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Criminal and Civil Enforcement

July 2020

July 1, 2020; Department of Justice
Novartis Pays Over $642 Million to Settle Allegations of Improper Payments to Patients and Physicians
Pharmaceutical company Novartis Pharmaceuticals Corporation (Novartis), based in East Hanover, New Jersey, has agreed to pay over $642 million in separate settlements resolving claims that it violated the False Claims Act (FCA).
July 1, 2020; U.S. Attorney's Office, Southern District of Texas
Houston-area cardiologist settles allegations
HOUSTON - Advanced Cardiovascular Care Center P.A. and its owner and administrator have agreed to pay $400,000 to resolve allegations they violated the False Claims Act (FCA), announced U.S. Attorney Ryan K. Patrick.
July 1, 2020; U.S. Attorney's Office, Western District of Kentucky
California Genetic Testing Company Agrees To Pay $8.25 Million To Resolve False Claims Allegations; Paducah, Ky, Area Hospital Also Settles
LOUISVILLE, Ky. - United States Attorney Russell Coleman today announced an $8.25 million settlement with Agendia, Inc., a molecular diagnostics testing company based in Irvine, California, for an alleged nationwide scheme to bill Medicare for Agendia's flagship genetic test, MammaPrint.

June 2020

June 30, 2020; Department of Justice
Guam Ambulance Company Owners Sentenced to Prison for Their Roles in Medicare Ambulance Fraud Scheme
Two owners of Guam Medical Transport (GMT) were sentenced to prison terms today for their roles in a health care fraud and money laundering scheme that resulted in a loss to the United States of approximately $10.8 million, one of the largest single Medicare ambulance fraud cases ever prosecuted by the Justice Department.
June 30, 2020; U.S. Attorney's Office, Southern District of West Virginia
Beckley Woman Who Faked Death to Avoid Sentencing Will Serve 42 Months in Federal Prison for Health Care Fraud
CHARLESTON, W.Va. - Julie M. Wheeler, 43, of Beckley, was sentenced by Senior United States District Judge John T. Copenhaver, Jr. to 42 months in federal prison for federal health care fraud, announced United States Attorney Mike Stuart.
June 30, 2020; U.S. Attorney's Office, Western District of Washington
Seattle Doctor Charged with Covid Relief Fraud
WASHINGTON - A Seattle doctor was taken into custody today on allegations that he fraudulently sought over $3 million in Paycheck Protection Program (PPP) loans.
June 30, 2020; U.S. Attorney's Office, Middle District of Florida
Eleventh Circuit Court Of Appeals Upholds Convictions Of Doctor On Twenty Counts Of Healthcare Fraud
Tampa, Florida - United States Attorney Maria Chapa Lopez announces that the United States Court of Appeals for the Eleventh Circuit has upheld the convictions of Dr. David M. Pon on 20 counts of healthcare fraud. The Eleventh Circuit also rejected Pon's challenges to his 121-month sentence.
June 30, 2020; U.S. Attorney's Office, Western District of Virginia
Opioid Manufacturer Indivior's Chief Executive Officer Pleads Guilty in Connection with Drug Safety Claims
ABINGDON, VIRGINIA - The chief executive officer of Indivior PLC, Shaun Thaxter, pleaded guilty today in federal court in Abingdon, Virginia to a one-count information charging him with causing the introduction into interstate commerce of the opioid drug Suboxone Film, which was misbranded in violation of the Federal Food, Drug, and Cosmetic Act.
June 30, 2020; U.S. Attorney's Office, Southern District of Texas
Katy anesthesiologist pays to settle allegations arising from electro-acupuncture device billing
HOUSTON - A 54-year-old anesthesiologist from Katy has paid $100,000 to resolve allegations that he falsely billed Medicare for the use of acupuncture devices, announced U.S. Attorney Ryan K. Patrick.
June 30, 2020; U.S. Attorney's Office, Middle District of Florida
Sarasota-Based Ophthalmic Consultants Agrees To Pay $4.8 Million To Resolve Claims Of Multi-Dosing Patients
Tampa, FL - United States Attorney Maria Chapa Lopez announces that Ophthalmic Consultants, P.A. (Sarasota, FL) and Dr. Robert K. Snyder- collectively, Ophthalmic Consultants - has agreed to pay $4.8 million to resolve allegations of healthcare fraud.
June 30, 2020; U.S. Attorney's Office, Eastern District of Virginia
University of Virginia Agrees to Settle Claims Associated with Federal Grants
ALEXANDRIA, Va. - The University of Virginia, located in Charlottesville, has agreed to pay $1 million to settle claims that it did not properly account for certain rebates and credits the university received on purchases it made in connection with federal grants and awards (Federal Awards).
June 26, 2020; U.S. Attorney's Office, Southern District of Georgia
Baxley pharmacist sentenced to four years in federal prison for conspiracy involving healthcare fraud, opioids
BRUNSWICK, GA: A pharmacist who owned and operated Fulghum Pharmacy in Baxley, Ga. was sentenced today to 48 months in federal prison after pleading guilty to a conspiracy that involved health care fraud and illegal distribution of opioids.
June 25, 2020; U.S. Attorney's Office, Northern District of Georgia
Atlanta hospital system to pay $16 million to resolve false claims allegations
ATLANTA - Piedmont Healthcare, Inc., an Atlanta-based hospital system, has agreed to pay $16 million to settle allegations that it violated the False Claims Act by billing Medicare and Medicaid for procedures at the more expensive inpatient level of care instead of the less costly outpatient or observation level of care. The settlement also resolves allegations that Piedmont paid a commercially unreasonable and above fair market value to acquire Atlanta Cardiology Group in 2007 in violation of the federal Anti-Kickback Statute.
June 25, 2020; U.S. Attorney's Office, Western District of Pennsylvania
Two Defendants Sentenced in Multi-Million Dollar Health Care Fraud Conspiracy
PITTSBURGH, Pa. - Two residents of Pittsburgh, Pennsylvania, were sentenced in federal court for conspiracy to defraud the Pennsylvania Medicaid program and health care fraud, United States Attorney Scott W. Brady announced today.
June 25, 2020; U.S. Attorney's Office, Eastern District of North Carolina
Greenville Ambulance Company Manager Sentenced to Prison in Multimillion Dollar Fraud and Identity Theft Scheme
RALEIGH, N.C. - Today a federal judge sentenced a Greenville ambulance company manager to 64 months in prison and 3 years of supervised release on charges of Conspiracy to Commit Health Care Fraud and Aggravated Identity Theft. He was also ordered to pay $4,726,464.42 in restitution.
June 24, 2020; U.S. Attorney's Office, District of Puerto Rico
Three Individuals Indicted & Arrested For Health Care Fraud
SAN JUAN, Puerto Rico - On June 17, 2020, a Federal Grand Jury in the District of Puerto Rico returned a 43-count indictment charging Sophia Piñeiro-Ruscalleda, Dr. Alice Ruscalleda-Lebrón and Juan José Ruscalleda, former officials of New Health Med Group, Inc. (NHMG), with health care fraud, aggravated identity theft, conspiracy to commit health care fraud and obstruction of a criminal investigation related to health care offenses.
June 24, 2020; U.S. Attorney's Office, Western District of Virginia
Owner and Operator of Tennessee Drug Screening Lab Plead Guilty to Health Care Fraud
Michael and Regan Dube to Pay More than $9 million
ABINGDON, VIRGINIA - Michael Norman Dube, 59, who operated American Toxicology Labs, pleaded guilty today in the Western District of Virginia to health care fraud charges. Dube's wife, Regan Gran Dube, 40, also pleaded guilty.
June 24, 2020; U.S. Attorney's Office, Southern District of New York
Ophthalmologist Previously Charged With Healthcare Fraud Indicted For Defrauding SBA Program Intended To Help Small Businesses During COVID-19 Pandemic
AMEET GOYAL, M.D., an ophthalmologist in Rye, New York, previously indicted in this District for healthcare fraud offenses in November 2019, has been charged in a Superseding Indictment with fraudulently obtaining Government-guaranteed loans intended to help small businesses during the COVID-19 pandemic while he was on pretrial release.
June 24, 2020; U.S. Attorney's Office, Southern District of Georgia
Augusta University Medical Center agrees to pay $2.625 million to settle False Claims Act investigation
AUGUSTA, GA: Augusta University Medical Center, Inc. (AUMC) has agreed to a settlement with the United States, the State of Georgia, and the State of South Carolina to resolve allegations that AUMC submitted false claims to several government-funded healthcare programs.
June 23, 2020; U.S. Attorney's Office, District of Massachusetts
Lawrence Man Indicted on Identity Fraud Charges
BOSTON - A Lawrence man who has been living under a false identity was indicted today by a federal grand jury in Boston on charges arising from his use of the name and Social Security number of a U.S. citizen.
June 22, 2020; U.S. Attorney's Office, District of Massachusetts
Dominican National Pleads Guilty to False Identity Crimes
BOSTON - A Dominican national pleaded guilty today in federal court in Boston to fraudulent use of a Social Security number.
June 22, 2020; U.S. Attorney's Office, District of South Dakota
Former Tribal Chair Sentenced for Embezzlement Scheme; Defendants Prosecuted as Part of The Guardians Project, a Federal Law Enforcement Initiative to Combat Corruption, Fraud, and Abuse in South Dakota
United States Attorney Ron Parsons announced today that a former Chairman of the Crow Creek Sioux Tribe was sentenced for his role in a scheme involving the embezzlement of tribal funds by former elected tribal officials. Chief U.S. District Judge Roberto A. Lange presided over the sentencing hearing on June 16, 2020.
June 19, 2020; U.S. Attorney's Office, Western District of Pennsylvania
Greensburg Medical Lab Owner Pleads Guilty in $1.6M Fraud Scheme
PITTSBURGH - A resident of Pittsburgh, Pennsylvania, pleaded guilty in federal court to a charge of conspiracy to defraud the United States, United States Attorney Scott W. Brady announced today.
June 17, 2020; Department of Justice
Nine Pharmacists Charged for Role in $12.1 Million Health Care Fraud Scheme
Nine pharmacists were charged in three separate indictments unsealed last week for their alleged participation in a $12.1 million health care fraud scheme executed in Detroit and southern Ohio.
June 16, 2020; U.S. Attorney's Office, Northern District of Ohio
Last of six sentenced in scheme to defraud Medicaid of millions; Jennifer Sheridan of Braking Point Recovery Center sentenced to 27 months imprisonment and ordered to pay $15,957,148 in restitution
Youngstown, Ohio - Justin E. Herdman, United States Attorney for the Northern District of Ohio, announced today that Jennifer Sheridan, age 42, of Austintown, Ohio, was sentenced to 27 months imprisonment, and ordered to pay $15,957,148 in restitution after pleading guilty to one count of health care fraud conspiracy.
June 15, 2020; U.S. Attorney's Office, District of Massachusetts
Registered Nurse Pleads Guilty to Drug Diversion Charge
BOSTON - A Haverhill nurse pleaded guilty today in federal court in Boston to tampering with patients' morphine.
June 11, 2020; U.S. Attorney's Office, Eastern District of Michigan
Nineteen Individuals Indicted In $41 Million Illegal Opioid Distribution Conspiracy
A Clinic Owner, Four Doctors, Two Nurse Practitioners and Three Pharmacists among Those Indicted
An indictment was unsealed today charging nineteen individuals with conspiracy to illegally distribute prescription drugs, U.S. Attorney Matthew Schneider announced today.
June 11, 2020; U.S. Attorney's Office, Southern District of Georgia
Florida man charged in telemedicine scheme; Defendant is 26th charged in telemedicine conspiracy in Southern District
SAVANNAH, GA: A Florida man who supplied Medicare patient information to his co-conspirators to ultimately bill Medicare for durable medical equipment claims has been charged for his alleged participation in a kickback and telemedicine fraud scheme.
June 11, 2020; Department of Justice
Former DEA Official Pleads Guilty to Elaborate $4 Million Fraud Scheme; Former Spokesman (2005-2009) Scammed Victims by Posing Falsely as Covert CIA Officer Involved in a Highly-classified Intelligence Program
A former Drug Enforcement Administration (DEA) public affairs officer pleaded guilty today to defrauding at least a dozen companies of over $4.4 million by posing falsely as a covert officer of the Central Intelligence Agency (CIA).
June 10, 2020; U.S. Attorney's Office, Eastern District of Missouri
Pharmacist Indicted for Presenting Forged Prescriptions for Opioid and Anti-Malaria Prescription
St. Louis, MO - Tamara Jo Nyachira, 40, of Pittsburg, Kansas, was indicted today with three felony charges of obtaining anti-malaria and narcotic opioid prescription drugs with forged prescriptions.
June 10, 2020; U.S. Attorney's Office, District of Maine
Portland Home Healthcare Company and Owner Settle False Claims Act Allegations
Portland, Maine: United States Attorney Halsey B. Frank today announced that a Portland home healthcare company and its owner have agreed to pay $111,200.46 to settle allegations that they violated the False Claims Act.
June 9, 2020; Department of Justice
Medical Technology Company President Charged in Scheme to Defraud Investors and Health Care Benefit Programs in Connection with COVID-19 Testing
The president of a California-based medical technology company was charged in a complaint unsealed today in the Northern District of California, in connection with his alleged participation in schemes to mislead investors, to manipulate the company's stock price and to conspire to commit health care fraud in connection with the submission of over $69 million in false and fraudulent claims for allergy and COVID-19 testing.
June 8, 2020; U.S. Attorney's Office, District of Connecticut
Wallingford Doctor Arrested for Selling Opioid Prescriptions for Cash, Health Care Fraud
John H. Durham, United States Attorney for the District of Connecticut, Brian D. Boyle, Special Agent in Charge of the Drug Enforcement Administration for New England, Phillip Coyne, Special Agent in Charge of the U.S. Department of Health and Human Services, Office of Inspector General (HHS-OIG), David Sundberg, Special Agent in Charge of the New Haven Division of the Federal Bureau of Investigation, and Wallingford Police Chief William J. Wright today announced that a Wallingford doctor has been charged with federal controlled substances and health care offenses related to the illegal distribution of prescription medication.
June 5, 2020; Department of Justice
Four Florida Men Charged for Their Roles in a $54 Million Compound Pharmacy Kickback Scheme
Four Florida men were charged in an indictment unsealed Thursday for their alleged participation in a compound pharmacy kickback scheme.
June 5, 2020; U.S. Attorney's Office, District of Alaska
Alaska Neurology Center LLC and Its Owner to Pay $2 Million to Settle False Claims Act Allegations Regarding Fraudulent Medical Billing
Anchorage, Alaska - U.S. Attorney Bryan Schroder announced today that Anchorage-based Alaska Neurology Center LLC and its owner, Franklin Ellenson, M.D., have agreed to pay $2 million to resolve False Claims Act allegations that the medical practice knowingly submitted false billing claims to federal healthcare programs. Contemporaneous with the civil settlement, Alaska Neurology Center LLC and Dr. Ellenson agreed to a three-year Integrity Agreement with the U.S. Department of Health and Human Services.
June 5, 2020; U.S. Attorney's Office, District of New Jersey
Illinois Man Admits Role in $4.6 Million Health Care Fraud Related to Genetic Testing
NEWARK, N.J. - An Illinois man today admitted his role in a scheme to defraud the Medicare Program in connection with fraudulent orders for genetic tests, U.S. Attorney Craig Carpenito announced.
June 5, 2020; U.S. Attorney's Office, Northern District of Iowa
Sioux Center Chiropractic Clinic to Pay $30,418 to Resolve Allegations Related to Claims Submitted to Medicaid for Treatment of Children for Constipation and Ear Infections
A Sioux Center chiropractic clinic, Sioux Center Chiropractic Wellness Center, P.C., and the two chiropractors who operate the clinic - Tyler and Tiffany Armstrong - have agreed to pay $30,418 to resolve allegations they violated the False Claims Act by billing Medicaid for the treatment of conditions for which payment is not allowed, including constipation and ear infections. The settlement agreement resolves allegations related to the treatment of Medicaid beneficiaries seven and under from April 2014 to July 2019. The claims settled by the agreement are allegations only; there has been no admission or judicial determination of liability. The case was handled by Assistant United States Attorneys Jacob Schunk and Melissa Carrington. The allegations resolved by the settlement arose from an investigation led by the State of Iowa's Medicaid Fraud Control Unit. False Claims Act cases also arise under the qui tam, or whistleblower provisions, of the False Claims Act. Under those provisions, a private party may file suit on behalf of the United States for false claims and share in any recovery.
June 2, 2020; U.S. Attorney's Office, Southern District of West Virginia
Meds2Go Express Pharmacy, Inc. Sentenced for Role in Drug Diversion Scheme; Pharmacy Shut Down and Ordered to Pay $250,000 in Community Restitution and Forfeiture
CHARLESTON, W.Va. - Meds2Go Express Pharmacy, Inc. (Meds2Go), a pharmacy located in Alum Creek in Lincoln County, was sentenced for money laundering, announced United States Attorney Mike Stuart. The money laundering conviction arose out of a conspiracy between the pharmacy and Hope Clinic, a pain clinic operating as a pill mill, to dispense compound opioids for no legitimate medical purpose and outside the bounds of professional medical practice. As part of the plea agreement in December 2019, Meds2Go was shut down and has now been ordered to pay $250,000 toward community restitution and forfeiture. The community restitution will be paid for the costs associated with drug abuse treatment in West Virginia to redress the harm caused by illicit opioid usage stemming from the sale of prescription opioids. The West Virginia Crime Victim's Compensation Fund will receive 65% of the community restitution amount, and 35% will be paid to West Virginia Department of Health and Human Resources, Bureau of Behavioral Health and Health Facilities.
June 2, 2020; U.S. Attorney's Office, District of New Jersey
Owners of Texas and Mississippi Laboratories Admit Roles in Kickback Scheme Related to Genetic Testing
NEWARK, N.J. - The owners of two clinical laboratories in Texas and Mississippi today admitted their roles in a scheme to pay kickbacks in exchange for referrals of patient DNA samples and genetic tests to the laboratories, U.S. Attorney Craig Carpenito announced.
June 2, 2020; U.S. Attorney's Office, District of New Jersey
Camden County Man Admits Role in Theft of Government Funds Scheme and Defrauding Supplemental Nutrition Assistance Program
CAMDEN, N.J. - A Camden County man today admitted his role in a scheme to steal hundreds of thousands of dollars in government funds using fraudulently procured electronic benefits transfer (EBT) cards, U.S. Attorney Craig Carpenito announced.

May 2020

May 29, 2020; U.S. Attorney's Office, District of Idaho
Eagle Woman Sentenced to 37 Months for Health Care Fraud
BOISE - Karina Renee Moore, 48, of Eagle, was sentenced to 37 months in federal prison for health care fraud, U.S. Attorney Bart M. Davis announced today. U.S. District Judge B. Lynn Winmill also ordered Moore to serve three years of supervised release following her release from prison and to pay $611,860.86 in restitution. Moore pleaded guilty on January 7, 2020.
May 29, 2020; U.S. Attorney's Office, Eastern District of Virginia
Woman Sentenced to Prison for $500K Health Care Fraud Scheme
RICHMOND, Va. - A North Carolina woman was sentenced today to four years in prison for committing a $506,000 fraud on the Virginia Medicaid program.
May 27, 2020; U.S. Attorney's Office, Eastern District of North Carolina
Las Vegas Couple Indicted in $13 Million Fraud Upon North Carolina Medicaid Program and Scheme to Launder Proceeds Into Private Jet
RALEIGH, N.C. - On May 19, 2020 a federal grand jury returned a Superseding Indictment charging a Las Vegas couple with numerous charges, including (1) Conspiracy to Commit Health Care Fraud and Wire Fraud, (2) Health Care Fraud, (3) Wire Fraud, (4) False Statements Relating to Health Care Matters, (4) Aggravated Identity Theft, (5) Conspiracy to Commit Money Laundering, and (6) Conducting Transactions in Criminally Derived Property with Fraud and Money Laundering. The charges were unsealed today, following the arrest of all defendants.
May 22, 2020; U.S. Attorney's Office, Eastern District of Pennsylvania
Pennsylvania Man Sentenced to 37 Months in Prison and Over $3 Million in Restitution for Health Care Fraud Scheme
PHILADELPHIA - United States Attorney William M. McSwain announced today that Branden Coluccio, 32, of Doylestown, Pennsylvania, has been sentenced to 37 months in prison for conspiracy to commit health care fraud. As part of his sentence, he was also ordered to pay restitution in the amount of $3,070,157, forfeiture in the amount of $110,000, and an additional $15,000 fine. United States District Judge Wendy Beetlestone presided over the sentencing hearing in Philadelphia via video teleconference. This scheme involved Liberation Way, a drug and alcohol rehabilitation organization that had treatment centers in Yardley, Bala Cynwyd, and Fort Washington, Pennsylvania.
May 21, 2020; U.S. Attorney's Office, Central District of California
Encino Man Sentenced to 9 Years in Prison for Leading Conspiracy to Distribute Opioids via Sham Clinics and Corrupt Doctors
LOS ANGELES - A San Fernando Valley man was sentenced today to 108 months in federal prison for leading a conspiracy to distribute powerful prescription opioids via sham medical clinics that hired corrupt doctors who wrote fraudulent prescriptions to black market customers.
May 21, 2020; U.S. Attorney's Office, Western District of Oklahoma
Mangum Pharmacist Sentenced to More Than Three Years in Federal Prison in Health Care Fraud Case; He Was Ordered to Pay Over $1 Million to Medicare and Medicaid
OKLAHOMA CITY - Jeffrey Scott Terry, 38, of Mangum, Oklahoma, was sentenced today to 37 months in federal prison for his role in a health care fraud scheme, announced Oklahoma Attorney General Mike Hunter and U.S. Attorney Timothy J. Downing.
May 20, 2020; U.S. Attorney's Office, Middle District of Florida
Premier Medical Associates Agree To Pay $750,000 To Resolve Claims Of False Billing
Tampa, FL - United States Attorney Maria Chapa Lopez announces today that Premier Medical Associates (PMA), a medical practice located in The Villages, Florida, has agreed to pay $750,000 to resolve allegations that it violated the False Claims Act. As part of the settlement, the United States contends that it has certain civil claims against PMA related to PMA's billing of federal healthcare programs for services that were not medically necessary and reasonable.
May 20, 2020; U.S. Attorney's Office, District of Massachusetts
Dominican National Sentenced for Identity Theft and Stealing MassHealth Benefits
BOSTON - A Dominican national formerly residing in Lawrence was sentenced today for Social Security and benefit fraud. Cesar Franco Lara, 37, was sentenced during a videoconference before U.S. District Court Judge Leo T. Sorokin to 20 months in prison and ordered to pay $3,468 in restitution to MassHealth. Franco Lara will also face deportation proceedings upon completion of his sentence. In January 2020, Franco Lara pleaded guilty to one count of false representation of Social Security number and one count of theft of government money. Pursuant to a plea agreement that was accepted by the Court today, the government dismissed one count of aggravated identity theft after the defendant was sentenced.
May 20, 2020; U.S. Attorney's Office, Middle District of Tennessee
Franklin, Tennessee-Based Rinova Settles Allegations Of Fraudulent Operations Of Former Pain MD Clinics Settlement More Than $480,000
NASHVILLE, Tenn. - May 20, 2020 - Franklin, Tennessee-based Rinova The Wellness Group, PC has settled the United States' allegations that Medicare overpaid Rinova for claims that were non-payable due to fraudulent misrepresentations, announced U.S. Attorney Don Cochran for the Middle District of Tennessee. The government alleged that Rinova misrepresented that it had provided services, when they were actually a continuation of services by the suspended company Pain MD, LLC.
May 20, 2020; U.S. Attorney's Office, Northern District of Ohio
Toledo couple indicted for fraudulent medical care scheme
A federal grand jury in Toledo, Ohio returned a four-count indictment today charging Sherry-Ann Jenkins, age 55, and Dr. Oliver H. Jenkins, age 57, both formerly of Ottawa Hills, Ohio, on one count each of conspiracy, mail fraud, wire fraud, and health care fraud in connection with their development and operation of the Toledo Clinic Cognitive Center from approximately 2013 through 2016.
May 19, 2020; Department of Justice
United States Joins False Claims Act Lawsuit against William M. Kelly, M.D. Inc. and Omega Imaging Inc.
The United States has partially intervened in a False Claims Act lawsuit against William M. Kelly, M.D. Inc. and Omega Imaging Inc. in the U.S. District Court for the Central District of California, the Department of Justice announced today. The government intervened as to allegations that the defendants, which operate 11 radiology facilities in Southern California, violated the False Claims Act by submitting claims to Medicare for unsupervised radiology services and services provided at unaccredited facilities.
May 15, 2020; Department of Justice
Georgia Woman Arrested for Role in Scheme to Defraud Health Care Benefit Programs Related to Cancer Genetic Testing and COVID-19 Testing
A Georgia woman was arrested today for her alleged role in a conspiracy to defraud Medicare, a federally funded health care benefit program, by submitting false and fraudulent claims for cancer genetic (CGX) testing, as well as her role in conspiring to submit fraudulent claims related to COVID-19 and other tests.
May 15, 2020; U.S. Attorney's Office, District of Massachusetts
United States Attorney's Office Honors Law Enforcement Personnel for Exceptional Service
BOSTON - United States Attorney Andrew E. Lelling recognized National Police Week by announcing the recipients of the Annual 2020 Law Enforcement Awards. Over 130 federal, state and local law enforcement personnel who contributed to the success of federal cases during the 2019 calendar year are being recognized for their commitment to pursuing justice and public safety.
May 14, 2020; Department of Justice
Former Cleveland Clinic Employee and Chinese "Thousand Talents" Participant Arrested for Wire Fraud
Assistant Attorney General for National Security John C. Demers, U.S. Attorney Justin E. Herdman of the Northern District of Ohio, and FBI Cleveland Special Agent in Charge Eric B. Smith announced a former Cleveland Clinic employee was arrested yesterday without incident by law enforcement and had his initial court appearance today.
May 14, 2020; U.S. Attorney's Office, Southern District of Texas
Missouri City physician pays nearly half a million to resolve illegal kickback and fraud allegations
HOUSTON - A local physician has agreed to pay the United States $450,000 to resolve allegations that he falsely signed home health certifications and plans of care in exchange for money, announced U.S. Attorney Ryan K. Patrick. Dr. Maaz Abbasi, 41, also agreed to a three-year period of exclusion from participation in any federal health care program.
May 13, 2020; U.S. Attorney's Office, Southern District of Georgia
Durable medical equipment company owner charged in kickback scheme; Defendant is 25th charged in telemedicine conspiracy
SAVANNAH, GA: A Florida man who operated a durable medical equipment company has been charged for his alleged participation in a Medicare kickback and telemedicine fraud scheme.
May 12, 2020; U.S. Attorney's Office, District of South Dakota
Former Contractor Sentenced to 24 Months in Federal Prison for Embezzlement Scheme; Defendant Prosecuted as Part of The Guardians Project, a Federal Law Enforcement Initiative to Combat Corruption, Fraud, and Abuse in South Dakota
United States Attorney Ron Parsons announced today that a former contractor was sentenced for an embezzlement scheme involving tribal funds, which he pleaded guilty to on September 23, 2019. Dustin Martin Kirk, age 48, of Sisseton, South Dakota, was sentenced to 24 months in federal prison, and ordered to pay $384,289 in restitution and $100 to the Federal Crime Victims Fund. Following his release from custody, Kirk will serve 3 years of supervised release. U.S. District Judge Charles B. Kornmann presided over the sentencing hearing.
May 11, 2020; U.S. Attorney's Office, Eastern District of Kentucky
Jackson Woman Sentenced to 10 Months for Soliciting Kickbacks and Obstructing Justice
LEXINGTON, Ky. - A Jackson, Ky., woman, Theresa C. Merced, 81, was sentenced to five months imprisonment to be followed by five months of home detention, and was ordered to pay a $55,000 fine, by Chief U.S. District Judge Danny C. Reeves, following her convictions for soliciting kickbacks from a toxicology laboratory in exchange for urine drug testing referrals, lying to law enforcement agents about the kickback she received, and then attempting to cover up the kickback by requesting the alteration of certain financial records.
May 11, 2020; Department of Justice
Former Emory University Professor and Chinese "Thousand Talents" Participant Convicted and Sentenced for Filing a False Tax Return
On May 8, 2020, Dr. Xiao-Jiang Li, 63, of Atlanta, Georgia, pleaded guilty to a criminal information charging him with filing a false tax return and has been sentenced by a U.S. District Judge on the same day. Dr. Li, a former Emory University professor and Chinese Thousand Talents Program participant, worked overseas at Chinese Universities and did not report any of his foreign income on his federal tax returns.
May 8, 2020; U.S. Attorney's Office, District of Massachusetts
Dominican National Pleads Guilty to False Identity Crimes
BOSTON - A Dominican national who previously resided in Lawrence pleaded guilty today in federal court in Boston to fraudulently applying for a Social Security number.
May 7, 2020; U.S. Attorney's Office, Western District of Washington
DOJ settles False Claims Act allegations with Seattle physician, his pain clinics, and his drug-testing lab; Agrees to pay $2.85 million to settle allegations his clinics ordered medically unnecessary urine tests at his lab, paid for by government healthcare programs
Seattle - The U.S. Department of Justice and the Washington State Attorney General today settled a False Claims Act investigation involving Seattle Pain Center, Northwest Analytics, and owner/physician Dr. Frank Danger Li, announced First Assistant U.S. Attorney Tessa M. Gorman. Dr. Li agreed to pay $2.85 million to state and federal authorities to settle allegations his companies billed government entities for medically unnecessary urine drug tests. Dr. Li's seven pain clinics closed in July 2016 when the Washington State Medical Quality Assurance Commission suspended his medical license for improperly monitoring prescriptions of powerful opioids. Today's settlement is a civil resolution unrelated to any criminal investigation or any action by state health regulators.
May 6, 2020; U.S. Attorney's Office, District of New Jersey
Florida Man Admits Role in $4.6 Million Health Care Fraud and Kickback Schemes Related to Genetic Testing
NEWARK, N.J. - A Florida man today admitted his role in using his company to defraud the Medicare Program in connection with fraudulent orders for genetic tests, U.S. Attorney Craig Carpenito announced.
May 6, 2020; U.S. Attorney's Office, Western District of Arkansas
Rogers Physician Pleads Guilty To Distribution Of A Controlled Substance Without An Effective Prescription
Fayetteville, Arkansas - David Clay Fowlkes, Acting United States Attorney for the Western District of Arkansas, announced that Dr. Robin Ann Cox plead guilty today to one count of Distribution of a Controlled Substance without an Effective Prescription.
May 6, 2020; U.S. Attorney's Office, District of South Dakota
Former Tribal Treasurer & Former Councilmember Sentenced to 42 and 30 Months, Respectively, for Embezzlement Scheme; Defendants Prosecuted as Part of The Guardians Project, a Federal Law Enforcement Initiative to Combat Corruption, Fraud, and Abuse in South Dakota
United States Attorney Ron Parsons announced today that two former Crow Creek Sioux Tribe councilmembers and one former employee were sentenced for their roles in an embezzlement scheme involving tribal funds.
May 5, 2020; U.S. Attorney's Office, District of Connecticut
Connecticut Substance Abuse Treatment Provider Pays $295K to Settle Improper Billing Allegations
New Haven - John H. Durham, United States Attorney for the District of Connecticut, today announced that CONNECTICUT COUNSELING CENTERS ("CCC") has entered into a civil settlement agreement with the federal and state governments in which it will pay more than $295,000 to resolve allegations that it caused overpayments to be paid by the Connecticut Medicaid Program.
May 4, 2020; U.S. Attorney's Office, Eastern District of Kentucky
Lexington Foot and Ankle Center Agrees to Pay $750,000 to Resolve Allegations of Violations of the False Claims Act
LEXINGTON, Ky. - Lexington-based podiatry practice Lexington Foot and Ankle Center, PSC ("Lexington Foot & Ankle") and Dr. Michael Allen have agreed to resolve civil allegations that they violated the False Claims Act, a federal law that prohibits the submission of false or fraudulent claims to the federal government, agreeing to pay the United States $750,000.
May 4, 2020; U.S. Attorney's Office, Eastern District of Virginia
Doctor Pleads Guilty to Opioid Conspiracy and Health Care Fraud
ALEXANDRIA, Va. - A Fairfax physician pleaded guilty today to leading and organizing an extensive and illegal prescription distribution conspiracy and a related health care fraud scheme. According to court documents, Dr. Felicia Lyn Donald, 65, of Great Falls, organized, led, and operated a prescription "pill mill" from at least April 2016 through April 2020. Donald practiced medicine at For Women OB/GYN Associates and NOVA Addiction Center. Donald distributed over 1.2 million milligrams (mg) of Schedule II opioids at or above the Centers for Disease Control and Prevention (CDC) guideline for dosages that a practitioner should avoid, with a total street value of over $1.2 million, and illegally distributed at least 325,190 mg of oxycodone and other Schedule II controlled substances. Donald also committed health care fraud on numerous occasions in furtherance of her scheme.
May 1, 2020; U.S. Attorney's Office, Eastern District of Wisconsin
Milwaukee Pain Management Clinic and Physician Agree to Pay At Least $1.35 Million to Resolve Allegations They Violated the False Claims Act and Anti-Kickback Statute
United States Attorney Matthew D. Krueger announced today that Center for Pain Management, S.C. ("CPM"), and its owner, Dr. Nosheen Hasan, agreed to pay at least $1.35 million to resolve allegations that they received kickbacks from a urine drug testing laboratory in exchange for ordering medically unnecessary tests for Medicare and Medicaid patients. CPM and Dr. Hasan also agreed to future contingent payments for the next five years, with the amount of the payments based on specified financial criteria. CPM and Dr. Hasan separately entered into an Integrity Agreement with the Office of Inspector General, Department of Health and Human Services ("HHS-OIG"), to monitor ongoing compliance with applicable Medicare and Medicaid rules.
May 1, 2020; U.S. Attorney's Office, Middle District of Florida
Owner Of Treatment Facility Pleads Guilty To Health Care Fraud
Tampa, Florida - Marcus Anderson (34, St. Petersburg) has pleaded guilty to health care fraud. He faces a maximum penalty of 10 years in federal prison. A sentencing date has not yet been set.

April 2020

April 30, 2020; U.S. Attorney's Office, Western District of Kentucky
Owensboro Doctor Faces Federal Civil False Claims Allegations
LOUISVILLE, Ky. - Owensboro Dr. Kishor N. Vora faces civil False Claims Act allegations for executing an elaborate and extensive scheme to maximize profits at the expense of both patients and Medicare, announced United States Attorney Russell Coleman.
April 28, 2020; Department of Justice
Former Caregiver Pleads Guilty to Obstructing Investigation Related to Violation of Disabled Resident's Civil Rights
WASHINGTON - Mary K. Paulo, a former employee of a Missouri residential treatment facility, pleaded guilty today in federal court in the Western District of Missouri to an obstruction of justice charge related to the death of C.D., a Missouri ward of the state with developmental disabilities. Paulo pleaded guilty to one count of knowingly falsifying a document with the intent to impede, obstruct, and influence an investigation related to the death of C.D.
April 28, 2020; U.S. Attorney's Office, Eastern District of Michigan
Macomb County Doctor Charged In Health Care Fraud Scheme
A Macomb County doctor was charged in a criminal complaint for his alleged role in a health care fraud scheme which involved submitting false claims to Medicare for services that were never rendered and/or were medically unnecessary, announced United States Attorney Matthew Schneider.
April 28, 2020; U.S. Attorney's Office, Central District of California
Attorney Agrees to Plead Guilty to a String of Crimes, Including Paying Bribes to Two Federal Law Enforcement Officials
LOS ANGELES - A Calabasas man has agreed to plead guilty to five federal offenses - one related to a credit card "bust-out" scheme, and the others related to more than $250,000 in bribes he paid to two federal agents for assistance that included sensitive law enforcement information.
April 27, 2020; Department of Justice
Testing Laboratory Agrees to Pay Up to $43 Million to Resolve Allegations of Medically Unnecessary Tests
Genova Diagnostics Inc., a clinical laboratory services company based in Asheville, North Carolina, has agreed to pay up to approximately $43 million to resolve allegations that it violated the False Claims Act, including claims that it billed for medically unnecessary lab tests, the Department of Justice announced today.
April 27, 2020; U.S. Attorney's Office, District of Massachusetts
Harvard University Agrees to Pay Over $1.3 Million to Resolve Allegations of Overcharging NIH Grants
BOSTON - Harvard University has agreed to pay $1,359,791 to resolve allegations that Harvard's T.H. Chan School of Public Health (HSPH) overcharged certain grants funded by the National Institutes of Health (NIH) and the Health Resources & Services Administration (HRSA). This settlement resulted from Harvard's self-disclosure of issues that it identified on NIH and HRSA grants by a particular professor and her team between at least 2009 and 2014.
April 27, 2020; U.S. Attorney's Office, District of Rhode Island
Dominican National Sentenced for Health Care Fraud, Misuse of a Social Security Number, ID Theft
PROVIDENCE - A Dominican national in the United States illegally, who admitted to fraudulently gaining access to Medicaid benefits with the use of a stolen identity and Social Security number, was sentenced today to two years and one day in federal prison.
April 24, 2020; U.S. Attorney's Office, Eastern District of Pennsylvania
Florida Man Sentenced to Over 15 Months in Prison and $3.4 Million in Restitution for Health Care Fraud Scheme Involving Liberation Way Drug and Alcohol Rehabilitation Centers
PHILADELPHIA - United States Attorney William M. McSwain announced today that Jesse Peters, 45, of Lake Worth, Florida, has been sentenced to 15 months and one day of imprisonment, three years of supervised release, and restitution of $3,405,065 for one count of conspiracy to commit health care fraud. United States District Judge Wendy Beetlestone presided over the sentencing hearing in Philadelphia via video teleconference. This scheme involved Liberation Way, a drug and alcohol rehabilitation organization that had treatment centers in Yardley, Bala Cynwyd, and Fort Washington, Pennsylvania.
April 24, 2020; U.S. Attorney's Office, District of Massachusetts
Surgeon Agrees to Pay $1.75 Million to Resolve Allegations that He Accepted Kickbacks fromSpineFrontier, Sixth Doctor Settles Claims Related to Sham Consulting Program
BOSTON - The U.S. Attorney's Office announced today that Dr. Jeffrey R. Carlson of Newport News, VA has agreed to pay $1.75 million to resolve allegations that he accepted kickbacks from SpineFrontier, Inc., a Massachusetts-based medical device manufacturer.
April 23, 2020; U.S. Attorney's Office, Eastern District of Virginia
Ambulance Provider Agrees to Settle False Claims Act Allegations
ALEXANDRIA, Va. - An ambulance transportation company that operates throughout Virginia has agreed to pay $110,000 to settle allegations that the company submitted false claims to Medicare for ambulance transports, in violation of the False Claims Act.
April 23, 2020; U.S. Attorney's Office, Southern District of Georgia
Telemedicine company owner charged in $60 million fraud scheme; Defendant is 23rd charged in largest fraud operation ever prosecuted by Southern District of Georgia
SAVANNAH, GA: A Georgia woman who operated a telemedicine network through two companies has been charged for her alleged participation in an ever-growing healthcare and telemedicine fraud scheme.
April 22, 2020; U.S. Attorney's Office, Western District of Virginia
Centra Health Inc. and Blue Ridge Ear, Nose, Throat, and Plastic Surgery, Inc. Agree to Pay Nearly $10 Million to Settle False Claims Act Allegations
Lynchburg, VIRGINIA - Centra Health Inc. and Blue Ridge Ear, Nose, Throat and Plastic Surgery, Inc. have agreed to pay the government $9,345,845 to settle claims alleging they violated the False Claims Act and the Virginia Fraud Against Taxpayers Act by engaging in improper financial relationships. Centra and its affiliates are nonprofit corporations operating hospital facilities in the Lynchburg-area including Southside Community Hospital, Virginia Baptist Hospital, and Lynchburg General Hospital. Blue Ridge ENT is a physician practice group in Lynchburg that refers patients to Centra's hospital system. The settlement involved financial relationships Centra and its affiliates had with several referring physicians and groups including Blue Ridge ENT in violation of the Stark Law, the Anti-Kickback Law, and other federal regulations that restrict the financial relationships hospitals may have with physicians who refer patients to them. Centra proactively came forward, self-disclosed its violations of the False Claims Act, and worked with the government to resolve these issues.
April 21, 2020; U.S. Attorney's Office, Southern District of Ohio
Tech company pays $1.7 million in restitution for defrauding hospital electronic records programs
CINCINNATI - An Anaheim, Calif. technology company was sentenced in U.S. District Court today and was ordered to pay nearly $1.7 million in restitution to federal and Ohio state programs it defrauded.
April 21, 2020; U.S. Attorney's Office, Eastern District of Pennsylvania
Psychiatrist Affiliated with Philadelphia and Lehigh Valley-Area Health Clinics Who Claimed to Have Seen Over 120 Patients per Day Agrees to Pay $91,109 to Resolve False Claims Act Liability
PHILADELPHIA - United States Attorney William M. McSwain announced that Pramod Pilania, M.D., has agreed to pay $91,109 to resolve potential liability under the False Claims Act. Dr. Pilania was a psychiatrist who previously saw patients at the Northeast Community Mental Health Centers ("Northeast clinic") in Philadelphia and the Lehigh Valley Community Mental Health Centers ("Lehigh Valley clinic"), with locations in Allentown, Bethlehem, and Reading. According to the settlement, the United States contends that Dr. Pilania claims to have seen more than 120 Medicaid patients, including children, on a single day on several occasions in 2010. On each of the dates when he supposedly saw in excess of 120 patients, he also travelled between the Northeast clinic in Philadelphia and the Lehigh Valley clinic in Allentown, which are separated by approximately an hour's drive.
April 17, 2020; U.S. Attorney's Office, Northern District of New York
North Country Man Sentenced for Health Care Fraud, Paying Kickbacks
ALBANY, NEW YORK - Anthony C. Armstrong, age 30, was sentenced today to 18 months in prison, to be followed by 3 years of supervised release, and ordered to pay $50,000 in restitution, for committing fraud and paying bribes in connection with Medicaid-funded transportation.
April 17, 2020; Department of Justice
Maryland Cardiologist and Related Practices to Pay the United States $750,000 for Alleged Kickbacks
Mubashar Choudry, M.D., and three medical practices with which he is associated, Washington Cardiovascular Institute, Advanced Vascular Resources, and Washington Vascular Institute, have agreed to pay the United States $750,000 to resolve False Claims Act allegations that they knowingly billed Medicare and TRICARE for claims in violation of the Anti-Kickback Statute (AKS), the Department of Justice announced today. Choudry is a cardiologist who has treated patients in Maryland and Washington, D.C. for peripheral arterial disease.
April 16, 2020; U.S. Attorney's Office, District of Massachusetts
Dominican National Sentenced for Identity Theft and Stealing MassHealth Benefits, Defendant collected unemployment benefits in the identity of a United States citizen
BOSTON - A Dominican national previously residing in Lawrence was sentenced yesterday for Social Security fraud, aggravated identity theft and benefit fraud.
April 16, 2020; U.S. Attorney's Office, Southern District of Georgia
Operator of durable medical equipment company charged in multi-million-dollar telemedicine kickback scheme
Defendant is 22nd charged in largest fraud scheme every prosecuted by Southern District of Georgia. SAVANNAH, GA: A California man who operated a durable medical equipment (DME) company has been charged for his alleged participation in a massive healthcare fraud scheme. The defendant is the 22nd charged in the Southern District of Georgia as part of an investigation that uncovered more than $410 million in fraudulent claims to Medicare, the largest fraud case in the history of the Southern District of Georgia.
April 15, 2020; U.S. Attorney's Office, District of Maryland
Baltimore Internist to Pay $436,000 to the United States to Resolve False Claims Act Allegations Relating to Medically Unnecessary Procedures
Baltimore, Maryland - Ebenezer Quainoo, M.D., an internist in Baltimore, Maryland, who operates a medical practice known as Baltimore Health Care, P.C., has agreed to pay the United States $436,000 to settle allegations that he submitted false claims to the United States for medically unnecessary autonomic nervous function tests and trigger point injections with the use of ultrasound guidance.
April 15, 2020; U.S. Attorney's Office, Eastern District of Pennsylvania
Florida-Based Laboratory, Pain Clinic, and Two Former Executives Agree to Pay $41 Million to Resolve Allegations of Unnecessary Drug Testing
PHILADELPHIA - United States Attorney William M. McSwain announced that Logan Laboratories, Inc. (Logan Labs), a reference laboratory in Tampa, Florida, Tampa Pain Relief Centers, Inc. (Tampa Pain), a pain clinic also based in Tampa, Florida, and two of their former executives, Michael T. Doyle and Christopher UtzToepke, have agreed to pay a total of $41 million to resolve alleged violations of the False Claims Act for billing Medicare, Medicaid, TRICARE, and other federal health care programs for medically unnecessary Urine Drug Testing (UDT). Both Logan Labs and Tampa Pain are subsidiaries of Surgery Partners, Inc. Doyle is the former CEO of Surgery Partners and Logan Labs. Toepke is the former Group President for Ancillary Services at Surgery Partners, with oversight of Logan Labs, and a former Vice President at Tampa Pain.
April 14, 2020; Department of Justice
Nursing Home Chain Saber Healthcare Agrees to Pay $10 Million to Settle False Claims Act Allegations
Saber Healthcare Group LLC, and related entities, (Saber) have agreed to pay $10 million to resolve allegations that Saber violated the False Claims Act by knowingly causing certain of its skilled nursing facilities (SNFs) to submit false claims to Medicare for rehabilitation therapy services that were not reasonable, necessary, or skilled, the Department of Justice announced today. Saber Healthcare, based in Bedford Heights, Ohio, owns and operates SNFs in seven states.
April 13, 2020; U.S. Attorney's Office, Middle District of Tennessee
Maury Regional Medical Center To Pay More Than $1.7 Million To Settle False Claims Act Allegations
NASHVILLE, Tenn. - April 14, 2020 - Maury Regional Hospital, d/b/a Maury Regional Medical Center, has agreed to pay $1,702,903 to settle False Claims Act allegations, announced U.S. Attorney Don Cochran for the Middle District of Tennessee.
April 13, 2020; U.S. Attorney's Office, District of Nevada
U.S. Attorney Nicholas Trutanich And Attorney General Aaron Ford Form Nevada COVID-19 Task Force
LAS VEGAS, Nev. - Today, U.S. Attorney Nicholas A. Trutanich and Nevada Attorney General Aaron D. Ford announced the formation of the Nevada COVID-19 Task Force. The Task Force is comprised of local, state and federal investigators and prosecutors with significant experience in handling complaints and cases related to general fraud, heath care fraud, Medicaid fraud, insurance fraud, workers' compensation fraud and cybercrime, among others. Together, they will share information and resources to protect Nevadans from those using the COVID-19 pandemic to take advantage of consumers.
April 10, 2020; Department of Justice
Contract Rehab Provider to Pay $4 Million to Resolve False Claims Act Allegations Relating to the Provision of Medically Unnecessary Rehabilitation Therapy Services
Encore Rehabilitation Services LLC (Encore) has agreed to pay $4.03 million to resolve allegations that Encore violated the False Claims Act by knowingly causing three Michigan skilled nursing facilities to submit false claims to Medicare for rehabilitation therapy services that were not reasonable, necessary or skilled, the Department of Justice announced today. Encore, based in Farmington Hills, Michigan, provides rehabilitation services to patients at over 600 health care facilities, including skilled nursing facilities, in over 30 states.
April 6, 2020; Department of Justice
New Jersey Chiropractor Agrees to Pay $2 Million to Resolve Allegations of Unnecessary Knee Injections and Knee Braces and Related Kickbacks
David Podell, a New Jersey chiropractor, has agreed to pay the United States $2 million to resolve False Claims Act allegations that he both knowingly billed Medicare for medically-unnecessary viscosupplementation injections and knee braces and that he received illegal kickbacks, the Justice Department announced today. The settlement follows the government's earlier settlement with seven former Osteo Relief Institutes (ORIs) and their owners, who agreed to pay the United States collectively more than $7.1 million to resolve their False Claims Act liability.
April 6, 2020; U.S. Attorney's Office, Eastern District of Wisconsin
Wisconsin Physician Agrees to Pay Financial Penalties to Resolve Allegations That He Prescribed Opioids Illegally and Violated False Claims Act
United States Attorney Matthew D. Krueger announced today that Dr. Mehran Heydarpour of Brookfield, Wisconsin, agreed to pay $175,000 to resolve allegations that he prescribed opioid pain medications in violation of the Controlled Substances Act and that he billed Medicare for patient visits that did not occur in violation of the False Claims Act. Dr. Heydarpour also agreed that he would never again seek to register with the Drug Enforcement Administration for authorization to prescribe controlled substances.
April 1, 2020; U.S. Attorney's Office, Northern District of Oklahoma
Physician Assistant Agrees to Pay $620, 500 for Allegedly Engaging in Illegal Kickback Scheme
A Louisiana physician assistant entered into settlement agreement this week with the U.S. Attorney's Office for allegedly accepting illegal payments from OK Compounding, LLC, in return for recommending and prescribing compounded drugs produced by the pharmacy, announced U.S. Attorney Trent Shores.

March 2020

March 31, 2020; U.S. Attorney's Office, District of Connecticut
New Britain Optician Group Pays More Than $263K to Resolve False Claims Allegations
U.S. Attorney John H. Durham and Connecticut Attorney General William Tong today announced that YOUR EYES OF NEW BRITAIN, INC., and its owner, CAROL SANDERSON, have entered into a civil settlement with the federal and state governments in which they will pay more than $263,000 to resolve allegations that they violated the federal and state False Claims Acts.
March 31, 2020; U.S. Attorney's Office, Eastern District of Virginia
Former Medical Employees Plead Guilty to Prescription Fraud Scheme
ALEXANDRIA, Va. - Two women pleaded guilty yesterday for their respective roles in helping run a "pill mill," which led to the fraudulent dispensing of thousands of prescription opioid pills.
March 30, 2020; U.S. Attorney's Office, District of New Jersey
Georgia Man Arrested for Orchestrating Scheme to Defraud Health Care Benefit Programs Related to COVID-19 and Genetic Cancer Testing
NEWARK, N.J. - A Georgia man will appear in court today for his alleged role in a conspiracy to defraud federally funded and private health care benefit programs by submitting fraudulent testing claims for COVID-19 and genetic cancer screenings, U.S. Attorney Craig Carpenito announced.
March 30, 2020; U.S. Attorney's Office, District of Montana
Ex-Blackfeet Tribal leader sentenced to prison for Head Start program fraud
GREAT FALLS - The former chairman of the Blackfeet Tribe today was sentenced to 10 months in prison and two years of supervised release along with being ordered to pay $174,000 restitution for his role in an overtime pay scheme that stole federal funds from the tribe's Head Start child assistance program, U.S. Attorney Kurt Alme said.
March 27, 2020; U.S. Attorney's Office, Eastern District of Pennsylvania
Progressions Behavioral Health Services, Inc. and One of its Former Mental Health Therapists Agree to Pay $27,500 to Resolve Potential False Claims Act Liability
PHILADELPHIA - United States Attorney William M. McSwain announced that Progressions Behavioral Health Services, Inc. ("Progressions") andSharmon James, a mental health therapist formerly employed by Progressions, have agreed to pay $27,500 to resolve claims under the False Claims Act set forth in a qui tam complaint filed against them in the United States District Court for the Eastern District of Pennsylvania.
March 27, 2020; U.S. Attorney's Office, Southern District of New York
Manhattan U.S. Attorney Files Civil Fraud Suit Against Anthem, Inc., For Falsely Certifying The Accuracy Of Its Diagnosis Data
Geoffrey S. Berman, the United States Attorney for the Southern District of New York, announced that the United States filed a civil fraud lawsuit today against ANTHEM, INC. ("ANTHEM"), alleging that ANTHEM falsely certified the accuracy of the diagnosis data it submitted to the Centers for Medicare and Medicaid Services ("CMS") for risk-adjustment purposes under Medicare Part C and knowingly failed to delete inaccurate diagnosis codes. As a result of these acts, ANTHEM caused CMS to calculate the risk-adjustment payments to ANTHEM based on inaccurate, and inflated, diagnosis information, which enabled ANTHEM to obtain millions of dollars in Medicare funds to which it was not entitled.
March 26, 2020; U.S. Attorney's Office, Southern District of Florida
CEO, CFO, President, and Owner of Sober Homes Network "Serenity Ranch Recovery" Convicted in $38 Million Fraud Scheme after Six-Week Trial
Fort Lauderdale, Florida -- Sebastian Ahmed, 42, of Delray Beach, Florida, has been convicted of conspiracy to commit health care fraud and wire fraud, five counts of health care fraud, conspiracy to commit money laundering, and eleven counts of money laundering. As part of the scheme, the conspirators exploited vulnerable drug addicts, the majority of whom were 18 to 26 years ago; falsified paperwork; and entered into various kickback arrangements, all in order to receive millions of dollars of falsely and fraudulently obtained funds for their own personal use and benefit. As demonstrated by the trial record, of all the conspirators, no one profited more than Sebastian Ahmed, who netted more than $2.8 million in less than three years.
March 17, 2020; U.S. Attorney's Office, Eastern District of Pennsylvania
Doctor Who Pleaded Guilty to Health Care Fraud for "Goodie Bags" Agrees to Resolve Civil Fraud and Controlled Substance Liability for $2.8 Million
PHILADELPHIA - U.S. Attorney William M. McSwain announced that the United States filed a civil lawsuit against Andrew M. Berkowitz, M.D., of Huntington Valley, PA, for engaging in healthcare fraud and improperly distributing and dispensing controlled substances. The civil complaint relates to criminal charges that were previously filed against Berkowitz and for which he has pleaded guilty. At the same time the new civil suit was filed, the United States also filed a proposed civil judgment, in which Berkowitz has agreed to pay a total of $2.8 million in civil damages and penalties under the False Claims Act, Controlled Substances Act, and in civil forfeiture, committed to never obtaining another controlled substance registration, and consented to a 20-year exclusion from Medicare and Medicaid. The consent judgment remains subject to court approval.
March 13, 2020; U.S. Attorney's Office, Western District of Pennsylvania
Southwestern PA Family Practitioner Charged in 161-Count Superseding Indictment with Dispensing Drugs in Exchange for Sex and Health Care Fraud
PITTSBURGH - A physician who operated private family practices in Perryopolis, Pennsylvania, and Mount Pleasant, Pennsylvania, has been indicted by a federal grand jury in Pittsburgh on charges of unlawfully dispensing controlled substances and health care fraud, United States Attorney Scott W. Brady announced today.
Villages Dermatologist Agrees To Pay More Than $1.7 Million To Settle False Claims Act Liability For Inflated Medicare Claims
Orlando, FL - United States Attorney Maria Chapa Lopez announces today that Dr. Thi Thien Nguyen Tran and Village Dermatology and Cosmetic Surgery, L.L.C. have agreed to pay the United States $1.744 million to resolve allegations that they violated the False Claims Act by submitting inflated claims to Medicare for wound repairs related to Mohs surgery.
March 13, 2020; U.S. Attorney's Office, Western District of Pennsylvania
Pittsburgh Resident Pleads Guilty to Conspiracy, Health Care Fraud and Aggravated Identity Theft
PITTSBURGH, Pa. - A resident of Pittsburgh, Pennsylvania, pleaded guilty in federal court to one count each of conspiracy to defraud the Pennsylvania Medicaid program, health care fraud, and aggravated identity theft, United States Attorney Scott W. Brady announced today.
March 13, 2020; U.S. Attorney's Office, Southern District of Mississippi
Federal Jury finds Defendants Guilty of Submitting False Claims to Medicare under Civil False Claims Act. Jury verdict results in recovery of more than $10.85 million to the Medicare program
Gulfport, Miss. - Following a nine week trial, a federal jury in Gulfport returned a guilty verdict yesterday against Ted and Julie Cain of Ocean Springs, Ted Cain's companies, Stone County Hospital (Wiggins) and Corporate Management, Inc. (Gulfport), and Tommy Kuluz, Chief Financial Officer of Corporate Management, Inc. for violating the Civil False Claims Act, announced U.S. Attorney Mike Hurst and Derrick Jackson, Special Agent in Charge of the Office of Inspector General for the U.S. Department of Health and Human Services.
March 11, 2020; U.S. Attorney's Office, Southern District of Texas
Physicians group pays over $1M to resolve false billing claims
HOUSTON - Millennium Physicians Association PLLC has paid the United States $1,248,964 to resolve claims that they improperly billed the Medicare program for sleep studies, announced U.S. Attorney Ryan K. Patrick.
March 11, 2020; Department of Justice
"Compound King" Convicted in $21 Million Health Care Fraud Scheme
A federal jury sitting in Houston, Texas, found a pharmacist guilty Tuesday of charges related to health care fraud, wire fraud and money laundering. After a six-day trial, George Phillip Tompkins, 75, of Houston, Texas, was convicted on all charges - one count each of conspiracy to pay and receive kickbacks, conspiracy to commit health care fraud, conspiracy to commit money laundering as well as 11 counts of health care fraud and three counts of wire fraud.
March 11, 2020; U.S. Attorney's Office, Northern District of Georgia
Atlanta man sentenced in multi-state health care fraud conspiracy
ATLANTA - Matthew Harrell has been sentenced for his role in organizing and managing a health care fraud scheme that stole millions in Medicaid funds in Georgia, Louisiana, and Florida.
March 10, 2020; Department of Justice
Owner of Detroit-Area Health Care Clinic Sentenced to Prison for a Drug Diversion Scheme
The owner of a Detroit-area physical therapy clinic was sentenced to 11 years in prison today for his role in a drug diversion scheme. Assistant Attorney General Brian A. Benczkowski of the Justice Department's Criminal Division, Special Agent in Charge Timothy J. Plancon of the U.S. Drug Enforcement Administration (DEA)'s Detroit Division and Special Agent in Charge Lamont Pugh III of the U.S. Department of Health and Human Services Office of Inspector General's (HHS-OIG) Chicago Regional Office made the announcement.
March 10, 2020; U.S. Attorney's Office, District of New Jersey
Eighteen South Jersey Residents Charged With Trafficking Prescription Drugs
CAMDEN, N.J. - Eighteen alleged members of two drug trafficking operations based in Gloucester City and Camden have been charged in connection with their roles in distributing drugs, including high-dosage oxycodone pills, U.S. Attorney Craig Carpenito announced today.
March 6, 2020; U.S. Attorney's Office, Eastern District of Texas
Houston Nurse Guilty in East Texas Health Care Kickback Scheme
TYLER, Texas - A 54-year-old Houston Registered Nurse has pleaded guilty to federal violations in the Eastern District of Texas, announced U.S. Attorney Joseph D. Brown today.
March 6, 2020; U.S. Attorney's Office, Southern District of Ohio
Marietta doctor convicted of illegally distributing opioid pain meds, health care fraud
COLUMBUS, Ohio - A federal jury has convicted a Southeast Ohio doctor of illegally prescribing controlled substances and defrauding health care programs.
March 5, 2020; U.S. Attorney's Office, District of Oregon
Southern California Man Accused of Health Care Fraud
PORTLAND, Ore.-A southern California man who owned and operated local compounding pharmacies has been indicted by a federal grand jury on allegations that he submitted dozens of fraudulent patient attestations in support of reimbursement claims to CVS Caremark, a national pharmacy benefit manager.
March 5, 2020; Department of Justice
DOJ Files Suit against Spine Device Manufacturer and Executives Alleging Kickbacks to Surgeons through Sham Consulting Payments
The Justice Department announced today that the United States intervened and filed a complaint in two whistleblower cases filed under the False Claims Act against SpineFrontier, Inc. (SpineFrontier) and related entities and executives, alleging that the defendants paid kickbacks to spine surgeons to induce use of SpineFrontier surgical devices, in violation of the Anti-Kickback Statute (AKS). According to the United States' complaint, the defendants paid spine surgeons over $8 million in sham "consulting" payments ostensibly for product evaluations, when in fact the payments were for use of SpineFrontier devices.
March 4, 2020; U.S. Attorney's Office, Middle District of Florida
Lecanto Medical Biller Sentenced In Large Healthcare Fraud Scheme
Tampa, FL - U.S. District Judge Mary S. Scriven today sentenced Teresa Johnson (53, Lecanto) to five years' probation, with four months of home detention, for conspiring with a local doctor to commit health care fraud. As part of her sentence, the court also ordered Johnson to pay restitution to the defrauded federal health care programs and, entered a money judgment of more than $5,700, representing a portion of Johnson's health care fraud proceeds.
March 4, 2020; U.S. Attorney's Office, Northern District of Georgia
Hospice to pay $1.75 million to resolve false claims act allegations
ATLANTA - STG Healthcare of Atlanta, Inc. ("STG Healthcare") and two of its senior executives, Paschal "Pat" Gilley and Mathew Gilley, have agreed to pay $1.75 million to resolve allegations that STG Healthcare, operating as Interim Healthcare of Atlanta, submitted or caused the submission of false claims to Medicare and Medicaid for patients who were not eligible for the hospice benefit and that resulted from STG Healthcare's provision of unlawful payments to a referring physician in violation of the Anti-Kickback Statutes.
March 3, 2020; U.S. Attorney's Office, District of Massachusetts
United States Files False Claims Act Complaint Against Drug Maker Mallinckrodt. Complaint alleges that company avoided paying hundreds of millions of dollars in Medicaid rebates due to significant drug price increases
BOSTON - The U.S. Attorney's Office announced today that it filed a complaint under the False Claims Act against Mallinckrodt ARD LLC (formerly known as Mallinckrodt ARD, Inc. and previously Questcor Pharmaceuticals, Inc.) (collectively "Mallinckrodt"). The government alleges that Mallinckrodt has violated the False Claims Act by underpaying Medicaid rebates due as a result of large increases in the price of its drug H.P. Acthar Gel ("Acthar").
March 2, 2020; U.S. Attorney's Office, District of Connecticut
Two Connecticut Physicians Pay over $4.9 Million to Settle False Claims Act Allegations
U.S. Attorney John H. Durham, Special Agent in Charge Phillip Coyne of the U.S. Department of Health and Human Services, Office of Inspector General, Special Agent in Charge Brian C. Turner of the New Haven Division of the Federal Bureau of Investigation, and Connecticut Attorney General William Tong today announced that DR. CRISPIN ABARIENTOS and his wife, DR. ANTONIETA ABARIENTOS, have entered into a civil settlement agreement with the federal and state governments in which they will pay $4,927,903 to resolve allegations that they violated the federal and state False Claims Acts.

February 2020

February 28, 2020; Department of Justice
Diversicare Health Services Inc. Agrees to Pay $9.5 Million to Resolve False Claims Act Allegations Relating to the Provision of Medically Unnecessary Rehabilitation Therapy Services
Diversicare Health Services Inc., has agreed to pay $9.5 million to resolve allegations that it violated the False Claims Act by knowingly submitting false claims to Medicare for rehabilitation therapy services that were not reasonable, necessary, or skilled, the Department of Justice announced today.
February 28, 2020; U.S. Attorney's Office, Eastern District of Virginia
Woman Sentenced for Cocaine Conspiracy and Multiple Fraud Schemes
ALEXANDRIA, Va. - A Nigerian woman was sentenced today to 10 years in prison and ordered to pay over $377,000 in restitution for leading a conspiracy to import more than five kilograms of cocaine into the United States, as well as to her role in a separate bank fraud scheme, and to making false statements relating to fraudulent claims submitted to Medicaid for reimbursement.
February 28, 2020; U.S. Attorney's Office, District of Massachusetts
Sanofi Agrees to Pay $11.85 Million to Resolve Allegations That it Paid Kickbacks Through a Co-Pay Assistance Foundation
BOSTON - The U.S. Attorney's Office announced today that pharmaceutical company Sanofi-Aventis U.S., LLC ("Sanofi"), has agreed to pay $11.85 million to resolve allegations that it violated the False Claims Act by paying kickbacks to Medicare patients through a purportedly independent charitable foundation, The Assistance Fund ("TAF").
February 28, 2020; U.S. Attorney's Office, Middle District of Tennessee
Diversicare Health Services, Inc. Agrees To Pay $9.5 Million To Resolve False Claims Act Allegations
NASHVILLE, Tenn. - February 28, 2020 - Diversicare Health Services, Inc., has agreed to pay $9.5 million to resolve allegations that it violated the False Claims Act by knowingly submitting false claims to Medicare for rehabilitation therapy services that were not reasonable, necessary, or skilled, the Department of Justice announced today. The settlement also resolves allegations that Diversicare submitted forged pre-admission evaluations of patient need for skilled nursing services to TennCare, the state of Tennessee's Medicaid Program. Diversicare, based in Brentwood, Tennessee, provides skilled nursing and rehabilitation services at approximately 74 facilities across the country.
February 27, 2020; U.S. Attorney's Office, Southern District of Florida
Five Defendants Sentenced in South Florida to Prison Terms for Their Roles in Tricare and Medicare Fraud Scheme
MIAMI - This week, U.S. District Judge Cecilia M. Altonaga sentenced five defendants, including a doctor, to federal prison terms for their roles in a scheme that defrauded Tricare and Medicare out of more than $9.6 million. The defendants tricked beneficiaries into having the federal health care programs pay for medically unnecessary compounded prescription medicines and cancer genetic tests.
February 27, 2020; United States Attorney, Eastern District of New York
Queens Pharmacy Owner Found Guilty of Health Care Fraud and Money Laundering Charges for Role in Billing Scheme
BROOKLYN, NY - A federal jury in Brooklyn returned a guilty verdict last night against pharmacy owner Yuriy Barayev on one count of health care fraud and seven counts of money laundering for his role in a scheme to defraud Medicare by billing for prescription medications that were not provided to patients. The verdict followed a four-day trial before United States District Judge Edward R. Korman. When sentenced, Barayev faces up to 10 years in prison for health care fraud and up to 20 years in prison on each of the money laundering counts.
February 27, 2020; U.S. Attorney's Office, District of Kansas
Kansas Clinic Agrees to Pay $775,000 To Resolve False Claims Act Allegations
KANSAS CITY, KAN. - Trina Health-Wichita NW, LLC, located in Wichita, Kan., and Jack West of Dallas, Texas, one of the company's principals, agreed to pay the United States $775,000 to resolve allegations that they violated the False Claims Act by submitting false claims to Medicare and TRICARE.
February 26, 2020; Department of Justice
Two Los Angeles Pharmacy Owners Sentenced for Multimillion-Dollar Scheme that Billed Medicare, Cigna $11.8 Million in Fraudulent Medication Claims
Two owners and operators of a Los Angeles pharmacy were both sentenced today to 144 months in prison for their roles in a health care fraud scheme where Medicare and CIGNA were billed more than $11.8 million in fraudulent claims for prescription drugs.
February 26, 2020; U.S. Attorney's Office, Northern District of Georgia
Georgia woman pleads guilty to social security fraud
ATLANTA - Valencia D. Williams has pleaded guilty to Social Security fraud. Williams received Supplemental Security Income (SSI) from the Social Security Administration because she claimed that she was so disabled by anxiety and depression that she spent most of her time in her room and could not work. In fact, she was working as an exotic dancer at a local adult entertainment club under the name "Chrissy the Doll." SSI is a needs-based disability benefits program. Individuals who are over a certain income threshold or are not disabled cannot collect SSI...
..."When individuals are approved for certain Social Security benefits, they automatically become entitled to Medicare and Medicaid," said Derrick L. Jackson, Special Agent in Charge at the U.S. Department of Health and Human Services, Office of Inspector General in Atlanta. "This case represents how federal agencies can leverage precious resources to protect vital taxpayer-funded programs."
February 26, 2020; Department of Justice
Physician Charged for Alleged Role in an Over $120 Million Health Care Fraud and Money Laundering Conspiracy Involving Sponsorship of Ultimate Fighting Championship Hall of Famers
A physician who from 2016 to 2017 was the top prescriber of oxycodone 30 mg in Michigan was charged in a superseding indictment unsealed today with an over $120 million health care fraud and money laundering scheme that involved the alleged medically unnecessary distribution of over 2.2 million dosage units of controlled substances and the administration of medically unnecessary injections that resulted in patient harm.
February 24, 2020; U.S. Attorney, Central District of California
Urologist Sentenced to Nearly Six Years in Prison for Fraudulent Billings of Nonexistent Patient Visits and Unnecessary Tests
LOS ANGELES - A urologist was sentenced today to 71 months in federal prison for submitting fraudulent billings totaling more than $700,000 to Medicare for medically unnecessary and nonexistent treatments, sometimes billing for purported patient visits miles apart and occurring at the exact same time.
February 21, 2020; Connecticut State Division of Criminal Justice Medicare Fraud Strike Force Case
Waterbury Woman Charged in Scheme to Defraud Medicaid
A Waterbury woman who worked as a personal care assistant to a developmentally disabled man was arrested and charged billing Medicaid for his care after she had stopped providing services. ADRIEONNA FISHER, age 26, of Grilleytown Road in Waterbury, was arrested Thursday by Inspectors from the Medicaid Fraud Control Unit (MFCU) in the Office of the Chief State's Attorney and charged with one count each of Larceny in the First Degree By Defrauding A Public Community, Criminal Attempt to Commit Larceny in the Second Degree and Health Insurance Fraud.
February 21, 2020; Department of Justice
Ohio Doctor Pleads Guilty to Unlawful Distribution of Opioids
An Ohio physician who owned a Dayton-area medical practice pleaded guilty today for illegally distributing opioids. Assistant Attorney General Brian A. Benczkowski of the Justice Department's Criminal Division, U.S. Attorney David DeVillers of the Southern District of Ohio, Special Agent in Charge Keith Martin of the Drug Enforcement Administration's (DEA) Detroit Division, Special Agent in Charge Lamont Pugh III of the U.S. Department of Health and Human Services Office of Inspector General's (HHS-OIG) Chicago Regional Office and Special Agent in Charge William C. Hoffman of the FBI's Cincinnati Field Office made the announcement. Morris Brown, M.D. 75, of Dayton, pleaded guilty to one count of unlawful distribution of controlled substances before U.S. District Judge Walter Rice of the Southern District of Ohio. Brown is scheduled to be sentenced by Judge Rice on May 8.
February 19, 2020; Department of Justice
Guardian Elder Care Holdings and Related Entities Agree to Pay $15.4 Million to Resolve False Claims Act Allegations for Billing for Medically Unnecessary Rehabilitation Therapy Services
Guardian Elder Care Holdings Inc., and related companies Guardian LTC Management Inc., Guardian Elder Care Management Inc., Guardian Elder Care Management I Inc., and Guardian Rehabilitation Services Inc., (Guardian) agreed to pay $15,466,278 to resolve False Claims Act allegations that they knowingly overbilled Medicare and the Federal Employees Health Benefits Program for medically unnecessary rehabilitation therapy services, the Department of Justice announced today. Guardian operates more than 50 nursing facilities throughout Pennsylvania, as well as in Ohio and West Virginia.
February 19, 2020; U.S. Attorney; Eastern District of Pennsylvania
Montgomery County "Pill Mill" Doctor Sentenced to Four Years in Prison for Illegal Opioid Distribution
PHILADELPHIA - United States Attorney William M. McSwain announced that Dr. Spiro Y. Kassis, 66, of Plymouth Township, PA was sentenced to 48 months' incarceration, two years' supervised release and a $25,000 fine by United States District Judge Gene E. K. Pratter after pleading guilty to 14 counts of distributing controlled substances outside the course of professional practice and without a legitimate medical purpose. Separately, in a related civil case which reached settlement in November 2019, the defendant agreed to pay $1.4 million to resolve similar allegations.
February 19, 2020; Connecticut State Division of Criminal Justice Medicare Fraud Strike Force Case
New Haven Woman Charged with Medicaid Fraud
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.
Thursday, February 13, 2020; Department of Justice
Former Caregiver Pleads Guilty to Obstructing Investigation Related to Violation of Disabled Resident's Civil Rights
Anthony R. K. Flores, a former employee of a Missouri residential treatment facility, pleaded guilty in federal court in the Western District of Missouri to criminal charges arising from a civil rights investigation into the death of C.D., a Missouri ward of the state with developmental disabilities. Flores pleaded guilty to one count of obstructing justice by knowingly falsifying a document with the intent to impede, obstruct, and influence an investigation related to the death of C.D.
Friday, February 14, 2020; Department of Justice
Chicago Woman Found Guilty for Role in $7 Million Scheme to Defraud Medicare
A federal jury found a Chicago woman guilty today for her role in a scheme to defraud Medicare of approximately $7 million between 2011 and 2017.
February 12, 2020; Kansas Attorney General
Two Sedgwick County residents found guilty of Medicaid fraud
WICHITA - (February 12, 2020) - Two Sedgwick County residents have been found guilty of Medicaid fraud, Kansas Attorney General Derek Schmidt said today.
February 12, 2020; District of Maine
Owner of Lewiston Counseling Agency Sentenced for Health Care Fraud
Portland, Maine: A Lewiston woman was sentenced today in federal court in Portland for conspiring to commit health care fraud, U.S. Attorney Halsey B. Frank announced.
February 11, 2020; Department of Justice
Tenet Healthcare and Affiliated California Hospital to Pay $1.41 Million to Settle False Claims Act Allegations for Implanting Unnecessary Cardiac Monitors
Tenet Healthcare Corporation and its affiliated hospital Desert Regional Medical Center (DRMC), a general medical and surgical hospital located in Palm Springs, California, have agreed to pay $1.41 million to resolve allegations that they violated the False Claims Act by knowingly charging Medicare for implanting unnecessary cardiac monitors, the Justice Department announced today.
February 11, 2020; Southern District of West Virginia
Raleigh County Woman Enters Guilty Plea to Health Care Fraud
Defendant fraudulently obtained over $300,000

CHARLESTON, W.Va. - Julie M. Wheeler entered a guilty plea for federal health care fraud, announced United States Attorney Mike Stuart. Wheeler, 43, of Beckley, faces up to 10 years of incarceration, a $250,000 fine, and three years of supervised release when sentenced on May 20, 2020. She will also be subject to an order of restitution in an amount ranging from $302,131 to $469,983, with the final determination to be made by the Court at sentencing.
February 11, 2020; Northern District of Illinois
Federal Jury Convicts Doctor on Fraud Charges for Approving Medically Unnecessary Tests
CHICAGO - A federal jury in Chicago has convicted a physician on fraud charges for approving medically unnecessary tests that were billed to Medicare.
February 10, 2020; District of New Jersey
Former Pharmacy Employee Admits Role in Multi-Million Dollar Illegal Kickback Scheme
NEWARK, N.J. - A Bergen County, New Jersey, man today admitted participating in a conspiracy to pay and accept kickbacks in exchange for medically unnecessary prescriptions, U.S. Attorney Craig Carpenito announced.
February 6, 2020; Department of Justice Medicare Fraud Strike Force Case
Patient Recruiter Sentenced to Prison for Role in More than $1 Million Illegal Kickback Conspiracy
A patient recruiter was sentenced to 60 months in prison yesterday for receiving more than $1 million in illegal kickback payments from numerous home health agencies from around the country in exchange for providing information on Medicare beneficiaries to home health agencies, who then used that information to submit fraudulent claims to Medicare.
February 6, 2020; Eastern District of California
Sacramento Man Pleads Guilty to Medicare Kickback Scheme
SACRAMENTO, Calif. - Jai Vijay, 54, of Sacramento, pleaded guilty today to conspiring with the owners of home health care agencies and a hospice agency to pay and receive illegal kickbacks in exchange for Medicare beneficiary referrals.
February 5, 2020; District of Maryland
Former Employee of Walter Reed National Military Medical Center Facing Federal Indictment in Maryland.
Maryland - A federal grand jury has indicted David Laufer, age 63, of Pittsburgh, Pennsylvania, formerly of Bethesda, Maryland, on five counts of the federal charge of making false statements. The indictment was returned on December 16, 2019, and was unsealed upon his arrest on January 28, 2020. Laufer had his initial appearance yesterday in U.S. District Court in Greenbelt and was released pending trial.
February 5, 2020; Department of Justice Medicare Fraud Strike Force Case
Two Owners of Telemedicine Companies Charged for Roles in $56 Million Conspiracy to Defraud Medicare and Receive Illegal Kickbacks in Exchange for Orders of Orthotic Braces
WASHINGTON - The owners of two telemedicine companies were charged in an indictment unsealed yesterday for allegedly orchestrating a nationwide scheme to receive kickbacks and bribes in exchange for the ordering of medically unnecessary orthotic braces (braces) for beneficiaries of Medicare.
February 4, 2020; Department of Justice
U. S. Settles False Claims Act Allegations Against Southeastern Retina Associates
Knoxville, Tenn. - Southeastern Retina Associates ("SERA") has paid $1.5 million to resolve False Claims Act allegations in the United States District Court for the Eastern District of Tennessee.
February 4, 2020; U.S. Department of Justice Medicare Fraud Strike Force Case
Four Detroit-Area Physicians Found Guilty of Health Care Fraud Charges for Role in Over $150 Million Health Care Fraud Scheme
A federal jury found four Detroit-area physicians guilty today of health care fraud charges for their roles in a scheme to administer unnecessary back injections to patients in exchange for prescriptions of over 6.6 million doses of medically unnecessary opioids. Patients were required to get the injections in order to get the prescriptions, some of which were resold on the street by drug dealers, the evidence at trial showed.
February 4, 2020; Central District of California
Returned Fugitive Sentenced to 2 1/2 Years in Federal Prison for Role in Medicare Fraud Scheme Featuring Bogus Physical Therapy Claims
SANTA ANA, California - A former chiropractor who was on a federal "Most Wanted" list of fugitives was sentenced today to 30 months in federal prison for his role in a $15 million Medicare fraud scheme in which claims were submitted for physical therapy services that either were not reimbursable or were not provided.
February 4, 2020; Western District of Pennsylvania
Doctor Sentenced to Probation and Home Confinement for Health Care Fraud
PITTSBURGH, PA - A resident of DuBois, Pennsylvania has been sentenced for health care fraud, United States Attorney Scott W. Brady announced today. In March 2019, David James Girardi pleaded guilty to one count of health care fraud. In connection with the guilty plea, Girardi admitted to committing health care fraud by submitting fraudulent claims to Highmark for six Oxycodone and Hydrocodone prescriptions that Girardi wrote for his wife, but which were in fact intended for his own use.
February 3, 2020; Western District of Pennsylvania
Greensburg Doctor Charged with Conspiring to Receive Kickbacks for Prescribing Fentanyl, and Then Causing Insurers to Pay for the Unlawful Prescriptions
PITTSBURGH - A Westmoreland County physician has been indicted by a federal grand jury in Pittsburgh, Pennsylvania, on charges of conspiracy to violate the Anti-Kickback Statute, conspiracy to distribute fentanyl, health care fraud, and conspiracy to distribute phentermine hydrochloride and diethylpropion, United States Attorney Scott W. Brady announced today.

January 2020

January 31, 2020; Western District of Virginia
Pennsylvania Physician Sentenced for Drug Charge
CLARKSBURG, WEST VIRGINIA - Dr. Parth Bharill, a Pittsburgh and Morgantown physician, was sentenced today to five years probation, with the first six months on home confinement, for a drug charge, U.S. Attorney Bill Powell announced.
January 29, 2020, District of Maryland
Two Baltimore Men Convicted After Three-Week Federal Trial for Witness Retaliation and Tampering Resulting in the Murder of a Baltimore Woman. Both Defendants Face Mandatory Life Sentences in Federal Prison
Baltimore, Maryland - A federal jury in Baltimore, today convicted Davon Carter, age 39, and Clifton Mosley, age 41, both of Baltimore, for two counts of conspiracy to murder a witness and one count each of witness retaliation murder and witness tampering murder, related to the murder of Latrina Ashburne, age 41, on May 27, 2016. Carter was also convicted of a federal narcotics conspiracy charge, two counts of using a cellular telephone to facilitate the commission of a felony, and possession with intent to distribute marijuana. Mosley was also convicted of distribution of marijuana.
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; State of Alaska Department of Law Medicare Fraud Strike Force Case
Anchorage Dentist Seth Lookhart Convicted of Medical Assistance Fraud, Illegal Practice of Dentistry, Reckless Endangerment
The Alaska Department of Law, Medicaid Fraud Control Unit (MFCU), announces that in a verdict issued today by Superior Court Judge Michael Wolverton, following a five-week bench trial, Seth Lookhart was convicted of 46 counts of felony Medical Assistance Fraud, felony Scheme to Defraud, and misdemeanor counts of Illegal Practice of Dentistry, and Reckless Endangerment. Judge Wolverton also found Lookhart's corporation "Lookhart Dental LLC, d/b/a Clear Creek Dental," guilty of all 40 counts alleged against it. Lookhart's office manager, Shauna Cranford, had previously pled guilty to all of the conduct underlying the counts pursuant to a plea agreement. Judge Wolverton found that the State's evidence was "simply overwhelming" as to each count.

The prosecution acknowledges the many law enforcement agencies and civilians who assisted in the prosecution of this case, especially the former patients who testified during the trial. The State extends a special thanks to the "hoverboard video" patient, the patient whose teeth were pulled out without consent, and the patient who was forced to repeatedly return to Lookhart for remedial care. The State acknowledges the thorough work of the federal agents with the federal Department of Health and Human Services, Office of Inspector General, who provided substantial litigation assistance with this case. The prosecution also expresses thanks to the agents of the FBI Anchorage Field Office, the federal DEA, the State Department of Health and Social Services, the six doctors who provided extensive testimony at trial, and the many, many hours spent by the Medicaid Fraud Control Unit's investigators and staff. The State extends a special thanks to Dr. Eric Nordstrom for his many hours of hard work as the State's primary expert in this case.
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.