and money laundering offenses, U.S. Attorney Matthew Schneider announced today.
January 10, 2019; U.S. Attorney; Eastern District of Arkansas
Doctor and Sales Rep Charged in $12 Million Fraud Scheme Targeting Tricare and Extensive Cover Up
LITTLE ROCK-A doctor and a medical sales representative have been charged in a scheme to pay and receive kickbacks to generate expensive prescriptions for compounded drugs. TRICARE, the military's health insurer, paid over $12 million for the prescriptions, which the indictment alleges were rubber stamped without examining patients or regard to medical necessity. The 43-count indictment alleges the scheme also encompassed widespread efforts to obstruct the ensuing investigation.
January 10, 2020; U.S. Attorney; Western District of Pennsylvania
Pittsburgh-Area Lab Owner Pleads Guilty To Multiple Kickback Conspiracies In Connection With Almost $130 Million In Medicare Claims For Genetic Testing
PITTSBURGH, Pa. - A resident of Monroeville, Pennsylvania, pleaded guilty in federal court to three conspiracy counts and one substantive count related to the payment and receipt of unlawful kickbacks, United States Attorney Scott W. Brady announced today.
January 8, 2020; U.S. Department of Justice Medicare Fraud Strike Force Case
Philadelphia-Area Doctor Sentenced to 12 Months in Prison for Unlawfully Distributing Oxycodone
A Philadelphia-area doctor was sentenced to 12 months and one day in prison and ordered to pay a $100,000 fine yesterday for the illegal distribution of oxycodone.
January 8, 2020; U.S. Attorney; Eastern District of Pennsylvania
Philadelphia-Based Personal Injury Law Firm Agrees to Resolve Allegations of Unpaid Medicare Debts
PHILADELPHIA - United States Attorney William M. McSwain announced that a Philadelphia-based personal injury law firm, Simon & Simon, P.C., has entered into a settlement agreement with the United States to resolve allegations that it failed to reimburse the United States for certain Medicare payments. The government had made these payments to medical providers for the firm's clients.
January 8, 2020; U.S. Attorney; Eastern District of Pennsylvania
Montgomery County Doctor Sentenced to 12 Months in Prison for Unlawfully Distributing OxyCodone
PHILADELPHIA - United States Attorney William M. McSwain and Assistant Attorney General Brian A. Benczkowski of the Justice Department's Criminal Division announced that Richard Ira Mintz, D.O., 69, of Dresher, Pennsylvania was sentenced to one year and one day imprisonment, three years' supervised release, and $100,000 fine by United States District Court Judge Michael Baylson for illegally distributing controlled substances.
January 6, 2019; U.S. Department of Justice Medicare Fraud Strike Force Case
Former Los Angeles-Area Physician Sentenced to Two Years in Federal Prison for Defrauding Medicare and Illegally Prescribing Opioid Drugs
A former Los Angeles-area physician was sentenced today to 24 months in prison and three years of supervised release for engaging in a multi-faceted Medicare fraud scheme and for illegally prescribing thousands of opioid painkillers and muscle relaxers.
January 2, 2020; U.S. Attorney; Southern District of California
San Diego Eye Doctors Pay $950,000 to Settle Medicare Billing Fraud Allegations
SAN DIEGO - Mark D. Smith and Fane Robinson, two San Diego-area physicians, have paid the United States $948,768.18 to resolve allegations that they violated the federal False Claims Act by knowingly submitting false claims to Medicare.