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Criminal and Civil Enforcement

December 2017

December 14, 2017; U.S. Department of Justice
DaVita Rx Agrees to Pay $63.7 Million to Resolve False Claims Act Allegations
DaVita Rx LLC, a nationwide pharmacy that specializes in serving patients with severe kidney disease, agreed to pay a total of $63.7 million to resolve False Claims Act allegations relating to improper billing practices and unlawful financial inducements to federal healthcare program beneficiaries, the Justice Department announced today. DaVita Rx is based in Coppell, Texas.
December 14, 2017; U.S. Attorney; Southern District of Mississippi
Mental Health Facility to Pay Almost $7 Million to Resolve Fraud Allegations
Jackson, Miss - Region 8 Mental Health Services has agreed to pay the United States government in excess of $6.93 million under the False Claims Act to resolve allegations that it was paid for services that it either did not provide or that were not provided by qualified individuals as part of its preschool Day Treatment program, announced United States Attorney Mike Hurst and Derrick Jackson, Special Agent in Charge, Department of Health and Human Services, Office of Inspector General. Today's announcement is believed to be the largest False Claims Act healthcare settlement in the history of the State of Mississippi.
December 13, 2017; U.S. Attorney; District of Columbia
Owner of Durable Medical Equipment Company Sentenced to Two Years in Prison for Health Care Fraud
WASHINGTON - Emeka H. Chijioke, 41, formerly of Atlanta, Ga., and Nigeria, was sentenced today to two years in prison on a federal charge stemming from a scheme in which he defrauded the District of Columbia's Medicaid program out of more than $500,000.
December 12, 2017; U.S. Department of Justice
21st Century Oncology to Pay $26 Million to Settle False Claims Act Allegations
21st Century Oncology Inc. and certain of its subsidiaries and affiliates have agreed to pay $26 million to the government to resolve a self-disclosure relating to the submission of false attestations regarding the company's use of electronic health records software and separate allegations that they violated the False Claims Act by submitting, or causing the submission of, claims for certain services provided pursuant to referrals from physicians with whom they had improper financial relationships.
December 12, 2017; U.S. Attorney; District of Nevada
Nevada Cardiologist Arrested For Unlawful Distribution of Prescription Opioids And Health Care Fraud
RENO, Nev. - An Elko, Nevada cardiologist was arrested today on 39-charges of unlawful distribution of prescription opioids and Medicare and Medicaid fraud, announced Attorney General Jeff Sessions, Acting U.S. Attorney Steven W. Myhre for the District of Nevada, Special Agent in Charge Aaron C. Rouse for the FBI's Las Vegas office, Special Agent in Charge David J. Downing for the DEA's Los Angeles field office, and Special Agent in Charge Christian Schrank for the Office of Inspector General of the U.S. Department of Health and Human Services Office Los Angeles Region.
December 12, 2017; U.S. Attorney; Eastern District of Texas
East Texas Imaging Companies and Owners Resolve Swapping and Medicare Fraud Allegations
PLANO, Texas - Multiple mobile imaging companies, along with their owners Dennis Whitsell and Jonathan Graham Lane, will pay the United States $300,000 after improperly billing Medicare for transportation charges related to portable x-ray services, announced Acting United States Attorney Brit Featherston. One of the companies also entered into a deferred prosecution agreement with the United States to resolve swapping allegations, which implicated the Anti-Kickback Statute.
December 11, 2017; U.S. Attorney; Middle District of Alabama
Another Montgomery "Pill Mill" Doctor Pleads Guilty to Drug Distribution and Money Laundering Charges
Montgomery, Ala. - On Friday, December 8, 2017, Dr. Shepherd A. Odom, 78, of Alexander City, Alabama, pleaded guilty to charges of drug distribution and conspiracy to commit money laundering, announced United States Attorney Louis V. Franklin, Sr. Dr. Odom's guilty plea was a part of the ongoing investigation and prosecution of those involved in operating a "pill mill" through the Family Practice medical office located at 4143 Atlanta Highway in Montgomery, Alabama.
December 8, 2017; U.S. Department of Justice Medicare Fraud Strike Force Case
Owner of Home Health Agency Sentenced in Absentia to 80 Years in Prison for Involvement in $13 Million Medicare Fraud Conspiracy and for Filing Fraudulent Tax Returns
The owner of a Houston home health agency was sentenced today to 80 years in prison for his role in a $13 million Medicare fraud scheme and for filing false tax returns.
December 8, 2017; U.S. Attorney; District of Connecticut
Substance Abuse Treatment Provider and CEO Pay More Than $800,000 to Settle Improper Billing Allegations
United States Attorney John H. Durham and Connecticut Attorney General George Jepsen today announced that APT FOUNDATION, INC. and its Chief Executive Officer, LYNN MADDEN, have entered into a civil settlement agreement with the federal and state governments in which they will pay $883,859 to resolve allegations that they caused overpayments to be paid by the Connecticut Medicaid Program.
December 7, 2017; U.S. Attorney; Eastern District of Missouri
Local Chiropractor and Wife, and One Police Officer Plead Guilty to Federal Charges
St. Louis, MO - Police Officer Terri Owens of the St. Louis Metropolitan Police Department (SLMPD); Dr. Mitchell Davis, a St. Louis chiropractor; and his wife Galina Davis, all pled guilty today to federal charges arising out of a scheme to obtain un-redacted accident reports for use in Dr. Davis's practice.
December 7, 2017; U.S. Attorney; Southern District of West Virginia
Charleston dentist sentenced to five years in federal prison for health care fraud
CHARLESTON, W.Va. - A Charleston dentist who falsely billed West Virginia Medicaid and West Virginia Medicaid Managed Care Organizations (MCOs) for more than $700,000 was sentenced today to five years in federal prison, announced United States Attorney Carol Casto. Antoine Skaff, 58, previously pleaded guilty to health care fraud. Skaff also previously entered into a civil settlement with the U.S. Attorney's Office, the Office of Inspector General for the U.S. Department of Health and Human Services, the West Virginia Department of Health and Human Resources (DHHR), DHHR's Bureau for Medical Services, and the West Virginia Medicaid Fraud Control Unit, in which he agreed to pay treble damages of $2.2 million, or three times the loss suffered by West Virginia Medicaid.
December 7, 2017; U.S. Attorney; Northern District of Texas
Federal Grand Jury Charges Grand Prairie Husband and Wife for Medicare Fraud
DALLAS - On December 6, 2017, a husband and wife were indicted on charges that they submitted false and fraudulent claims for home health services and defrauded Medicare of more than $3.4 million, announced U.S. Attorney Erin Nealy Cox of the Northern District of Texas.
December 6, 2017; U.S. Department of Justice Medicare Fraud Strike Force Case
Former Owners of Sleep Study Clinics in Northern Virginia and Maryland Charged With Health Care Fraud and Tax Evasion
An indictment was unsealed today charging two individuals with leading a multi-million dollar health care fraud and tax evasion scheme.
December 6, 2017; U.S. Attorney; District of New Jersey
Passaic County, New Jersey, Man Sentenced to 37 Months in Prison for Taking Bribes for Referring Tests to New Jersey Clinical Lab
NEWARK, N.J. - An internal medicine doctor with a practice in West New York, New Jersey, was sentenced today to 37 months in prison for accepting bribes in exchange for test referrals as part of a long-running scheme operated by Biodiagnostic Laboratory Services LLC (BLS), of Parsippany, N.J., its president and numerous associates, Acting U.S. Attorney William E. Fitzpatrick announced.
December 5, 2017; U.S. Attorney; Middle District of Alabama
One Physician and Three Nurse Practitioners Charged for Participating in the Operation of a Montgomery "Pill Mill"
Montgomery, Ala. - On Tuesday, December 5, 2017, four individuals were arrested after being indicted by a federal grand jury for their role in operating a "pill mill," out of a Montgomery, Alabama medical office, announced United States Attorney Louis V. Franklin, Sr. A "pill mill" is a medical clinic that is dispensing controlled substances inappropriately, unlawfully, and for non-medical reasons.
December 4, 2017; U.S. Attorney; Northern District of Texas
Dallas-Based Physician-Owned Hospital to Pay $7.5 Million to Settle Allegations of Paying Kickbacks to Physicians in Exchange for Surgical Referrals
WASHINGTON - Pine Creek Medical Center LLC ("Pine Creek"), a physician-owned hospital serving the Dallas/Fort Worth area, has agreed to pay $7.5 million to resolve claims that it violated the False Claims Act by paying physicians kickbacks in the form of marketing services in exchange for surgical referrals, the Department of Justice announced today.
December 4, 2017; U.S. Department of Justice
Owner of Michigan Home Health Agency Convicted in $1.6 Million Healthcare Fraud Scheme
A federal jury found a Detroit home health agency owner guilty today for her role in a scheme involving approximately $1.6 million in fraudulent Medicare claims for home health services that were procured through the payment of kickbacks, and that were medically unnecessary and not provided.
December 1, 2017; U.S. Attorney; Middle District of Florida
Podiatrists Plead Guilty To Fraud
Jacksonville, Florida - Acting United States Attorney W. Stephen Muldrow announces that William Danzeisen (60, Ponte Vedra Beach), a licensed podiatrist, and Sachin Brahmbhatt (37, Jacksonville), an unlicensed podiatrist, have pleaded guilty to theft of government property. Each faces a maximum penalty of 10 years in federal prison. The sentencing hearings have been set for January 30, 2018.
December 1, 2017; U.S. Attorney; Middle District of Florida
Sarasota Physician Agrees To Pay $1.95 Million To Resolve False Claims Act Allegations Regarding Unnecessary Ultrasounds
Tampa, FL - Acting United States Attorney W. Stephen Muldrow announces that Dr. Arthur S. Portnow, the owner and operator of Arthur S. Portnow, P.A., d/b/a Apple Medical and Cardiovascular Group, d/b/a Apple Medical Group (collectively, Dr. Portnow) has agreed to pay $1.95 million to resolve allegations that he and his practice violated the False Claims Act by knowingly seeking reimbursement for medically unnecessary ultrasound tests that were performed on Medicare beneficiaries.
December 1, 2017; U.S. Attorney; District of Minnesota
Local Dermatologist Pays $850,000 To Settle False Claims Act Allegations
Acting United States Attorney Gregory G. Brooker today announced that Skin Care Doctors, P.A. and its founder and CEO, Michael J. Ebertz, M.D. have agreed to pay $850,000 to the United States to resolve allegations of false claims submitted for certain dermatology procedures in violation of the False Claims Act ("FCA").
December 1, 2017; U.S. Attorney; Middle District of Pennsylvania
Doctor Indicted On Heath Care Fraud And Opioid Diversion Charges
HARRISBURG - The United States Attorney's Office for the Middle District of Pennsylvania announced today that Charles J. Gartland, D.O., age 59, of Cochranville, Pennsylvania, was indicted on November 29, 2017, by a federal grand jury on health care fraud and opioid diversion charges.
December 1, 2017; U.S. Attorney; Western District of North Carolina
School Counselor Sentenced To Two Years In Prison For Defrauding North Carolina Medicaid
ASHEVILLE, N.C. - Joseph Frank Korzelius, 47, of Tryon, N.C. was sentenced yesterday to 24 months in prison for fraudulently billing Medicaid for more than $450,000 in false claims for mental and behavioral health services he did not provide, announced R. Andrew Murray, U.S. Attorney for the Western District of North Carolina. In addition to the prison term imposed, U.S. District Judge Martin Reidinger ordered Korzelius to serve three years of supervised release and to pay $436,229.08 as restitution to Vaya Health, the administrator of Medicaid funds in Western North Carolina.

November 2017

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

October 2017

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

September 2017

September 29, 2017; U.S. Department of Justice
Former Executive of a Tenet Hospital Charged Along With Clinic Owner and Operator in $400 Million Fraud and Bribery Scheme
A former executive of a Tenet Healthcare Corporation-owned hospital and the owner and operator of an Atlanta-area chain of pre-natal clinics were charged in a superseding indictment that also added additional charges against another former Tenet executive for their alleged roles in an over $400 million fraud and bribery scheme. The indictment alleges that the scheme victimized the United States government, the Georgia and South Carolina Medicaid Programs and patients of Tenet hospitals.
September 27, 2017; U.S. Attorney; Northern District of Georgia
ANMED Health agrees to pay $7 million to settle False Claims Act allegations
ATLANTA - AnMed Health, a South Carolina hospital based in Anderson, South Carolina, has agreed to pay over $7 million to resolve allegations that it violated the False Claims Act by submitting false Medicare claims. The settlement announced today resolves allegations that AnMed Health knowingly disregarded the statutory conditions for submitting claims to the Medicare program for a variety of services, including radiation oncology services, emergency department services, and clinic services.
September 27, 2017; U.S. Attorney; Eastern District of New York
Amerisourcebergen Specialty Group Pleads Guilty to Distributing Misbranded Drugs and is Sentenced to Pay $260 Million to Resolve Criminal Liability
Earlier today, at the federal courthouse in Brooklyn, New York, AmerisourceBergen Specialty Group (ABSG), a wholly-owned subsidiary of AmerisourceBergen Corporation (NYSE: ABC), one of the nation's largest wholesale drug companies and number 11 on the Fortune 500 list, pled guilty to illegally distributing misbranded drugs. ABSG agreed to pay a total of $260 million to resolve criminal liability for its distribution of oncology supportive-care drugs from a facility that was not registered with the Food and Drug Administration (FDA). The guilty plea and sentencing took place before United States District Judge Nina Gershon.
September 27, 2017; U.S. Attorney; District of Connecticut
Norwich Podiatrist Pays $35,000 to Settle Allegations under the False Claims Act
Deirdre M. Daly, United States Attorney for the District of Connecticut, today announced that EDWARD TARKA, a podiatrist with a practice in Norwich, has entered into a civil settlement with the government in which he will pay $35,000 to resolve allegations that he violated the False Claims Act.
September 27, 2017; U.S. Attorney; District of New Jersey
Adult Daycare Facility Agrees To $2.72 Million Settlement To Resolve Allegations Of Violating False Claims Act
NEWARK, N.J. - Edison Adult Medical Daycare (Edison), its former owner, Dinesh Patel, and current owners, Daxa Patel and Satish Mehtani, have agreed to pay the United States and the State of New Jersey $2.72 million to resolve allegations that Edison improperly billed and received payments from Medicaid despite Dinesh Patel having been excluded from participating in Medicaid following his 2012 conviction for accepting kickbacks, Acting U.S. Attorney William E. Fitzpatrick announced today.
September 27, 2017; U.S. Attorney; Middle District of Tennessee
Murfreesboro Podiatrist Convicted Of 16-Month Scheme To Defraud Medicare And Other Health Care Benefit Programs
Podiatrist John J. Cauthon, 51, of Murfreesboro, Tenn., was convicted today by a federal jury of four counts of health care fraud involving a 16-month scheme to defraud Medicare and other health care benefit programs, announced Donald Q. Cochran, U.S. Attorney for the Middle District of Tennessee. The convictions came after a two-week trial before United States Chief District Judge Waverly D. Crenshaw, Jr. Cauthon was also acquitted of three counts of health care fraud.
September 22, 2017; U.S. Department of Justice
Drug Maker Aegerion Agrees to Plead Guilty; Will Pay More Than $35 Million to Resolve Criminal Charges and Civil False Claims Allegations
Aegerion Pharmaceuticals Inc., a Cambridge, Massachusetts-based subsidiary of Novelion Therapeutics Inc., has agreed to plead guilty to charges relating to its prescription drug, Juxtapid, the Justice Department announced today.
September 22, 2017; U.S. Department of Justice
Former Clinical Psychologist Sentenced to 25 Years in Prison for Role in $550 Million Social Security Fraud Scheme
A former Kentucky clinical psychologist was sentenced today to 25 years in prison for his role in a scheme to fraudulently obtain more than $550 million in federal disability payments from the Social Security Administration (SSA) for thousands of claimants.
September 22, 2017; U.S. Attorney; District of Connecticut
Stamford Dental Office Manager Sentenced to Prison for Defrauding Insurance Companies
Deirdre M. Daly, United States Attorney for the District of Connecticut, announced that ELENA ILIZAROV, 45, of Stamford, was sentenced today by U.S. District Judge Victor A. Bolden in Bridgeport to 12 months and one day of imprisonment, followed by three years of supervised release, for using an identity theft victim's personal identifying information to submit fraudulent bills to private insurance companies offering dental insurance.
September 21, 2017; U.S. Attorney; Eastern District of Louisiana
Owner and Healthcare Company Sentenced for Conspiracy to Commit Healthcare Fraud and Conspiracy to Pay and Receive Illegal Kickbacks
Acting U.S. Attorney Duane A. Evans announced that LISA CRINEL age 52; of New Orleans, and PCAH, INC. a/k/a PRIORITY CARE AT HOME, INC. d/b/a ABIDE HOME CARE SERVICES INC. ("ABIDE"), were sentenced today for their roles in approximately $30,052,295 in Medicare fraud.
September 20, 2017; U.S. Attorney; Eastern District of North Carolina
Nurse Practitioner Admits to Receiving Kickbacks for Signing Orders for Medicaid Services
RALEIGH - The United States Attorney Office for the Eastern District of North Carolina, John Stuart Bruce, announced that today in federal court, CHRISTINE HICKS THOMAS, 62, of Murfreesboro, North Carolina, pleaded guilty to Illegal Remunerations. Under the terms of the plea agreement, THOMAS faces up to 5 years in prison, $25,000 in fines, and 3 years of supervised release. Under additional terms discussed in court, THOMAS agreed to surrender her nursing license, to surrender any interest she has in companies that bill the government for health care services, and to be permanently excluded from Medicare and Medicaid programs.
September 20, 2017; U.S. Attorney; District of South Carolina
Wellford Woman Indicted for Forged Prescriptions
Columbia, South Carolina ---- United States Attorney Beth Drake stated today that Felicia L. Prysock, age 41, of Wellford, South Carolina, was charged in a thirty-count Indictment by a Grand Jury in Columbia for Aggravated Identity Theft, a violation of Title 18, United States Code, § 1028A; False Statements Related to Health Care Matters, a violation of Title 18, United States Code, § 1035(a)(2); and Obtaining a Controlled Substance by Fraud, a violation of Title 21, United States Code, § 843(a)(3).
September 19, 2017; U.S. Attorney; District of Minnesota
Health Care Business Owners Plead Guilty To Fraud And Tax Charges On Eve Of Trial
Acting United States Attorney Gregory G. Brooker today announced the guilty pleas of three defendants for their involvement in a years-long, multi-million dollar heath care fraud and tax conspiracy. THURLEE BELFREY, 52, ROYLEE BELFREY, 52, and LANORE BELFREY, 42, pleaded guilty on September 14, 2017, before Senior U.S. District Judge Ann D. Montgomery in Minneapolis, Minn. THURLEE BELFREY pleaded guilty to conspiracy to defraud the federal-state Medicaid program and failing to pay over taxes withheld from employees' pay. ROYLEE BELFREY pleaded guilty to two counts of failure to pay over taxes withheld from employees' pay. LANORE BELFREY pleaded guilty to conspiring to evade personal income taxes.
September 19, 2017; U.S. Attorney; District of Columbia
Owner of Durable Medical Equipment Company Pleads Guilty to Health Care Fraud
WASHINGTON - Emeka H. Chijioke, 40, formerly of Atlanta, Ga., and Nigeria, pled guilty today to a federal charge of health care fraud stemming from a scheme in which he defrauded the District of Columbia's Medicaid program out of more than $500,000.
September 19, 2017; U.S. Attorney; Northern District of Texas
Garland Woman Admits Role in Health Care Fraud Conspiracy
DALLAS, Texas - Latecia P. Hill, 51, of Garland, Texas, pleaded guilty today, before U.S. Magistrate Judge Paul D. Stickney, to one count of conspiracy to commit health care fraud stemming from a scheme to defraud Medicare through the submission of false claims for hearing related services. The announcement was made today by U.S. Attorney John Parker of the Northern District of Texas.
September 15, 2017; U.S. Department of Justice
Owner of Two New York Medical Clinics Sentenced to 84 Months for Her Role in $55 Million Health Care Fraud Scheme
The owner of two Brooklyn, New York, medical clinics was sentenced today to 84 months in prison for her role in a $55 million health care fraud scheme.
September 14, 2017; U.S. Department of Justice
New Orleans Woman Convicted of Conspiracy, Identity Theft and False Statement Charges for Role in $2.1 Million Medicare Kickback Scheme
On Tuesday, a federal jury found a New Orleans woman guilty of conspiracy, identity theft and false statements charges for her role in an approximately $2.1 million Medicare kickback scheme.
September 14, 2017; U.S. Attorney; Southern District of Ohio
Couple Sentenced for More Than $1 Million in Health Care Fraud
COLUMBUS, Ohio - Riyad Altallaa, 52, and Muna Alnoubani, 50, both of Hilliard, were each sentenced in U.S. District Court today for conspiracy to commit health care fraud. Altallaa was sentenced to 48 months in prison and Alnoubani was sentenced to 36 months of probation.
September 13, 2017; U.S. Department of Justice
New York Hospital Operator Agrees to Pay $4 Million to Settle Alleged False Claims Act Violations Arising from Improper Payments to Physicians
MediSys Health Network Inc., which owns and operates Jamaica Hospital Medical Center and Flushing Hospital and Medical Center, two hospitals in Queens, New York, has agreed to pay $4 million to settle allegations that it violated the False Claims Act by engaging in improper financial relationships with referring physicians, the Justice Department announced today.
September 13, 2017; U.S. Attorney; Northern District of Texas
Doctor Convicted of $50 Million Medicare Fraud Scheme Sentenced to 200 Months in Federal Prison
DALLAS - Noble U. Ezukanma, 57, of Fort Worth, Texas, was sentenced today by U.S. District Judge Jane Boyle to 200 months in federal prison and ordered to pay $34,003,151.24 in restitution for his role in an over $50 million Medicare fraud scheme, announced U.S. Attorney John Parker of the Northern District of Texas.
September 13, 2017; U.S. Attorney; Eastern District of New York
Operator Of Hospitals In Queens, NY, Agrees To Pay $4 Million To Settle Alleged False Claims Act Violations Arising From Improper Payments To Physicians
BROOKLYN, N.Y. - MediSys Health Network, Inc., which owns and operates Jamaica Hospital Medical Center and Flushing Hospital Medical Center, two hospitals in Queens, New York, has agreed to pay $4 million to settle allegations that it violated the False Claims Act by engaging in improper financial relationships with referring physicians, the Department of Justice announced today.
September 11, 2017; U.S. Department of Justice
South Carolina Family Practice Chain, Its Co-Owner, and Its Laboratory Director Agree to Pay the United States $2 Million to Settle Alleged False Claims Act Violations for Illegal Medicare Referrals and Billing for Unnecessary Medical Services
Family Medicine Centers of South Carolina LLC (FMC), has agreed to pay the United States $1.56 million, and FMC's principal owner and former chief executive officer, Dr. Stephen F. Serbin, and its former Laboratory Director, Victoria Serbin, have agreed to pay $443,000 to resolve a False Claims Act lawsuit alleging that they submitted and caused the submission of false claims to the Medicare and TRICARE programs. FMC is a physician-owned chain of family medicine clinics located in and around Columbia, South Carolina, whose practices include Springwood Lake Family Practice, Woodhill Family Practice, Midtown Family Medicine, Saluda Pointe Family Medicine, Lake Murray Family Medicine, and the now closed Rice Creek Family Medicine.
September 8, 2017; U.S. Department of Justice
Galena Biopharma Inc. to Pay More Than $7.55 Million to Resolve Alleged False Claims Related to Opioid Drug
Galena Biopharma Inc. (Galena) will pay more than $7.55 million to resolve allegations under the civil False Claims Act that it paid kickbacks to doctors to induce them to prescribe its fentanyl-based drug Abstral, the Department of Justice announced today.
September 7, 2017; U.S. Attorney; District of Connecticut
Connecticut Substance Abuse Treatment Provider Pays $627K to Settle False Claims Act Allegations
United States Attorney Deirdre M. Daly and Connecticut Attorney General George Jepsen today announced that a Connecticut substance abuse treatment provider and its former CEO will pay $627,000 to resolve allegations that they violated the federal and state False Claims Acts.
September 7, 2017; U.S. Attorney; Eastern District of Louisiana
California Resident Sentenced for Conspiracy to Commit Healthcare Fraud
Acting U.S. Attorney Duane A. Evans announced that SUNYUP KIM, age 41, of Granada Hills, CA, was sentenced today after previously pleading guilty to conspiracy to commit healthcare fraud.
September 6, 2017; U.S. Attorney; District of Maryland
Former National Institutes Of Health Employee Sentenced To 12 Months For Stealing Government Property
Greenbelt, Maryland - On September 5, 2017, U.S. District Judge Paul W. Grimm sentenced Christopher Dame, age 51, of Gaithersburg, Maryland, to six months in federal prison, six months home confinement, and three years of supervised release for theft of government property. Dame, a former Visual Information Specialist for the National Institutes of Health's (NIH) Medical Arts Division, which is located in Bethesda, Maryland, previously pled guilty to stealing NIH property and selling it online without authorization.
September 5, 2017; U.S. Attorney; District of Massachusetts
National Dental Clinic Chain to Pay $1.3 Million to Resolve Allegations of Overbilling Medicaid
BOSTON - The U.S. Attorney's Office and the Massachusetts Attorney General's Office announced today that Dental Dreams, LLC, a national dental chain with locations in Massachusetts, has agreed to pay $1.375 million to resolve allegations that it improperly billed the Massachusetts Medicaid program (MassHealth) for unnecessary and unjustifiable dental procedures.
September 5, 2017; U.S. Department of Justice
Novo Nordisk Agrees to Pay $58 Million for Failure to Comply with FDA-Mandated Risk Program
Pharmaceutical Manufacturer Novo Nordisk Inc. will pay $58.65 million to resolve allegations that the company failed to comply with the FDA-mandated Risk Evaluation and Mitigation Strategy (REMS) for its Type II diabetes medication Victoza, the Justice Department announced today. The resolution includes disgorgement of $12.15 million for alleged violations of the Federal Food, Drug, and Cosmetic Act (FDCA) from 2010 to 2012 and a payment of $46.5 million for alleged violations of the False Claims Act (FCA) from 2010 to 2014. Novo Nordisk is a subsidiary of Novo Nordisk U.S. Holdings Inc., which is a subsidiary of Novo Nordisk A/S of Denmark. Novo Nordisk's U.S. headquarters is in Plainsboro, New Jersey.
September 4, 2017; U.S. Attorney; Western District of Wisconsin
Former Janesville Pharmacy Owner Sentenced for Health Care Fraud
Madison, Wis. - Jeffrey M. Anderson, Acting United States Attorney for the Western District of Wisconsin, announced that Mark Johnson, 55, Janesville, Wis., was sentenced today by U.S. District Judge James Peterson to 24 months in federal prison for health care fraud. Johnson will begin serving his sentence in October.
September 1, 2017; U.S. Department of Justice
CHRISTUS St. Vincent Regional Medical Center and CHRISTUS Health to Pay $12.24 Million to Settle Medicaid False Claims Act Allegations
CHRISTUS St. Vincent Regional Medical Center (St. Vincent) and its partner, CHRISTUS Health (CHRISTUS), have agreed to resolve allegations that they violated the False Claims Act by making illegal donations to county governments, which were used to fund the state share of Medicaid payments to the hospital, the Department of Justice announced today. Under the settlement agreement, St. Vincent and CHRISTUS have agreed to pay $12.24 million, plus interest. St. Vincent is located in Santa Fe, New Mexico. CHRISTUS is based in Irving, Texas.

August 2017

August 30, 2017; U.S. Attorney; Southern District of Ohio
Doctor, Wife Plead Guilty to Running Pill Mill
DAYTON - David Kirkwood, 61, and Beverly Kirkwood, 50, of Dayton, pleaded guilty in U.S. District Court to health care fraud. David Kirkwood also pleaded guilty to one count of unlawful drug trafficking.
August 28, 2017; U.S. Attorney; Western District of Oklahoma
Oklahoma Doctor Agrees to Pay $580,000 to Settle Allegations of Submitting False Claims to Medicare
Oklahoma City, Oklahoma - Dr. Gordon P. Laird has agreed to pay $580,000 to settle civil claims stemming from allegations that he violated the False Claims Act by submitting false claims to the Medicare program, announced Mark A. Yancey, United States Attorney for the Western District of Oklahoma.
August 25, 2017; U.S. Department of Justice
Former Social Security Administrative Law Judge Sentenced to Four Years in Prison for Role in $550 Million Social Security Fraud Scheme
A former social security administrative law judge (ALJ) was sentenced today to four years in prison for his role in a scheme to fraudulently obtain more than $550 million in federal disability payments from the Social Security Administration (SSA) for thousands of claimants.
August 24, 2017; New York Attorney General
A.G. Schneiderman Announces Civil Suit And Criminal Charges Against Pharmacy Owner For Allegedly Defrauding Medicaid Of Millions
NEW YORK - Attorney General Eric T. Schneiderman today announced a lawsuit and criminal charges against pharmacist Hin T. Wong, 49, of Manhattan, and NY Pharmacy, Inc. ("NY Pharmacy") for allegedly defrauding the New York State Medicaid program out of millions of dollars. Wong, a licensed pharmacist and owner of NY Pharmacy, located at 131 Walker Street in Manhattan, allegedly paid undercover agents posing as Medicaid recipients kickbacks for HIV prescriptions and for referring other Medicaid recipients to bring their prescriptions to NY Pharmacy. Wong and NY Pharmacy also allegedly billed and were eventually paid over $60,0000 by Medicaid for refills on prescriptions submitted by undercover agents that NY Pharmacy either did not dispense or were predicated on the payment of a kickback. Various state laws and Medicaid regulations prohibit the payment of kickbacks for the referral of patients or individual prescriptions. In addition, the Attorney General also announced the filing of a civil asset forfeiture action seeking over $11 million in damages from Wong, NY Pharmacy and two other pharmacies owned by Wong that are now closed.
August 23, 2017; U.S. Attorney; Southern District of New York
Acting Manhattan U.S. Attorney Announces $13.4 Million Settlement Of Civil Healthcare Fraud Lawsuit Against US Bioservices Corp.
Joon H. Kim, the Acting United States Attorney for the Southern District of New York, and Scott J. Lampert, Special Agent in Charge of the U.S. Department of Health and Human Services' Office of Inspector General for the New York Region ("HHS-OIG"), announced that the United States has settled a civil fraud case against US BIOSERVICES CORP. ("US BIO") pursuant to which US BIO will pay a total of $13.4 million. The settlement resolves claims that US BIO violated the Anti-Kickback Statute and the False Claims Act by participating in a kickback scheme with Novartis PharmaceuticalS Corp. ("Novartis") relating to the NOVARTIS drug Exjade. Specifically, the United States' Complaint alleges that US BIO and NOVARTIS entered into a kickback arrangement pursuant to which US BIO was promised additional patient referrals and related benefits in return for refilling a higher percentage of Exjade than the two other pharmacies that also dispensed Exjade. The settlement will also resolve numerous state law civil fraud claims.
August 23, 2017; U.S. Attorney; District of Maryland
St. Agnes Healthcare Agrees To Resolve False Claims Act Allegations Of Overbilling Medicare
Baltimore, Maryland - St. Agnes Healthcare has agreed to pay the United States $122,928 to resolve claims under the False Claims Act alleging that St. Agnes submitted false claims to Medicare by billing for evaluation and management (E&M) services at a higher reimbursement rate than the Federal health care programs allowed.
August 23, 2017; U.S. Attorney; Western District of Virginia
Former Floyd Pharmacist Sentenced for Structuring
Roanoke, VIRGINIA - A former Floyd pharmacist, who structured cash deposits to avoid Internal Revenue Reporting Requirements, was sentenced today in the United States District Court for the Western District of Virginia.
August 21, 2017; U.S. Attorney; District of Minnesota
United States Recovers More Than $12 Million In False Claims Act Settlements For Alleged Kickback Scheme
Acting United States Attorney Gregory G. Brooker today announced that Sightpath Medical, Inc. (n/k/a Sightpath Medical, LLC) ("Sightpath"), TLC Vision Corporation (n/k/a TLC Vision (USA, LLC)) ("TLC") (collectively the "Sightpath Entities") and their former CEO, JAMES TIFFANY, have agreed to pay more than $12 million to the United States to resolve kickback allegations under the False Claims Act ("FCA"). The United States also intervened in an underlying lawsuit against the Cameron-Ehlen Group, Inc. d/b/a Precision Lens ("Precision Lens"), Precision Lens' owner PAUL EHLEN, and JITENDRA SWARUP.
August 21, 2017; U.S. Attorney; Southern District of West Virginia
Charleston dentist pleads guilty to health care fraud
CHARLESTON, W.Va. - A Charleston dentist who falsely billed West Virginia Medicaid and West Virginia Medicaid Managed Care Organizations (MCOs) for more than $700,000 pleaded guilty today, announced United States Attorney Carol Casto. Antoine Skaff, 58, entered his guilty plea to health care fraud. Skaff also entered into a civil settlement today with the U.S. Attorney's Office, the Office of Inspector General for the U.S. Department of Health and Human Services, the West Virginia Department of Health and Human Resources (DHHR), DHHR's Bureau for Medical Services, and the West Virginia Medicaid Fraud Control Unit, in which he agreed to pay treble damages of $2.2 million, or three times the loss suffered by West Virginia Medicaid.
August 18, 2017; U.S. Department of Justice Medicare Fraud Strike Force Case
Houston Home Health Agency Owner Sentenced to 480 Months in Prison for Conspiring to Defraud Medicare and Medicaid of More Than $17 Million
WASHINTON - The owner and operator of five Houston-area home health agencies was sentenced on Thursday to 480 months in prison for conspiring to defraud Medicare and the State of Texas' Medicaid-funded Home and Community-Based Service (HCBS) and Primary Home Care (PHC) Programs of more than $17 million and launder the money that he stole from Medicare and Medicaid. The HCBS and PHC Programs provided qualified individuals with in-home attendant and community-based services that are known commonly as "provider attendant services" (PAS). This case marks the largest PAS fraud case charged in Texas history.
August 18, 2017; U.S. Attorney; Northern District of Texas
Doctor & Owner of Multiple Home Health Companies Sentenced in a nearly $60 Million Medicare Fraud Scheme
DALLAS - Myrna S. Parcon, a/k/a "Merna Parcon," 62, of Dallas and Ransome N. Etindi, 57, of Waxahachie, Texas, were sentenced yesterday by U.S. District Judge Jane Boyle for their role in a nearly $60 million Medicare fraud scheme, announced U.S. Attorney John Parker of the Northern District of Texas.
August 17, 2017; U.S. Attorney; Northern District of Alabama
Compounding Pharmacy Sales Representative Pleads Guilty to Prescription Fraud Conspiracy
TUSCALOOSA - A sales representative for a Haleyville, Ala.-based compounding pharmacy pleaded guilty today in federal court to participating in a conspiracy to generate prescriptions and defraud health care insurers and prescription drug administrators out of tens of millions of dollars in 2015.
August 17, 2017; U.S. Attorney; District of Massachusetts
Mylan Agrees to Pay $465 Million to Resolve False Claims Act Liability
BOSTON - The U.S. Attorney's Office announced today that pharmaceutical companies Mylan Inc. and Mylan Specialty L.P. have agreed to pay $465 million to resolve allegations that they violated the False Claims Act by knowingly misclassifying EpiPen, a branded epinephrine auto-injector drug, as a generic drug to avoid paying rebates owed to Medicaid. Mylan Inc. and Mylan Specialty L.P. are both wholly owned subsidiaries of Mylan N.V., a Dutch-registered entity headquartered in Canonsburg, Penn.
August 16, 2017; U.S. Attorney; District of New Jersey
Cardiologist Admits Billing Veterans Affairs For Hundreds Of Bogus Medical Procedures
NEWARK, N.J. - A Somerset, New Jersey, man today admitted defrauding the Veterans Affairs program by billing for services he had not actually performed, Acting U.S. Attorney William E. Fitzpatrick announced.
August 10, 2017; U.S. Attorney; District of Maryland
CEO Indicted For Wire Fraud And Aggravated Identity Theft
Greenbelt, Maryland - A federal grand jury has indicted Zheng Geng, a/k/a "Jason Geng", age 59, of Vienna, Virginia, on charges related to a scheme to defraud the United States. The indictment was returned on August 9, 2017, and unsealed today upon the arrest of Geng. Geng is the Chief Executive Officer of Xigen LLC (Xigen), which has offices in Maryland and Virginia.
August 15, 2017; U.S. Attorney; Eastern District of Missouri
Chicago Podiatrist Sentenced for Health Care Fraud Charges
St. Louis, MO - Dr. Yev Gray was sentenced to 90 months in prison and ordered to pay $6,974,895.00 in restitution related to the submission of false reimbursement claims for non-rendered podiatric services.
August 14, 2017; U.S. Attorney; District of Nevada
Former Medical Doctor And Business Partner Indicted For $7.1 Million Medicare Health Care Fraud Scheme
LAS VEGAS, Nev. - Two Californians, a former medical doctor and his business partner, who were indicted on July 5, 2017 for a $7.1 million Medicare health care fraud scheme that occurred at three Las Vegas hospices, made their initial appearances in federal court today, announced Acting U.S. Attorney Steven W. Myhre for the District of Nevada.
August 14, 2017; U.S. Attorney; Northern District of Mississippi
Cleveland Doctor Sentenced in Hospice Fraud Case
OXFORD, Miss. - Robert H. Norman, Acting United States Attorney for the Northern District of Mississippi; Derrick L. Jackson, Special Agent in Charge at the U.S. Department of Health and Human Services, Office of Inspector General; Christopher Freeze, Special Agent in Charge at the Federal Bureau of Investigation, and Mississippi Attorney General Jim Hood announced that:

Dr. Nathaniel Brown, 62, of Cleveland, Mississippi, was sentenced Thursday, August 10, 2017 before United States District Judge Neal B. Biggers, Jr. in Oxford, Mississippi. Dr. Brown was sentenced to serve thirty-nine (39) months in federal prison followed by three (3) years supervised release and ordered to pay $1,941,254 in restitution to the Medicare program.
August 11, 2017; U.S. Department of Justice
Owner of Home Health Agency Sentenced to 75 Years in Prison for Involvement in $13 Million Medicare Fraud Conspiracy
The owner and director of nursing of a Houston home health agency was sentenced today to 75 years in prison for her role in a $13 million Medicare fraud scheme.
August 10, 2017; U.S. Department of Justice
Registered Nurse Who Owned Two Houston Home Health Companies Convicted in $20 Million Medicare Fraud Scheme
A federal jury today convicted a registered nurse who was the owner of two home health companies in Houston for her role in a $20 million Medicare fraud scheme involving fraudulent claims for home health services.
August 10, 2017; U.S. Attorney; District of Columbia
Nurse-Practitioner Found Guilty of Federal Charges for Illegally Distributing Oxycodone and Money Laundering
WASHINGTON - Ivan Lamont Robinson, a licensed nurse practitioner who was based in Southeast Washington, was found guilty by a jury today of 42 federal charges that he distributed oxycodone outside the legitimate scope of professional practice and without a legitimate medical purpose, and two counts of money laundering.
August 9, 2017; U.S. Attorney; Northern District of Texas
Dallas Doctor Sentenced on Health Care Fraud Conviction
DALLAS - A 60-year-old doctor from Rockwall, Texas, Jacques Roy, who was convicted in April 2016 of various health care fraud charges following a six-week-long trial, was sentenced today by U.S. District Judge Sam A. Lindsay to 420 months in federal prison and ordered to pay $268,147,699.15 in restitution, joint and several with all codefendants to Medicare and Medicaid, announced U.S. Attorney John Parker of the Northern District of Texas.
August 9, 2017; U.S. Attorney; District of Oregon
Jury Convicts Leader of Nationwide Identity Theft and IRS Tax Fraud Scheme
MEDFORD, Ore. - On Friday, August 4, 2017, a federal jury in Medford convicted Emmanuel Oluwatosin Kazeem, 34, of Bowie, Maryland and Nigeria of 19 counts of mail and wire fraud, aggravated identity theft and conspiracy to commit mail and wire fraud.
August 7, 2017; U.S. Attorney; Middle District of Florida
Palm Harbor Oncologist Sentenced To Nearly Six Years For Treating Patients With Unapproved Cancer Drugs
Tampa, Florida - U.S. District Judge James S. Moody, Jr. has sentenced D. Anda Norbergs to 5 years and 10 months in federal prison for receipt and delivery of misbranded drugs, smuggling goods into the United States, health care fraud, and mail fraud. As part of her sentence, the Court also entered a money judgment in the amount of $848,671.19, the proceeds of the criminal conduct. A federal jury found Norbergs guilty on November 18, 2016.
August 4, 2017; U.S. Attorney; Eastern District of North Carolina
Pitt County Behavioral Health President Pleads Guilty to Medicaid Fraud Conspiracy and Perjury Charges
RALEIGH - The United States Attorney for the Eastern District of North Carolina John Stuart Bruce Office announced that yesterday in federal court, SHEPHARD LEE SPRUILL, II, 46, of Winterville, North Carolina, pleaded guilty to Conspiracy to Commit Health Care Fraud, and Perjury. Under the terms of a plea agreement, SPRUILL faces up to 15 years in prison, $500,000 in fines, and 3 years of supervised release. Under additional terms discussed in court, SPRUILL also agreed to make restitution in the amount of $1,846,377 to the North Carolina Medicaid program, as well as additional restitution for any other fraud committed by or through Medicaid providers Pride in North Carolina, Carolina Support Services, Elite Care, Southern Support Services, One to One Youth, Vision of New Hope, Bridge Builders Youth Services, and Jameson Consultants.
August 3, 2017; U.S. Attorney; Middle District of Georgia
Navicent Settles Ambulance Fraud Claims For Over $2.5MM
G.F. "Pete" Peterman, III, United States Attorney for the Middle District of Georgia, and Georgia Attorney General Christopher M. Carr announced today a civil settlement with The Medical Center of Central Georgia, Inc., d/b/a The Medical Center, Navicent Health ("Navicent"). Navicent agreed to pay to the United States and the State of Georgia $2,549,742 to resolve allegations that it violated the False Claims Act and the Georgia False Medicaid Claims Act by submitting bills for ambulance transports that were either inflated or medically unnecessary. Additionally, Navicent's current Corporate Integrity Agreement (CIA) will be heightened and extended to cover the newly resolved conduct. A CIA is an agreement between a private provider of services and the United States whereby the provider, at its own expense, institutes and maintains a program, overseen by the OIG with reviews by an independent review organization, to insure compliance with the laws and regulations regarding participation in federally funded programs.
August 3, 2017; U.S. Attorney; Central District of California
Operators of Bogus Medical Clinics Charged in Conspiracy to Divert Massive Amounts of Prescription Narcotics to the Black Market
LOS ANGELES - The operators of seven sham medical clinics were among 12 defendants taken into custody this morning on federal drug trafficking charges that allege they diverted at least 2 million prescription pills - including oxycodone and other addictive and dangerous narcotics - to the black market.
August 2, 2017; U.S. Attorney; Northern District of Georgia
Atlanta Pain Clinic and its owner agree to pay $250,000 to resolve allegations that they violated the False Claims Act
ATLANTA - Atlanta Medical Clinic ("AMC"), which is an Atlanta-based pain management clinic, and Dr. Timothy Dembowski (AMC's owner), have agreed to pay the United States $250,000 to resolve allegations that they violated Medicare rules and the False Claims Act ("FCA") by billing the Government for: (1) services performed by a physician suspended from the Medicare program, and (2) the administration of foreign, non-FDA approved drugs, which are not eligible for reimbursement under the Medicare program.

July 2017

July 26, 2017; U.S. Attorney; Middle District of Pennsylvania
Denver Woman Sentenced To 46 Months' Imprisonment For Health Care Fraud
HARRISBURG- The United States Attorney's Office for the Middle District of Pennsylvania announced that Tammie Sensenig, age 46, of Denver, Pennsylvania was sentenced July 25, 2017, by United States District Court Judge William C. Caldwell to serve 46 months' imprisonment for health care fraud.
July 26, 2016; U.S. Attorney; Southern District of Ohio
Former Home Healthcare Nurse Sentenced for Medicaid Fraud in Case that Resulted in Minor's Death
DAYTON, Ohio - Mollie Parsons, 47, of Middletown, Ohio, was sentenced in U.S. District Court to 36 months in prison for healthcare fraud related to the death of a severely physically disabled minor.
July 26, 2017; U.S. Attorney; Northern District of West Virginia
Marshall County physician indicted on health care fraud charges
WHEELING, WEST VIRGINIA - A physician with a pain management clinic in McMechen, West Virginia, was indicted by a federal grand jury sitting in Wheeling on June 6, 2017 on health care fraud, mail fraud, and wire fraud charges, Acting United States Attorney Betsy Steinfeld Jividen announced.
July 26, 2017; U.S. Attorney; Northern District of Texas
Rowlett Woman Sentenced to 48 Months in Federal Prison for Role in Healthcare Fraud Conspiracy
DALLAS - Charity Eleda, R.N., 56, of Rowlett, Texas, was sentenced this morning in federal court in Dallas on a health care fraud conspiracy conviction, announced U.S. Attorney John Parker of the Northern District of Texas.
July 25, 2017; U.S. Attorney; Central District of California
Celgene Agrees to Pay $280 Million to Resolve Fraud Allegations Related to Promotion of Cancer Drugs Not Approved by FDA
LOS ANGELES - Celgene Corp., a manufacturer of pharmaceuticals headquartered in Summit, New Jersey, has agreed to pay $280 million to settle fraud allegations related to the promotion of two cancer treatment drugs for uses not approved by the Food and Drug Administration, the Justice Department announced today.
July 24, 2017; U.S. Attorney; Middle District of Florida
Owner Of Tampa Parathyroid Practice Agrees To Pay $4 Million To Resolve False Claims Act Allegations
Tampa, FL - Dr. James Norman, the owner and operator of James Norman, MD, PA, a/k/a James Norman, MD, PA Parathyroid Center, d/b/a Norman Parathyroid Center (collectively, Norman) has agreed to pay $4 million to resolve allegations that he violated the False Claims Act by knowingly engaging in various unlawful billing practices with respect to Medicare and other federal health care programs and their beneficiaries.
July 24, 2017; U.S. Attorney; Middle District of Tennessee
Pain Management Group Agrees To Pay $312,000 To Resolve False Claims Act And Overpayment Allegations
Pain Management Group P.C. ("PMG"), based in Antioch, Tenn., has agreed to pay $312,000 to settle federal and state False Claims Act and overpayment allegations, announced Jack Smith, Acting United States Attorney for the Middle District of Tennessee.
July 21, 2017; U.S. Department of Justice Medicare Fraud Strike Force Case
Houston Physician Convicted of Conspiracy in $1.5 Million Medicare Fraud Scheme
A federal jury convicted a Houston physician today for his role in a scheme involving approximately $1.5 million in fraudulent Medicare claims for home health care services and various medical testing and services.
July 21, 2017; U.S. Attorney; Middle District of Louisiana
Baton Rouge Home Health Company Settles False Claims Act Case For $1.7 Million
BATON ROUGE, LA - Acting United States Attorney Corey R. Amundson announced that CHARTER HOME HEALTH, a Baton Rouge-based healthcare company, has agreed to settle a civil fraud complaint filed under the federal False Claims Act by paying the United States $1.7 million and entering into a Corporate Integrity Agreement.
July 19, 2017; U.S. Attorney; Southern District of Florida
Nine Miami-Dade Assisted Living Facility Owners Sentenced to Federal Prison for Receipt of Health Care Kickbacks
Miami-Dade County assisted living facility owners, Marlene Marrero, 60, of Miami, Norma Casanova, 67, of Miami Lakes, Yeny De Erbiti, 51, of Miami, Rene Vega, 57, of Miami, Maribel Galvan, 43, of Miami Lakes, Dianelys Perez, 34, of Miami Gardens, Osniel Vera, 47, of Hialeah, Alicia Almeida, 56, of Miami Lakes, and Jorge Rodriguez, 57, of Hialeah, were sentenced to prison for receiving health care kickbacks. United States District Judge Marcia G. Cooke imposed sentences upon the nine defendants ranging from eight months to one year and one day, in prison. One assisted living facility owner, Blanca Orozco, 69, of Miramar, was sentenced to home confinement. In addition to their federal convictions, all ten defendants were also ordered to serve three years of supervised release, pay restitution and are subject to forfeiture judgments.
July 19, 2017; U.S. Attorney; Western District of Missouri
Two University of Missouri Physicians Plead Guilty to Health Care Fraud
JEFFERSON CITY, Mo. - Tom Larson, Acting United States Attorney for the Western District of Missouri, announced today that two physicians at the University of Missouri School of Medicine in Columbia, Mo., have pleaded guilty in federal court, in separate cases, to engaging in a health care fraud scheme that totaled more than $190,000.
July 18, 2017; U.S. Attorney; Western District of Virginia
Danville Doctor Pleads Guilty to Healthcare Fraud, Tax Evasion Charges
Danville, VIRGINIA - A Danville doctor, who billed various insurers for services he never administered to patients, pled guilty today in the United States District Court for the Western District of Virginia in Danville to healthcare fraud and tax evasion charges, Acting United States Attorney Rick A. Mountcastle announced.
July 17, 2017; U.S. Department of Justice
Three Companies and Their Executives Pay $19.5 Million to Resolve False Claims Act Allegations Pertaining to Rehabilitation Therapy and Hospice Services
Ohio based Foundations Health Solutions Inc. (FHS), Olympia Therapy Inc. (Olympia), and Tridia Hospice Care Inc. (Tridia), and their executives, Brian Colleran (Colleran) and Daniel Parker (Parker), have agreed to pay approximately $19.5 million to resolve allegations pertaining to the submission of false claims for medically unnecessary rehabilitation therapy and hospice services to Medicare, the Department of Justice announced today.
July 17, 2017; U.S. Attorney; Southern District of New York
Manhattan U.S. Attorney Announces $4.4 Million Settlement Of Civil Lawsuit Against VNS Choice For Improper Collection Of Medicaid Payments
Joon H. Kim, the Acting United States Attorney for the Southern District of New York, announced today that the United States has settled a civil fraud lawsuit against VNS CHOICE, VNS CHOICE COMMUNITY CARE, and VISITING NURSE SERVICE OF NEW YORK (collectively, "VNS") for improperly collecting monthly Medicaid payments for 365 Medicaid beneficiaries whom VNS Choice failed to timely disenroll from the VNS Choice Managed Long-Term Care Plan ("Choice MLTCP"). Most of the beneficiaries who should have been disenrolled from the Choice MLTCP were no longer receiving health care services from VNS. Under the terms of the settlement approved today by United States District Judge Ronnie Abrams, VNS Choice must pay a total sum of $4,392,150, with $1,756,860 going to the United States and the remaining amount to the State of New York. In the settlement, VNS admits that VNS Choice failed to timely disenroll 365 Choice MLTCP members and, as a result, received Medicaid payments to which it was not entitled.
July 14, 2017; U.S. Department of Justice
Clinical Psychologist and Owner of Psychological Services Centers Sentenced to 264 Months for Roles in $25 Million Psychological Testing Scheme Carried out Through Eight Companies in Four States
Two owners of psychological services companies, one of whom was a clinical psychologist, were sentenced yesterday for their involvement in a $25.2 million Medicare fraud scheme carried out through eight companies at nursing homes in four states in the Southeastern U.S.
July 14, 2017; U.S. Attorney; Southern District of Georgia
Southern District Of Georgia Announces Participation in National Health Care Fraud Takedown
SAVANNAH, GA: On Thursday, Attorney General Jeff Sessions and Department of Health and Human Services ("HHS") Secretary Tom Price, M.D., announced the largest ever health care fraud enforcement action by the Medicare Fraud Strike Force, involving 412 charged defendants across 41 federal districts, including 115 doctors, nurses and other licensed medical professionals, for their alleged participation in health care fraud schemes involving approximately $1.3 billion in false billings. Of those charged, over 120 defendants, including doctors, were charged for their roles in prescribing and distributing opioids and other dangerous narcotics.
July 14, 2017; U.S. Attorney; Eastern District of New York
Senior Executives Of Medical Drug Re-Packager Plead Guilty To Defrauding Healthcare Providers
Earlier today, in federal court in Brooklyn, Gerald Tighe, the president and owner of Med Prep Consulting Inc. (Med Prep), and Stephen Kalinoski, its director of pharmacy and registered pharmacist-in-charge, pleaded guilty to wire fraud conspiracy in connection with their operation of the now-defunct Tinton Falls, New Jersey-based medical drug re-packager and compounding pharmacy. The pleas were entered before United States District Judge I. Leo Glasser.
July 13, 2017; U.S. Department of Justice
National Health Care Fraud Takedown Results in Charges Against Over 412 Individuals Responsible for $1.3 Billion in Fraud Losses
Attorney General Jeff Sessions and Department of Health and Human Services (HHS) Secretary Tom Price, M.D., announced today the largest ever health care fraud enforcement action by the Medicare Fraud Strike Force, involving 412 charged defendants across 41 federal districts, including 115 doctors, nurses and other licensed medical professionals, for their alleged participation in health care fraud schemes involving approximately $1.3 billion in false billings. Of those charged, over 120 defendants, including doctors, were charged for their roles in prescribing and distributing opioids and other dangerous narcotics. Thirty state Medicaid Fraud Control Units also participated in today's arrests. In addition, HHS has initiated suspension actions against 295 providers, including doctors, nurses and pharmacists.
July 13, 2017; U.S. Attorney; Northern District of New York Medicare Fraud Strike Force Case
Kinderhook Podiatrist Pleads Guilty to Health Care Fraud, Pays $410,000 to Resolve False Claims Act Liability
ALBANY, NEW YORK - Podiatrist Perrin D. Edwards, age 64, of Kinderhook, New York, pled guilty on Tuesday to health care fraud for illegally charging Medicare and private insurance companies for services that he never provided. Edwards has also paid $410,000 to the United States to resolve his civil liability for his submission of false claims for payment to the Medicare.
July 13, 2017; U.S. Attorney; Northern District of Illinois Medicare Fraud Strike Force Case
National Healthcare Fraud Takedown Results in Charges Against More Than 400 Individuals, Including Several Chicago-Area Medical Professionals
CHICAGO - Several Chicago-area medical professionals, including two licensed physicians, are facing federal criminal charges as part of the largest health care fraud enforcement action in Department of Justice history, federal authorities announced today.
July 13, 2017; U.S. Attorney; Southern District of Florida Medicare Fraud Strike Force Case
Seventy-Seven Charged in Southern District of Florida as Part of Largest Health Care Fraud Action in Department of Justice History
Benjamin G. Greenberg, Acting United States Attorney for the Southern District of Florida; George L. Piro, Special Agent in Charge, Federal Bureau of Investigation (FBI), Miami Field Office; Shimon R. Richmond, Special Agent in Charge, U.S. Department of Health & Human Services, Miami Regional Office, Office of Inspector General (HHS-OIG); and Pam Bondi, Florida Attorney General; announced today the largest ever health care fraud enforcement action by the Medicare Fraud Strike Force, involving 412 charged defendants across 41 federal districts, including 115 doctors, nurses and other licensed medical professionals, for their alleged participation in health care fraud schemes involving approximately $1.3 billion in false billings. In the Southern District of Florida a total of 77 defendants were charged with offenses relating to their participation in various fraud schemes involving over $141 million in false billings for services including home health care, mental health services and pharmacy fraud.
July 13, 2017; U.S. Attorney; Central District of California Medicare Fraud Strike Force Case
As Part of National Health Care Fraud Takedown, Federal Prosecutors in Los Angeles Charge 14 Defendants in Fraud Schemes that Allegedly Cost Public Healthcare Programs nearly $150 Million
LOS ANGELES - In the largest-ever health care fraud enforcement action by federal prosecutors, 14 defendants - including doctors, nurses and other licensed medical professionals - have been charged in the Central District of California for allegedly participating in health care fraud schemes that caused approximately $147 million in losses.
July 13, 2017; U.S. Attorney; Eastern District of Arkansas Medicare Fraud Strike Force Case
Twenty-Four Charged in Arkansas as Part of Largest Nationwide Health Care Fraud Enforcement Action in Department of Justice History
WASHINGTON-Attorney General Jeff Sessions and Department of Health and Human Services (HHS) Secretary Tom Price, M.D., announced today the largest ever health care fraud enforcement action by the Medicare Fraud Strike Force, involving 412 charged defendants across 41 federal districts-including the Eastern District of Arkansas. Among the defendants were 115 doctors, nurses and other licensed medical professionals, all alleged to have participated in health care fraud schemes involving approximately $1.3 billion in false billings. Of those charged, over 120 defendants, including doctors, were charged for their roles in prescribing and distributing opioids and other dangerous narcotics. Thirty state Medicaid Fraud Control Units also participated in today's arrests. In addition, HHS has initiated suspension actions against 295 providers, including doctors, nurses and pharmacists.
July 13, 2017; U.S. Attorney; Northern District of Alabama Medicare Fraud Strike Force Case
U.S. Attorney Charges NW Alabama Compounding Pharmacy Sales Representatives in Prescription Fraud Conspiracy
BIRMINGHAM - The U.S. Attorney's Office on Wednesday charged two sales representatives for a Haleyville, Ala.,-based compounding pharmacy for participating in a conspiracy to generate prescriptions and defraud health care insurers and prescription drug administrators out of tens of millions of dollars in 2015.
July 13, 2017; U.S. Attorney; Eastern District of Virginia Medicare Fraud Strike Force Case
Woman Indicted on Medicaid Fraud and Identity Theft Charges
RICHMOND, Va. - As part of the largest ever health care fraud enforcement action in Department of Justice History, a Richmond woman has been charged with healthcare fraud, aggravated identity theft, and making a false statement to federal agents.
July 13, 2017; U.S. Attorney; Middle District of Louisiana Medicare Fraud Strike Force Case
Baton Rouge-Based Medicare Fraud Strike Force Announces Charges Against Four More Individuals For Health Care Fraud And Related Offenses
BATON ROUGE, LA - Acting United States Attorney Corey R. Amundson announced today the unsealing of two federal grand jury indictments charging four individuals with health care fraud and related offenses. The cases were unsealed as part of the 2017 National Health Care Fraud Takedown, during which federal, state, and local law enforcement partners announced charges of more than 400 defendants across 41 different federal judicial districts.
July 13, 2014; U.S. Attorney; Southern District of Ohio Medicare Fraud Strike Force Case
National Health Care Fraud Takedown Includes Two Central Ohio Companies and Owners Charged with False Billing
COLUMBUS, Ohio - A federal grand jury has returned separate indictments charging two central Ohio health care companies and the people who own them with health care fraud. One company allegedly billed government insurance programs for unnecessary medical procedures and the other is accused of billing government insurance programs for pain and scar creams that recipients said they never requested or wanted.
July 13, 2017; U.S. Attorney; Northern District of California Medicare Fraud Strike Force Case
Charges Filed Against Northern California Physician For Unlawfully Dispensing Oxycodone
SAN FRANCISCO - Christopher Owens, a physician licensed to practice in California, was indicted on Tuesday with unlawfully prescribing oxycodone, announced U.S. Attorney Brian J. Stretch and Drug Enforcement Administration Special Agent in Charge John J. Martin. The indictment alleges that between September of 2012 and June of 2015, Owens, 50, now of Indianapolis, IN, intended to act outside the course of usual professional practice and without a legitimate medical purpose when he prescribed oxycodone on numerous occasions. In sum, Owens is charged with 36 counts of distributing oxycodone, in violation of 21 U.S.C. § 841(a)(1) and (b)(1)(C).
July 13, 2017; U.S. Department of Justice
Miami-Based Physician Pleads Guilty for Role in Pain Pill Diversion and Medicare Fraud Scheme
A licensed physician in Miami pleaded guilty in federal court yesterday for his role in a multi-faceted $4.8 million health care fraud scheme that ran from April 2011 to February 2017, involving the submission of false and fraudulent claims to Medicare and the illegal prescribing of Schedule II (e.g., oxycodone and hydrocodone) and Schedule IV (e.g., alprazolam) controlled substances.
July 12, 2017; U.S. Attorney; Southern District of Texas
Two Men Indicted in Medicare Fraud Scheme in Rio Grande Valley
McALLEN, Texas - A former laboratory technician at a medical clinic in Mission and an account representative for a toxicology testing company have been indicted in connection with a scheme to defraud Medicare, announced Acting U.S. Attorney Abe Martinez.
July 11, 2017; U.S. Attorney; Northern District of Texas
Woman Indicted for Running Health Care Fraud Scheme from Prison
DALLAS - Alexis C. Norman, 46, of Midlothian, Texas has been indicted on felony offenses stemming from a health care fraud conspiracy she ran from prison that involved the submission of more than $810,000 in false claims to Medicaid, announced U.S. Attorney John Parker of the Northern District of Texas.
July 11, 2017; U.S. Attorney; District of Connecticut
Drug Company Sales Rep Admits Role in Kickback Scheme Related to Fentanyl Spray Prescriptions
Deirdre M. Daly, United States Attorney for the District of Connecticut, announced that NATALIE LEVINE, 33, of Scottsdale, Arizona, waived her right to be indicted and pleaded guilty today before U.S. District Judge Michael P. Shea in Hartford to one count of engaging in a kickback scheme that defrauded federal healthcare programs.
July 10, 2017; U.S. Attorney; Southern District of New York
Brooklyn Pharmacy Owner/Operator Charged With Defrauding Medicare And Medicaid Programs Of Approximately $9 Million
Joon H. Kim, the Acting United States Attorney for the Southern District of New York, William F. Sweeney Jr., the Assistant Director-in-Charge of the New York Office of the New York Office of the Federal Bureau of Investigation ("FBI"), Scott J. Lampert, Special Agent in Charge of the New York Regional Office for the Department of Health and Human Services, Office of Inspector General ("HHS-OIG"), and Dennis Rosen, Inspector General of the New York State Office of the Medicaid Inspector General ("OMIG"), announced today the unsealing of a criminal Complaint charging defendant SUNITA KUMAR with operating a health care fraud scheme utilizing two pharmacies in Brooklyn, New York, through which KUMAR submitted approximately $9 million in fraudulent claims to Medicaid and Medicare. KUMAR was arrested this morning and was presented in Manhattan federal court today before U.S. Magistrate Judge Andrew J. Peck.
July 7, 2017; U.S. Attorney; Eastern District of California
Wal-Mart Pays $1.65M to Settle False Claims Act Allegations of Improper Medi Cal Billings
SACRAMENTO, Calif. - Wal-Mart Stores Inc. has paid $1.65 million to resolve allegations that it violated the federal False Claims Act when it knowingly submitted claims for reimbursement to California's Medi Cal program that were not supported by applicable diagnosis and documentation requirements, U.S. Attorney Phillip A. Talbert announced today.
July 6, 2017; U.S. Attorney; Northern District of Georgia
Hospice to pay $2.4 Million to resolve False Claims Act Allegations
ATLANTA - Compassionate Care Hospice Group, Inc., ("CCH Group") has agreed to pay $2.4 million to resolve allegations that CCH Group and its subsidiary Compassionate Care Hospice of Atlanta, LLC, ("CCH Atlanta") submitted or caused the submission of false claims to Medicare and Medicaid by engaging in improper financial relationships with contracted physicians. CCH Group is a Florida corporation with its principal place of business in Parsippany, New Jersey, and subsidiaries and affiliates in numerous states.
July 6, 2017; U.S. Attorney; District of New Jersey
Hospice Company To Pay $2 Million To Resolve Alleged False Claims Related To Unnecessary Hospice Care
NEWARK, N.J. - A hospice company in Bensalem, Pennsylvania, has agreed to pay to the United States $2 million to resolve allegations that it provided unnecessary hospice services, Acting U.S. Attorney William E. Fitzpatrick announced today.
July 6, 2017; U.S. Attorney; Eastern District of Pennsylvania
Defunct Philly Hospice's Owners/Operators to Pay Millions to Settle Civil False Claims Suit
PHILADELPHIA - Acting United States Attorney Louis D. Lappen announced today that Matthew Kolodesh, Alex Pugman, Svetlana Ganetsky, and Malvina Yakobashvili have agreed to pay millions of dollars to settle False Claims Act allegations that they and their now-defunct company, Home Care Hospice, Inc. (HCH), falsely claimed and received taxpayer dollars for hospice services that were either unnecessary or never provided. Previously, a federal jury found Kolodesh guilty on, and Pugman and Ganetsky pleaded guilty to, related criminal charges.
July 5, 2017; U.S. Attorney; Eastern District of Missouri
U.S. Reaches $8.3 Million Civil Settlement with Reliant Care Group and Reliant Affiliated Entities
St. Louis, Missouri: The United States Attorney's Office for the Eastern District of Missouri announced today that the United States, Reliant Care Group, Reliant Care Management Company, Reliant Care Rehabilitative Services, and a number of Reliant affiliated skilled nursing facilities (Reliant) reached a civil settlement that will resolve the United States' claims against Reliant under the False Claims Act for knowingly submitting false claims to Medicare for providing unnecessary physical, speech, and occupational therapy to nursing home residents.
June 30, 2017; U.S. Attorney; Southern District of Alabama
Pain Management Doctor Arrested in Health Care Fraud Cases
Acting United States Attorney Steve Butler of the Southern District of Alabama and Alabama Attorney General Steve Marshall announced today that Dr. Rassan M. Tarabein, 58, a neurologist residing in Fairhope, Alabama, was arrested by law enforcement officials on federal and state criminal charges relating to health care fraud. On June 16, 2017, a state grand jury in Montgomery County, Alabama returned a 2-count indictment against Dr. Tarabein, charging him with Medicaid fraud and theft of property in the first degree. On June 28, 2017, a federal grand jury for the Southern District of Alabama returned a 22-count superseding indictment against Dr. Tarabein, charging him with health care fraud, making false statements relating to health care matters, lying to a federal agent, unlawfully distributing schedule II controlled substances, and money laundering. Later today, Dr. Tarabein is scheduled for an initial appearance on the federal charges before United States Magistrate Judge P. Bradley Murray in Mobile, Alabama. Dr. Tarabein operated the Eastern Shore Neurology and Pain Center, a private clinic in Daphne, Alabama where he provided services relating to neurology and pain management, such as spinal injections.
June 30, 2017; U.S. Department of Justice
Detroit Area Medical Biller Sentenced to 50 Months in Prison for Her Role in a $7.3 Million Dollar Healthcare Fraud Scheme
A Detroit-area medical biller was sentenced today to 50 months in prison for her role in a $7.3 million Medicare and Medicaid fraud scheme involving medical services that were billed to Medicare and Medicaid but not rendered as billed.
June 30, 2017; U.S. Attorney; Western District of North Carolina
Carolina Healthcare System Agreems To Pay $6.5 Million To Settle False Claims Act Allegations
CHARLOTTE, N.C. - U.S. Attorney Jill Westmoreland Rose announced today that the Charlotte-Mecklenburg Hospital Authority, dba Carolinas Healthcare System (CHS), has agreed pay the Government $6.5 million to resolve allegations that the company violated the False Claims Act, by "up-coding" claims for urine drug tests in order to receive higher payment than allowed for the tests.
June 30, 2017; U.S. Attorney; Western District of Pennsylvania
Physician Sentenced to 7 Years in Prison for Accepting Kickbacks and Failing to Remit Employment Taxes
JOHNSTOWN, Pa. - A resident of Hollidaysburg, Pa. has been sentenced in federal court to 84 months in prison, 60 months of which will be concurrent with a sentence imposed in the Southern District of Florida; three years' supervised release; and was ordered to pay restitution to the Internal Revenue Service of $722,476.55 and to Health and Human Services of $2,300,000, on his convictions of conspiring to commit an offense against the United States and willfully failing to remit employment taxes, Acting United States Attorney Soo C. Song announced today.
June 30, 2017; U.S. Attorney; Western District of Washington
Former CFO of Health Insurance Company Sentenced to Prison for Embezzlement
The former Chief Financial Officer (CFO) of Soundpath Health was sentenced today in U.S. District Court in Seattle to a year and a day in prison for embezzling more than $631,000 from his employer, announced U.S. Attorney Annette L. Hayes. The embezzlement was part of a complex wire fraud scheme that 58-year-old ZACHARY AUGUSTUS SMULSKI used in an attempt to fund his own start-up companies. When the Comptroller at Soundpath Health discovered that SMULSKI had hidden company funds, SMULSKI transferred the money to Soundpath and left the company. Today SMULSKI paid $29,514 in restitution. U.S. District Judge Robert S. Lasnik imposed three years of supervised release to follow prison and told SMULSKI, "it was a crime done for selfish reasons."
June 29, 2017; U.S. Attorney; Middle District of Tennessee
Durable Medical Equipment Manufacturer Agrees To Pay $2.715 Million To Resolve False Claims Allegations
Innovative Therapies, Inc. ("ITI") and its ultimate parent company Cardinal Health, Inc. ("Cardinal") have agreed to pay $2.715 million to settle False Claims Act allegations, announced Jack Smith, Acting United States Attorney for the Middle District of Tennessee. The settlement concerns conduct initiated by ITI before being purchased by Cardinal in August 2014 and resolves a qui tam action filed by a whistleblower in May 2015.
June 28, 2017; U.S. Department of Justice
Los Angeles Hospital Agrees to Pay $42 Million to Settle Alleged False Claims Act Violations Arising from Improper Payments to Physicians
PAMC Ltd., and Pacific Alliance Medical Center Inc., which together own and operate Pacific Alliance Medical Center, an acute care hospital located in Los Angeles, California, have agreed to pay $42 million to settle allegations that they violated the False Claims Act by engaging in improper financial relationships with referring physicians, the Justice Department announced today. Of the total settlement amount, $31.9 million will be paid to the Federal Government, and $10 million will be paid to the State of California.
June 28, 2017; U.S. Attorney; Middle District of Florida
Former WellCare, Inc. General Counsel Pleads Guilty To Making A False Statement To Florida Medicaid Program
Tampa, Florida - Acting United States Attorney W. Stephen Muldrow announces that WellCare's former General Counsel, Thaddeus M.S. Bereday (52, Tampa) has pleaded guilty to one count of making a false statement to the Florida Medicaid program. He faces a maximum penalty of five years in federal prison. A sentencing date has not yet been set.
June 28, 2017; U.S. Attorney; District of Maine
Manchester Physician Agrees to Pay $133,464 to Settle Civil Health Care Fraud Case
Portland, Maine: Acting United States Attorney Richard W. Murphy today announced that Charles G. Landry, D.O. ("Dr. Landry") has entered into a civil settlement agreement with the United States in which he will pay $133,464 to resolve allegations that from January 2011 through August 2014 he submitted false claims to Medicare.
June 27, 2017; U.S. Department of Justice
Physician and Wife to Pay $1.2 Million to Settle False Claims Act Allegations that They Billed Medicare and Medicaid for Unapproved Drugs
Dr. Anindya Sen and Patricia Posey Sen will pay $1.208 million to resolve state and federal False Claims Act allegations that their medical practice billed Medicare and Tennessee Medicaid (TennCare) for anticancer and infusion drugs that were produced for sale in foreign countries and not approved by the U.S. Food and Drug Administration (FDA) for marketing in the United States, the Department of Justice announced today. Dr. Sen owns and operates East Tennessee Cancer & Blood Center and East Tennessee Hematology Oncology and Internal Medicine located in Greeneville and Johnson City, Tennessee. Mrs. Sen managed Dr. Sen's medical practice from 2009 through 2012.
June 26, 2017; U.S. Department of Justice
Cardiac Monitoring Companies and Executive Agree to Pay $13.45 Million to Resolve False Claims Act Allegations
AMI Monitoring Inc. aka Spectocor, its owner, Joseph Bogdan, Medi-Lynx Cardiac Monitoring LLC, and Medicalgorithmics SA, the current majority owner of Medi-Lynx Cardiac Monitoring LLC, have agreed to resolve allegations that they violated the False Claims Act by billing Medicare for higher and more expensive levels of cardiac monitoring services than requested by the ordering physicians, the Department of Justice announced today. Spectocor and Bogdan have agreed to pay $10.56 million, and Medi-Lynx and Medicalgorithmics have agreed to pay $2.89 million.
June 26, 2017; U.S. Department of Justice Medicare Fraud Strike Force Case
Orlando Doctor and Infusion Clinic Owner Sentenced to 64 Months and 90 Months in Prison for Role in Medicare Fraud
An Orlando medical doctor and an infusion clinic owner were sentenced to 64 months in prison and two years supervised release, and 90 months and two years supervised release, respectively, today for their roles in a $13.7 million Medicare fraud conspiracy that involved submitting claims for expensive infusion-therapy drugs that were never purchased, never provided and not medically necessary.
June 26, 2017; U.S. Attorney; Eastern District of Tennessee
Former Clinical Pharmacy Manager Sentenced to Serve 16 Months in Prison for $4.4 Million TennCare Fraud Scheme
GREENEVILLE, Tenn. - On June 26, 2017, Amber Reilly, 33, of Jonesborough, Tennessee, was sentenced by the Honorable J. Ronnie Greer, U.S. District Judge, to serve 16 months in federal prison for healthcare fraud, which resulted in at least a $4.4 million loss to TennCare. Upon her release from prison, she will be supervised by U.S. Probation for three years.
June 26, 2017; U.S. Attorney; Western District of Oklahoma
Norman Orthopedic Practice Pays $1,537,796 to Resolve Allegations of False Claims Submitted to Federal and State Programs for Medical Services
Oklahoma City, Oklahoma - Orthopedic AND Sports Medicine Center-Norman, P.C., and its physician-owners, Dr. Mark Moses, Dr. David Bobb, Dr. William Harris, Dr. Vytautus Ringus, Dr. Steven Schultz, and Dr. Brad Vogel (collectively "OSC") have paid $1,537,796 to settle civil claims stemming from allegations that they submitted false claims to Medicare, Medicaid, the Department of Veterans Affairs, and TRICARE.
June 23, 2017; U.S. Attorney; District of Wyoming
Colorado Podiatrist Sentenced to Prison for Health Care Fraud
A Fort Collins podiatrist was sentenced to serve six (6) months in prison and pay a $20,000 fine for fraudulently billing Medicare for routine foot care services, announced Acting United States Attorney John Green.
June 22, 2017; U.S. Attorney; Southern District of Alabama
Local Physician, Dr. James M. Crumb, and Mobile Based Physician Group, Coastal Neurological Institute, P.C., paid $1.4 million to Settle False Claims Act Allegations
Acting United States Attorney Steve Butler, of the Southern District of Alabama, announced today that Dr. James M. Crumb, a Physical Medicine and Rehabilitative specialist currently practicing in Mobile, Alabama as Mobility Metabolism and Wellness, P.C. (MMW), and Coastal Neurological Institute, P.C. (CNI), a local neurosurgeon physician group, collectively paid $1.4 million to resolve allegations that they violated the False Claims Act ("FCA") by engaging in fraudulent schemes to maximize payment from the Medicare, Medicaid, and TRICARE health care programs.
June 22, 2017; U.S. Attorney; Southern District of Ohio
Athens County Home Health Care Agency Owner Pleads Guilty to $2M in Fraud
COLUMBUS, Ohio - Cheryl McGrath, 49, of Guysville, Ohio, pleaded guilty today in U.S. District Court to health care fraud and willful failure to pay over tax.
June 22, 2017; U.S. Attorney; Western District of Missouri
Former Physician Sentenced for Health Care Fraud
KANSAS CITY, Mo. - Tom Larson, Acting United States Attorney for the Western District of Missouri, announced today that a former Kansas City, Mo., physician who lost his medical license due to an earlier fraud scheme, has been sentenced in federal court for his role in a fraud scheme that involved disability examinations of veterans.
June 21, 2017; U.S. Attorney; District of New Jersey
Five Doctors Plead Guilty in Connection with Test-Referral Scheme with New Jersey Clinical Lab
Newark, N.J. - Five doctors today admitted taking bribes in connection with a long-running and elaborate test referral scheme operated by Biodiagnoatic Laboratory Services LLC (BLS), of Parsippany, New Jersey, its president and numerous associates, Acting U.S. Attorney William E. Fitzpatrick announced.
June 20, 2017; U.S. Attorney; District of New Jersey
Bergen County Doctor Sentenced to 41 Months in Prison for Taking Bribes in Test-Referral Scheme
NEWARK, N.J. - A family doctor practicing in Bergen County, New Jersey, was sentenced today to 41 months in prison for accepting bribes in exchange for test referrals as part of a long-running and elaborate scheme operated by Biodiagnostic Laboratory Services LLC (BLS), of Parsippany, New Jersey, its president and numerous associates, Acting U.S. Attorney William E. Fitzpatrick announced.
June 16, 2017; U.S. Department of Justice
Genesis Healthcare, Inc. Agrees To Pay Federal Government $53.6 Million To Resolve Allegations Of Medically Unnecessary Rehabilitation Therapy And Hospice Services
SAN FRANCISCO- The Justice Department announced today that Genesis Healthcare, Inc. (Genesis) will pay the federal government $53,639,288.04, including interest, to settle six federal lawsuits and investigations regarding the submission of false claims for medically unnecessary therapy and hospice services, and grossly substandard nursing home care. Genesis, headquartered in Kennett Square, Pennsylvania, owns and operates through its subsidiaries skilled nursing facilities, assisted/senior living facilities, and a rehabilitation therapy business. According to the allegations in the lawsuits, companies and facilities acquired by Genesis violated the False Claims Act. The settlement announced today resolves the claims and investigations into the allegations.
June 15, 2017; U.S. Attorney; Eastern District of Michigan
Former Doctor Sentenced to 23 Years in Prison for Distributing Prescription Drugs, Health Care Fraud and Money Laundering
Sardar Ashrafkhan of Ypsilanti, Michigan, was sentenced today to 23 years in prison for participating in a conspiracy to distribute prescription pills, conspiracy to commit health care fraud, and money laundering, Acting U.S. Attorney Daniel Lemisch announced.
June 14, 2017; U.S. Department of Justice Medicare Fraud Strike Force Case
Mother and Daughter Co-Owners of Seven Miami, Florida-Area Home Health Agencies Each Sentenced to Over 10 Years in Prison for Roles in $20 Million Home Health Care Fraud Schemes
A mother and daughter who secretly co-owned and operated seven home health care agencies in the Miami, Florida area were each sentenced to over 10 years in prison today for their roles in a $20 million Medicare fraud conspiracy that involved paying illegal health care kickbacks to patient recruiters and medical professionals.
June 14, 2017; U.S. Attorney; Middle District of Florida
Jacksonville Man Sentenced For Perpetrating Fraud Schemes While Illegally Collecting Disability And Medicaid Benefits
Jacksonville, Florida - U.S. District Judge Brian J. Davis today sentenced Douglas Thompson (52, Jacksonville) to 27 months in federal prison for wire fraud and theft of government property. The Court also ordered him to pay $149,218.26 in restitution to the victims of his crimes.
June 13, 2017; U.S. Attorney; Southern District of Georgia
Dodge County Pharmacy and Pharmacist Agree To Pay Over $2 Million to Resolve False Claims Act and Controlled Substances Act Allegations
SAVANNAH, GA: Rhine Drug Company and Andrew "Carter" Clements, Jr. agreed to pay a total of $2.175 million to resolve allegations that they violated the False Claims Act and the Controlled Substances Act. This settlement is the largest False Claims Act recovery with a pharmacy or pharmacist and largest recovery of civil penalties under the Controlled Substances Act in the history of the Southern District of Georgia.
June 13, 2017; U.S. Attorney; Southern District of Texas
RGV Durable Medical Equipment Company Owner and Four Others Sentenced in Health Care Fraud Scheme
McALLEN, Texas - The owner of a Rio Grande Valley area durable medical equipment (DME) company has been ordered to federal prison for her role in a scheme to defraud Texas Medicaid through fraudulent billings, announced Acting U.S. Attorney Abe Martinez. Maria Teresa Paz Garza, 41, of McAllen, was previously found guilty by a jury on all counts on Feb. 24, 2017, following a seven-day trial and six hours of deliberation.
June 13, 2017; U.S. Attorney; Northern District of Texas
Owner of Apple of Your Eye Healthcare Services, Inc. Sentenced to 210 Months in Federal Prison for Role in Healthcare Fraud Conspiracy
DALLAS - Wilbert James Veasey, Jr., 65, of Dallas, was sentenced this morning in federal court in Dallas on a health care fraud conspiracy conviction, announced U.S. Attorney John Parker of the Northern District of Texas.
June 13, 2017; U.S. Attorney; Northern District of New York
University of Rochester to Pay More Than $100,000 to Resolve False Claims Act Lawsuit
SYRACUSE, NEW YORK - United States Attorney Richard S. Hartunian and New York State Attorney General Eric. T. Schneiderman announced today that the University of Rochester (UR), which among other things operates a teaching hospital based in Rochester, New York, will pay $113,722.10 to resolve allegations that it violated the federal and New York False Claims Acts by improperly using a billing modifier on certain healthcare claims at UR's Flaum Eye Institute, resulting in UR receiving payments to which it was not entitled.
June 13, 2017; U.S. Attorney; District of New Jersey
Cherry Hill Doctor And Son Admit Defrauding Medicare, Agree To $1.78 Million Settlement
CAMDEN, N.J. - A doctor and his chiropractor son today admitted conspiring to defraud Medicare by using unqualified people to give physical therapy to Medicare recipients, Acting U.S. Attorney William E. Fitzpatrick announced.
June 12, 2017; U.S. Department of Justice
Lexington, Kentucky, Jury Convicts Clinical Psychologist for Role in $600 Million Social Security Disability Fraud Scheme
A federal jury in Lexington, Kentucky, today convicted a clinical psychologist for his role in a Social Security disability fraud scheme that included a former Social Security Administration (SSA) administrative law judge and that involved the submission of thousands of falsified medical documents to the SSA, obligating the SSA to pay more than $600 million in lifetime benefits to claimants predicated on these fraudulent submissions.
June 9, 2017; U.S. Attorney; Southern District of Florida
Miami-Area Man Charged For Role in $63 Million Health Care Fraud Scheme
A Miami-area man was charged in an indictment unsealed today for his alleged participation in a $63 million health care fraud scheme involving a now-defunct community mental health center located in Miami.
June 7, 2017; U.S. Attorney; Southern District of Florida
Shelter Worker Charged With Attempting to Coerce and Entice An Unaccompanied Alien Minor
Benjamin G. Greenberg, Acting United States Attorney for the Southern District of Florida; Special Agent in Charge Shimon R. Richmond of the U.S. Department of Health and Human Services Office of Inspector General's (HHS-OIG) Miami Regional Office; and Mark Selby, Special Agent in Charge, U.S. Immigration and Customs Enforcement, Homeland Security Investigations (ICE-HSI), Miami Field Office, announced the Indictment of Merice Perez Colon.
June 7, 2017; U.S. Attorney; District of Idaho
Fruitland Woman Sentenced to 60 Months in Prison for Health Care Fraud and Aggravated Identity Theft
BOISE - Cherie R. Dillon, 62, of Fruitland, Idaho, was sentenced yesterday to 60 months in prison to be followed by three years of supervised released for health care fraud and aggravated identity theft, Acting U.S. Attorney Rafael Gonzalez announced. Chief U.S. District Judge B. Lynn Winmill also ordered Dillon to pay restitution in the amount $549,605.19 and to forfeit $847,016 proceeds from the offenses, although those sums are preliminary pending a hearing on August 9, 2017.
June 7, 2017; U.S. Attorney; Western District of North Carolina
School Counselor Pleads Guilty To Health Care Fraud Scheme
ASHEVILLE, N.C. - Joseph Frank Korzelius, owner of Western Carolina Counseling Services and a school counselor in the Polk County school system, admitted today to defrauding the North Carolina Medicaid Program of over $400,000, by submitting false and fraudulent reimbursement claims. Korzelius, 46, of Tryon, N.C., appeared before U.S. Magistrate Judge Dennis L. Howell and pleaded guilty to one count of health care fraud.
June 6, 2017; U.S. Attorney; District of New Jersey
Paterson Doctor And Wife, Woodland Park Doctor, Charged In Test-Referral Bribe Scheme With New Jersey Clinical Lab
NEWARK, N.J. - A cardiologist with a practice in Paterson, New Jersey, his wife, and a doctor with a practice in Woodland Park, New Jersey, were charged today with accepting bribes in exchange for test referrals as part of a long-running scheme involving Biodiagnostic Laboratory Services LLC (BLS), of Parsippany, New Jersey, Acting U.S. Attorney William E. Fitzpatrick announced.
June 5, 2017; U.S. Attorney; District of Connecticut
Physical Therapist Sentenced for Obstruction and Tax Fraud Offenses
Deirdre M. Daly, United States Attorney for the District of Connecticut, announced that DANIELLE FAUX, 49, of Weston, was sentenced today by U.S. District Judge Stefan R. Underhill in Bridgeport to two years of probation, the first six months of which FAUX must spend in home confinement, for obstruction and tax fraud offenses. Judge Underhill also ordered FAUX to perform 100 hours of community service and pay a $3,000 fine.
June 5, 2017; U.S. Attorney; Eastern District of New York
Manhattan Doctor Arrested For Illegal Distribution of Oxycodone
A criminal complaint was unsealed today in federal court in Brooklyn charging medical doctor Martin Tesher with writing thousands of illegal prescriptions for Schedule II controlled substances, particularly opioids such as oxycodone, without a legitimate medical purpose. Tesher was arrested earlier today in Manhattan, and his initial appearance is scheduled for this afternoon before United States Magistrate Judge Lois Bloom.
June 2, 2017; U.S. Attorney; Eastern District of Virginia
Fredericksburg Hospitalist Group Pays $4.2 Million to Settle Civil Fraud Case
RICHMOND, Va. - Fredericksburg Hospitalist Group, P.C. (FHG), and 14 of its member shareholders have agreed to pay approximately $4.2 million to settle a federal False Claims Act (FCA) case brought under the qui tam whistleblower provisions of the FCA.
June 1, 2017; U.S. Attorney; Southern District of Texas
Medicare Fraudster Given Maximum Prison Sentence
HOUSTON - A Houston woman and a California man have been ordered to federal prison for conspiring to defraud Medicare through so-called diagnostic testing labs in the Houston area, announced Acting U.S. Attorney Abe Martinez. Zaven "George" Sarkisian, 55, of Fresno, California, and Konna Hanks, 48, of Houston, pleaded guilty Dec. 9 and 2, 2015, respectively.

May 2017

May 31, 2017; U.S. Department of Justice
Electronic Health Records Vendor to Pay $155 Million to Settle False Claims Act Allegations
One of the nation's largest vendors of electronic health records software, eClinicalWorks (ECW), and certain of its employees will pay a total of $155 million to resolve a False Claims Act lawsuit alleging that ECW misrepresented the capabilities of its software, the Justice Department announced. The settlement also resolves allegations that ECW paid kickbacks to certain customers in exchange for promoting its product. ECW is headquartered in Westborough, Massachusetts.
May 31, 2017; U.S. Attorney; District of New Jersey
Skilled Nursing Facility To Pay $888,000 To Resolve Alleged False Claims Related To Materially Substandard Care
NEWARK, N.J. - A skilled nursing facility in Sussex County, New Jersey, has agreed to pay to the United States and the State of New York $888,000 to resolve allegations that it provided materially substandard or worthless nursing services to some patients, Acting U.S. Attorney William E. Fitzpatrick announced today.
May 31, 2017; U.S. Attorney; District of Massachusetts
Former Tufts Health Plan Employee Sentenced for Disclosing Personal Patient Information
BOSTON - A former employee of Tufts Health Plan was sentenced today in federal court in Boston for stealing personal identifying information belonging to hundreds of customers. The stolen data included names, dates of birth, and Social Security numbers, primarily of customers over the age of 65.
May 31, 2017; U.S. Attorney; Eastern District of Louisiana
Marrero Woman Pleads Guilty to $536,724 in Health Care Fraud
Acting U.S. Attorney Duane A. Evans announced that MONICA SYLVEST, age 52, of Marrero, pled guilty today to a Bill of Information charging her with health care fraud.
May 30, 2017; U.S. Department of Justice
Medicare Advantage Organization and Former Chief Operating Officer to Pay $32.5 Million to Settle False Claims Act Allegations
Freedom Health Inc., a Tampa, Florida-based provider of managed care services, and its related corporate entities (collectively "Freedom Health"), agreed to pay $31,695,593 to resolve allegations that they violated the False Claims Act by engaging in illegal schemes to maximize their payment from the government in connection with their Medicare Advantage plans, the Justice Department announced today. In addition, the former Chief Operating Officer (COO) of Freedom Health Siddhartha Pagidipati, has agreed to pay $750,000 to resolve his alleged role in one of these schemes.
May 30, 2017; U.S. Attorney; District of Connecticut
Bristol Woman Convicted of Defrauding Medicaid Program
Deirdre M. Daly, United States Attorney for the District of Connecticut, Phillip Coyne, Special Agent in Charge for the U.S. Department of Health and Human Services, Office of Inspector General, and Chief State's Attorney Kevin T. Kane today announced that on May 26, a jury in Bridgeport convicted RONNETTE BROWN, 44, of Bristol, on 23 counts of health care fraud and one count of conspiracy to commit health care fraud. The trial before U.S. District Judge Victor A. Bolden began on May 22 and the jury returned a verdict of guilty on all counts of the indictment on Friday afternoon.
May 30, 2017; U.S. Attorney; District of Minnesota
Minnesota Mental Health Nonprofit And Its Leaders To Pay $4.5 Million To Resolve Fraud Allegations
Acting United States Attorney Gregory G. Brooker and Minnesota Attorney General Lori Swanson today announced that Complementary Support Services and its related entities (collectively "CSS"), TERI DIMOND and HERBERT STOCKLEY have agreed to pay a total of $4.52 million to resolve allegations that they violated the False Claims Act (FCA) and Minnesota False Claims Act by defrauding Medicaid, a program jointly funded by the federal government and State of Minnesota to provide health care to low-income Minnesotans. CSS will pay the government $4 million, DIMOND agreed to pay $400,000, and STOCKLEY agreed to pay $120,000.
May 23, 2017; U.S. Department of Justice Medicare Fraud Strike Force Case
Houston-Area Psychiatrist Convicted of Health Care Fraud for Role in $158 Million Medicare Fraud Scheme
A federal jury convicted a Houston-area psychiatrist today for his role in a $158 million Medicare fraud scheme.
May 23, 2017; U.S. Attorney; Northern District of New York
Albany Physician Pays $100,000 And Agrees To 15-Year Period Of Exclusion From Medicare For Submitting False Claims
ALBANY, NEW YORK - Dr. Michael Esposito has agreed to pay $100,000 for billing Medicare despite his exclusion from all federal health care programs, announced United States Attorney Richard S. Hartunian. Dr. Esposito is an endocrinologist who treated patients in the Capital Region until earlier this year, when the New York State Board of Professional Medical Conduct ordered him to stop practicing medicine because he had engaged in professional misconduct.
May 22, 2017; U.S. Attorney; Eastern District of Missouri
United States Reaches $291,288 Civil Settlement with Dr. Sherry Ma and Aima Neurology, LLC Related to Botox® and Myobloc® Injections
St. Louis, Missouri: Acting United States Attorney Carrie Costantin announced today that the United States, Sherry X. Ma, M.D., of Ladue, Missouri, and AIMA Neurology, LLC, reached a civil settlement that will resolve the United States claims against Dr. Ma and AIMA Neurology under the False Claims Act for false Medicare billings related to Dr. Ma's Botox® and Myobloc® injections.
May 19, 2017; U.S. Attorney; Eastern District of Missouri
Medical Resident Pleads Guilty to Fraudulently Obtaining Prescription Opioid Pain Medications
St. Louis, MO - Kyle Betts pled guilty today to fraudulently obtaining pain relief drugs, including Percocet® and Norco®, by writing over seventy false prescriptions.
May 19, 2017; U.S. Attorney; Eastern District of Michigan
Farmington Hills Doctor Sentenced to 19 Years in Prison for Distributing Prescription Drugs and Health Care Fraud
A Farmington Hills, Michigan, doctor was sentenced yesterday to 19 years in prison for participating in a conspiracy to distribute prescription pills and conspiracy to commit health care fraud, Acting U.S. Attorney Daniel Lemisch announced.
May 18, 2017; U.S. Department of Justice
Missouri Hospitals Agree to Pay United States $34 Million to Settle Alleged False Claims Act Violations Arising from Improper Payments to Oncologists
Two Southwest Missouri health care providers have agreed to pay the United States $34,000,000 to settle allegations that they violated the False Claims Act by engaging in improper financial relationships with referring physicians, the Justice Department announced today. The two Defendants are Mercy Hospital Springfield f/k/a St. John's Regional Health Center, and its affiliate, Mercy Clinic Springfield Communities f/k/a St. John's Clinic. Among other health care facilities, the Defendants operate a hospital, clinic, and infusion center in Springfield, Missouri.
May 18, 2017; U.S. Attorney; District of New Jersey
New York Doctor Pleads Guilty In Connection With Test-Referral Scheme With New Jersey Clinical Lab
NEWARK, N.J. - An internal medicine doctor practicing in Yonkers, New York, today admitted taking bribes in connection with a long-running and elaborate test referral scheme operated by Biodiagnostic Laboratory Services LLC (BLS), of Parsippany, New Jersey, its president and numerous associates, Acting U.S. Attorney William E. Fitzpatrick announced.
May 18, 2017; U.S. Attorney; Middle District of Tennessee
Final Group Of Physicians And Owner Of Medical Practice Plead Guilty In Medical Kickback Scheme
Pam Gardner, 55, of Springfield, Tennessee, pleaded guilty yesterday, to conspiracy to solicit and receive cash kickbacks in exchange for making patient referrals, announced Jack Smith, Acting United States Attorney for the Middle District of Tennessee.
May 17, 2017; U.S. Attorney; Northern District of Ohio
Cleveland Heights woman sentenced to 10 years in prison, son to seven years for $8 million home healthcare fraud
A Cleveland Heights woman was sentenced to 10 years in prison for leading a $8 million healthcare fraud conspiracy in which participants provided forged documents and fraudulent forms to bill for services that were not provided, law enforcement officials said.
May 16, 2017; U.S. Department of Justice
United States Intervenes in Second False Claims Act Lawsuit Alleging that UnitedHealth Group Inc. Mischarged the Medicare Advantage and Prescription Drug Programs
For the second time in two weeks, the United States has filed a complaint against UnitedHealth Group Inc. (UHG) that alleges UHG knowingly obtained inflated risk adjustment payments based on untruthful and inaccurate information about the health status of beneficiaries enrolled in UHG's Medicare Advantage Plans throughout the United States, the Justice Department announced today. Today's action follows the government's filing of a complaint earlier this month in United States ex rel. Swoben v. Secure Horizons, a related action that also alleges that UHG submitted false claims for payment to the Medicare Program.
May 16, 2017; U.S. Attorney; District of New Jersey
Omnicare Inc. Agrees To $8 Million Settlement In False Claims Act Case
NEWARK, N.J. - The U.S. Attorney's Office of the District of New Jersey, the U.S. Department of Justice and 28 states have reached an $8 million settlement with Omnicare Inc. resolving allegations arising from a whistle-blower suit filed under the False Claims Act. The agreement was announced today by Acting U.S. Attorney William E. Fitzpatrick.
May 12, 2017; U.S. Department of Justice
Former Administrative Law Judge Pleads Guilty for Role in $550 Million Social Security Disability Fraud Scheme
A former administrative law judge for the Social Security Administration (SSA) pleaded guilty in federal court today for his role in a scheme to fraudulently obtain more than $550 million in federal disability payments from the SSA for thousands of claimants.
May 11, 2017; U.S. Attorney; Middle District of Louisiana
Patient Marketer For All-Star Medical Supply Sentenced To Prison For Health Care Fraud
BATON ROUGE, LA - Acting United States Attorney Corey R. Amundson announced that U.S. District Judge Shelly D. Dick sentenced DEMETRIAS TEMPLE, age 56, of New Orleans, Louisiana, to serve ten (10) months in federal prison following her conviction for health care fraud. TEMPLE was ordered to make restitution to the Medicare program totaling $100,000 and pay a $100 special assessment. TEMPLE was ordered to forfeit an additional $100,000 as the proceeds of her criminal activity. Finally, following her release from prison, TEMPLE will be required to serve a two-year term of supervised release.
May 11, 2017; U.S. Attorney; Southern District of New York
Acting U.S. Attorney Announces $54 Million Settlement Of Civil Fraud Lawsuit Against Benefits Management Company For Improper Authorization Of Medical Procedures
Joon H. Kim, the Acting United States Attorney for the Southern District of New York, and Scott Lampert, Special Agent in Charge of the New York Regional Office for the Office of Inspector General for the Department of Health and Human Services ("HHS-OIG"), announced today that the United States simultaneously filed and settled a civil fraud lawsuit against benefits management company CaRECORE NATIONAL LLC ("CARECORE"), now part of eviCore healthcare, for authorizing medical diagnostic procedures paid for with Medicare and Medicaid funds over a period of at least eight years without properly assessing whether the procedures were necessary or reasonable. The settlement, approved in Manhattan federal court by U.S. District Judge Richard J. Sullivan, resolves CARECORE's civil liabilities to the United States under the federal False Claims Act. Under the settlement, CARECORE must pay a total of $54 million, of which $45 million will be paid to the United States and $9 million will be paid to the states that are named as plaintiffs in the suit. CARECORE also admitted and accepted responsibility for, among other things, improperly approving prior authorizations requests for hundreds of thousands of diagnostic procedures paid for with Medicare Part C and Medicaid funds.
May 11, 2017; U.S. Attorney; Northern District of Illinois
Chicago Dermatologist Convicted on Federal Fraud Charges for Billing Health Insurance Programs for Medically Unnecessary Treatments
CHICAGO - A federal jury has convicted a Chicago dermatologist on fraud charges for billing health-insurance programs for purported pre-cancerous treatments that were not medically necessary.
May 10, 2017; U.S. Attorney; Eastern District of Louisiana
Six Individuals Found Guilty of Health Care Fraud
Acting U.S. Attorney Duane A. Evans announced that on May 9th, after over four weeks of trial, a federal jury returned guilty verdicts against six individuals charged with committing approximately $13,655,094 in Medicare fraud.
May 10, 2017; U.S. Attorney; District of Oregon
Mary Holden Ayala Charged with Theft of Over $800,000 From Oregon Foster Care Agency Give Us This Day
PORTLAND, Ore. -A federal grand jury in Portland has charged Mary Holden Ayala, 56, a longtime resident of Portland, with theft of over $800,000, money laundering and filing false personal tax returns. Ayala served as the President and Executive Director of Give Us This Day (GUTD), an Oregon state-licensed private foster care agency and residential program for hard-to-place foster youth, until its closing in September of 2015.
May 9, 2017; U.S. Attorney; Central District of California
Oncology Therapy Center in High Desert Pays $3 Million to Resolve Allegations of Providing Radiation Treatments without Doctor Present
LOS ANGELES - A Lancaster-based radiation therapy center has paid $3 million to resolve allegations that it submitted fraudulent bills over a nearly 10-year period to three government-run healthcare programs for unsupervised radiation oncology services.
May 9. 2017; U.S. Attorney; Northern District of Alabama
Sales Rep for North Alabama Compounding Pharmacy Charged in $13 M Insurance Conspiracy
BIRMINGHAM - Federal prosecutors today charged a sales representative for a Haleyville, Ala.,-based compounding pharmacy with conspiracy in a multi-faceted scheme to generate prescriptions and defraud Blue Cross Blue Shield of Alabama and one of its prescription drug administrators out of over $13 million in one year. Acting U.S. Attorney Robert O. Posey, Federal Bureau of Investigation Special Agent in Charge Roger Stanton, United States Postal Inspector in Charge, Houston Division Adrian Gonzalez, U.S. Department of Health and Human Services, Office of Inspector General, Special Agent in Charge Derrick L. Jackson, and Defense Criminal Investigative Service Special Agent in Charge John F. Khin announced the charges.
May 8, 2017; U.S. Department of Justice Medicare Fraud Strike Force Case
Third Detroit-Area Physician Convicted in $17.1 Million Health Care Fraud Scheme
A third Detroit-area physician was convicted today for his role in a $17 million Medicare fraud scheme involving medically unnecessary physician visits.
May 8, 2017; U.S. Attorney; District of Connecticut
Morris Woman Sentenced to 10 Months in Federal Prison for Health Care Fraud
Deirdre M. Daly, United States Attorney for the District of Connecticut, announced that ANNE CHARLOTTE SILVER, 63, of Morris, was sentenced today by U.S. District Judge Victor A. Bolden in Bridgeport to 10 months of imprisonment, followed by three years of supervised release, for committing health care fraud. Judge Bolden also ordered SILVER to provide 100 hours of community service upon her release from prison, and to pay restitution of $1.6 million.
May 8, 2017; U.S. Attorney; District of Kansas
Kansas Medical Supplier to Pay $1 Million To Settle False Claim Allegations
KANSAS CITY, KAN. - A Dodge City medical equipment supplier has agreed to pay $1 million to settle allegations it submitted false claims to the Medicare program, U.S. Attorney Tom Beall said today.
May 4, 2017; U.S. Attorney; Eastern District of Texas
Smith County Husband and Wife Sentenced in Health Care Fraud Conspiracy
TYLER, Texas - A Smith County couple has been sentenced for health care fraud violations in the Eastern District of Texas announced Acting U.S. Attorney Brit Featherston today.
May 4, 2017; U.S. Attorney; Western District of Virginia
Third Member of Healthcare Conspiracy Pleads Guilty
Abingdon, VIRGINIA - A Bristol woman, who along with a husband and wife were accused of healthcare fraud, pled guilty today to related charges, Acting United States Attorney Rick A. Mountcastle, Virginia Attorney General Mark R. Herring and Nick DiGiulio, Special Agent in Charge, Philadelphia Regional Office for U.S. Health and Human Services - Office of Inspector General announced today.
May 2, 2017; U.S. Department of Justice
United States Intervenes in False Claims Act lawsuit Against UnitedHealth Group Inc. for Mischarging the Medicare Advantage and Prescription Drug Programs
The United States has intervened and filed a complaint in a lawsuit against UnitedHealth Group Inc. (UHG) that alleges UHG obtained inflated risk adjustment payments based on untruthful and inaccurate information about the health status of beneficiaries enrolled in UHG's largest Medicare Advantage Plan, UHC of California, the Justice Department announced today. Yesterday's action follows the government's intervention in February of this year in United State ex rel. Poehling v. UnitedHealth Group. Inc., a related lawsuit in the Central District of California that also alleges that UHG defrauded the Medicare Program. government is scheduled to file a complaint in that matter no later than May 16.
May 2, 2017; U.S. Attorney; Western District of North Carolina
Hickory Pathology Lab Agrees To Pay The United States $601,000 To Settle False Claims Act Allegation
CHARLOTTE, N.C. - U.S. Attorney Jill Westmoreland Rose announced today that Piedmont Pathology in Hickory, N.C., has agreed to pay the United States $601,000 to settle allegations that it violated the False Claims Act by submitting false claims to Medicare and Medicaid for medically unnecessary procedures.
May 1, 2017; U.S. Attorney; District of Kansas
Kansas Chiropractor to Pay $1 Million-plus To Settle False Claim Allegations
KANSAS CITY, KAN. - A Kansas City area chiropractor has agreed to pay more than $1 million to settle allegations his offices submitted false claims to Medicare for treating patients with peripheral neuropathy, U.S. Attorney Tom Beall said today.
May 1, 2017; U.S. Attorney; District of Rhode Island
Poplar Healthcare to Pay Nearly $900,000 to Resolve A False Claims Act Allegations
PROVIDENCE, RI - Acting United States Attorney Stephen G. Dambruch and Philip Coyne, Special Agent-in-Charge of the Boston Office of Inspector General for the Department of Health and Human Services (HHS-OIG), today announced that Poplar Healthcare PLLC, and Poplar Healthcare Management, LLC ("Poplar"), of Memphis, TN, have entered into a civil settlement agreement with the United States, under which Poplar will pay $897,640 to resolve allegations under the federal False Claims Act. The government alleges that Poplar, directly and through a subsidiary known as GI Pathology, promoted and billed the government for diagnostic tests that the government contends were not medically necessary.

April 2017

April 28, 2017; U.S. Attorney; Southern District of Florida
South Florida Doctor Convicted of Sixty-Seven Criminal Counts Related to Medicare Fraud Scheme
Today, a federal jury in South Florida convicted Dr. Salomon Melgen of sixty-seven criminal counts related to his participation in a health care fraud scheme involving the filing of false claims and the inclusion of false entries into patients' medical charts.
April 28, 2017; U.S. Department of Justice
Blood Testing Laboratory to Pay $6 Million to Settle Allegations of Kickbacks and Unnecessary Testing
Quest Diagnostics Inc. has agreed to pay $6 million to resolve a lawsuit by the United States alleging that Berkeley HeartLab Inc., of Alameda, California, violated the False Claims Act by paying kickbacks to physicians and patients to induce the use of Berkeley for blood testing services and by charging for medically unnecessary tests. Quest, which is headquartered in Madison, New Jersey, acquired Berkeley in 2011, and ended the conduct that gave rise to the settlement.
April 27, 2017; U.S. Department of Justice
Indiana University Health and HealthNet to Pay $18 Million to Resolve Allegations of False Claims
The Department of Justice announced today that Indiana University Health Inc. (IU Health) and HealthNet Inc., have agreed to pay a total of $18 million to resolve allegations that they violated federal and state false claims laws by engaging in an illegal kickback scheme related to the referral of HealthNet's OB/GYN patients to IU Health's Methodist Hospital. Under the settlement agreement, IU Health and HealthNet each will pay approximately $5.1 million to the United States and $3.9 million to the State of Indiana.
April 27, 2017; U.S. Attorney; District of Connecticut
Torrington Woman Sentenced to 21 Months in Federal Prison for Health Care Fraud
Deirdre M. Daly, United States Attorney for the District of Connecticut, announced that PATRICIA LAFAYETTE, 62, of Torrington, was sentenced today by U.S. District Judge Victor A. Bolden in Bridgeport to 21 months of imprisonment, followed by three years of supervised release, for committing health care fraud. Judge Bolden also ordered LAFAYETTE to serve her first six months of supervised release in home confinement, and to pay restitution of $1.6 million.
April 27, 2017; U.S. Attorney; Western District of Kentucky
Louisville Based Physician Settles Federal False Claims Act And State Civil Claims
LOUISVILLE, KY - Forrest S. Kuhn, Jr., M.D., a physician specializing in allergy, asthma and immunology with medical offices in Louisville, Danville, and Glasgow, Kentucky, has agreed to pay $751,681.16 to resolve allegations that he violated the federal False Claims Act by submitting false claims to Medicare, Medicaid, and other government health care programs, announced United States Attorney John E. Kuhn, Jr., who is no relation to the defendant.
April 26, 2017; Middle District of Florida
Pharmacist Pleads Guilty To Conspiracy To Pay Healthcare Kickbacks
Tampa, FL - Acting United States Attorney W. Stephen Muldrow announces that Benjamin Nundy (39, Ruskin) today pleaded guilty to conspiracy to commit healthcare fraud. He faces a maximum penalty of five years in federal prison.
April 25, 2017; U.S. Department of Justice
Oxygen Equipment Provider Pays $11.4 Million to Resolve False Claims Act Allegations
The Department of Justice announced today that Braden Partners, L.P., doing business as Pacific Pulmonary Services, has agreed to pay $11.4 million to resolve allegations against it and its general partner, Teijin Pharma USA LLC, for violating the False Claims Act by submitting claims for reimbursement to Medicare and other federal healthcare programs for oxygen and related equipment supplied in violation of program rules, and for sleep therapy equipment supplied as part of a cross-referral kickback scheme with sleep clinics.
April 20, 2017; U.S. Attorney; Western District of Missouri
Owner of Independence Clinic Pleads Guilty to Health Care Fraud Scheme
KANSAS CITY, Mo. - Tom Larson, Acting United States Attorney for the Western District of Missouri, announced that the owner of an Independence, Mo., medical clinic pleaded guilty in federal court today to his role in a fraud scheme that involved disability examinations of veterans and to making false statements regarding his role in the physical examinations of commercial truck drivers.
April 20, 2017; U.S. Attorney; Eastern District of California
Walgreen Co. Pays $9.86M to Settle Allegations of Improper Medi Cal Billings
SACRAMENTO, Calif. - United States Attorney Phillip A. Talbert announced today that Walgreen Co. (Walgreens) has paid $9.86 million to resolve allegations that it violated the federal False Claims Act when it knowingly submitted claims for reimbursement to California's Medi-Cal program that were not supported by applicable diagnosis and documentation requirements.
April 20, 2017; U.S. Attorney; Central District of California
Encino Dermatologist Pays Nearly $2.7 Million to Resolve Allegations He Billed Medicare for Unnecessary Mohs Skin Cancer Surgeries
LOS ANGELES - The owner of The Skin Cancer Medical Center in Encino has paid the United States nearly $2.7 million to resolve allegations that he submitted bills to Medicare for Mohs micrographic surgeries for skin cancers that were medically unnecessary.
April 18, 2017; U.S. Attorney; Western District of Pennsylvania
Pittsburgh Doctor and His Employee Charged with Illegal Rx Drug Distribution, Health Care Fraud
PITTSBUGH - Two Pittsburgh residents have been indicted by a federal grand jury on charges of distribution of Oxycodone, a Schedule II controlled substance, and Amphetamine, a Schedule II controlled substance, outside the usual course of professional practice, and health care fraud, Acting United States Attorney Soo C. Song announced today.
April 18, 2017; U.S. Attorney; Northern District of Texas
Hospice Companies To Pay $12.2 Million To Settle Kickback Claims
DALLAS - International Tutoring Services, LLC, f/k/a International Tutoring Services, Inc., and d/b/a Hospice Plus; Goodwin Hospice, LLC; Phoenix Hospice, LP; Hospice Plus, L.P.; and Curo Health Services, LLC f/k/a Curo Health Services, Inc. have agreed to pay $12.21 million to resolve allegations that they violated the False Claims Act by paying kickbacks in exchange for patient referrals, announced U.S. Attorney John Parker of the Northern District of Texas. Curo Health Services is headquartered in Mooresville, North Carolina and operates eight hospice affiliates across 18 states. In September 2010, Curo Health Services purchased Hospice Plus, Goodwin Hospice, and Phoenix Hospice, and consolidated the hospice companies under the Hospice Plus brand, which operates primarily in and around Dallas, Texas.
April 18, 2017; U.S. Attorney; Western District of Pennsylvania
Pittsburgh Doctor and His Employee Charged with Illegal Rx Drug Distribution, Health Care Fraud
PITTSBUGH - Two Pittsburgh residents have been indicted by a federal grand jury on charges of distribution of Oxycodone, a Schedule II controlled substance, and Amphetamine, a Schedule II controlled substance, outside the usual course of professional practice, and health care fraud, Acting United States Attorney Soo C. Song announced today.
April 17, 2017; U.S. Attorney; Middle District of Alabama
Dothan Woman Sentenced For Medicaid Fraud
Montgomery Alabama - Catrina R. Copeland, 43, of Dothan, Alabama, was sentenced to five months in prison and five months of home confinement on Wednesday, April 12, 2017 for defrauding the Alabama Medicaid Agency and the federal government, announced Acting U.S. Attorney A. Clark Morris, Alabama Attorney General Steven T. Marshall, and Health and Human Services Office of Inspector General Special Agent in Charge Derrick L. Jackson.
April 13, 2017; U.S. Department of Justice Medicare Fraud Strike Force Case
Detroit Podiatrist Charged for Role in $13.9 Million Medicare Fraud Scheme
A Detroit podiatrist was charged in an indictment unsealed today for his alleged participation in a $13.9 million health care fraud scheme involving fraudulent claims for unnecessary foot surgeries and other podiatric services that were never rendered.
April 13, 2017; U.S. Attorney; Southern District of Texas
Home Health Care Owners Indicted for Fraud
A Houston couple is set to appear in federal court on charges they fraudulently billed more than $24 million to Medicare through several home health companies, announced Acting U.S. Attorney Abe Martinez. Oluyemisi Amos, 35, and her husband Felix Amos, 66, are charged in an eight-count indictment with conspiracy to commit health care fraud, health care fraud and money laundering.
April 13, 2017; U.S. Attorney; District of Massachusetts
Adoption Counselor Convicted of Stealing Personal Information from Former Employer
BOSTON - A former employee of Tufts Health Plan was convicted yesterday by a federal jury in Boston of stealing the identifying information of over 3,000 Medicare customers.
April 12, 2017; U.S. Attorney; Middle District of Florida
Pharmacist Pleads Guilty to Conspiracy to Pay Healthcare Kickbacks
Tampa, FL - Acting United States Attorney W. Stephen Muldrow announces that Carlos Mazariegos (40, St. Petersburg) has pleaded guilty to conspiracy to commit healthcare fraud. He faces a maximum penalty of five years in federal prison.
April 12, 2017; U.S. Attorney; District of Columbia
Owner of Durable Medical Equipment Company Indicted for Health Care Fraud and Related Offenses
WASHINGTON - Emeka H. Chijioke, 40, formerly of Atlanta, Ga., and Nigeria, has been indicted on charges alleging that he schemed to defraud the District of Columbia's Medicaid program out of more than $2 million.
April 12, 2017; U.S. Attorney; District of South Carolina
Mount Pleasant Speech Pathologist Charged in Health Fraud Scheme
Columbia, South Carolina---- United States Attorney Beth Drake today announced that a Charleston Grand Jury has returned a six-count indictment charging Gena C. Randolph of Mt. Pleasant , South Carolina, with health care fraud, aggravated identity theft, and making false statements relating to health care matters. The indictment alleges that Randolph was barred from submitting Medicaid and Medicare claims in 2012 and 2013, respectively, but that she continued to do so under other provider's names or companies in which she had a hidden interest. The indictment also alleges that Randolph submitted false claims for services that had not been provided, including for patient beneficiaries who had died. The fraud charge carries a maximum prison term of ten years; the false statement charges carry a maximum 5 years in prison; and the aggravated identity theft a mandatory two years in prison. Each count carries a fine of up to $250,000.
April 12, 2017; U.S. Attorney; Western District of Virginia
Bristol, Virginia Man Pleads Guilty to Conspiracy to Commit Healthcare Fraud
Abingdon, VIRGINIA - A Bristol man, who along with his wife and another woman, was accused of healthcare fraud charges, has pled guilty to related federal charges, Acting United States Attorney Rick A. Mountcastle, Virginia Attorney General Mark R. Herring and Nick DiGiulio, Special Agent in Charge, Philadelphia Regional Office for U.S. Health and Human Services - Office of Inspector General announced today.
April 11, 2017; U.S. Attorney; Western District of Oklahoma
Oklahoma Hospital, Former Hospital Administrator, and Physicians Agree to Pay $1,618,750 to Settle Allegations of Submitting False Claims for Medical Services Provided to Medicare Patients
Oklahoma City, Oklahoma -NORMAN REGIONAL HOSPITAL AUTHORITY d/b/a NORMAN REGIONAL HEALTH SYSTEM; GREG TERRELL; CHADWICK WEBBER, M.D.; MERL KARDOKUS, M.D.; RICK WEDEL, M.D.; GAUTHAM DEHADRAI, M.D.; BARBARA LANDAAL, M.D.; and SANJAY NAROTAM, M.D., have agreed to pay $1,618,750 to the United States to settle civil claims stemming from allegations that the hospital submitted false claims to Medicare, Mark A. Yancey, United States Attorney for the Western District of Oklahoma, announced today.
April 10, 2017; U.S. Attorney; Western District of Wisconsin
Prestige Healthcare Agrees to Pay Nearly $1 Million for Role in Alleged False Billing of Genetic Testing
Madison, Wis. - Jeffrey M. Anderson, Acting United States Attorney for the Western District of Wisconsin, announced today that Prestige Healthcare has agreed to pay the United States $995,500 to resolve allegations that it violated the False Claims Act with regard to its role in an alleged scheme to falsely bill Medicare for unnecessary genetic testing.
April 10, 2017; U.S. Attorney; Southern District of Texas
Five RGV Residents Charged With Medicare Fraud and Illegal Kickbacks
McALLEN, Texas - Five local residents have been charged following an operation conducted by the Rio Grande Valley (RGV) health care fraud task force targeting Medicare fraud and the payment of illegal kickbacks, announced Acting U.S. Attorney Abe Martinez.
April 6, 2017; U.S. Attorney; Middle District of Florida
Coral Gables Woman Sentenced For Skimming Social Security And Medicaid Benefits From Mentally Ill And Elderly Beneficiaries
Tampa, FL - U.S. District Judge Mary S. Scriven has sentenced Ilfrenise Charlemagne (68, Coral Gables) to 33 months in federal prison for wire fraud. She pleaded guilty on November 8, 2011.
April 5, 2017; U.S. Attorney; Eastern District of Louisiana
Metairie Doctor Pleads Guilty to Operating a Pill Mill, Threatening Federal Law Enforcement and Health Care Fraud
Acting U.S. Attorney Duane A. Evans announced that SHANNON CHRISTOPHER CEASAR, M.D., age 44, a physician and former co-owner and operator of Gulf South Physician's Group in Metairie, pled guilty today to Counts 1, 2 and 3 of a Superseding Bill of Information.
April 4, 2017; U.S. Attorney; District of Oregon
Gresham Medical Practice Manager Sentenced to Prison for False Billing and Tax Fraud
PORTLAND, Ore. - On Tuesday, April 4, 2017, United States District Court Judge Robert E. Jones sentenced Anthony C. Neal to one year and one day in federal prison followed by three years of supervised release. Neal pleaded guilty in July 2016 to engaging in a seven-year health care fraud scheme and conspiring to defraud the Internal Revenue Service (IRS). Neal was also ordered to pay $1,702,567 in restitution to Medicare, Care Oregon and several private health insurance companies and $817,378 to the IRS.
April 4, 2017; U.S. Attorney; Eastern District of Missouri
Six Home Healthcare Workers and Patients Charged with Billing Medicaid while Working other Jobs, Going on a Cruise, and Gambling
St. Louis, MO - Six area home health care workers and patients were charged with making false statements to Medicaid regarding home healthcare services that were neither received nor provided. All of the Indictments involve allegations that the defendants made false statements in Medicaid timesheets that certain patients and workers provided or received personal care services (e.g. grooming, cleaning, feeding, and medication assistance) in the home setting during certain dates and times when, in reality, the patients or workers were actually somewhere else.

March 2017

March 31, 2017; U.S. Department of Justice Medicare Fraud Strike Force Case
Second Detroit-Area Physician Pleads Guilty in $17.1 Million Health Care Fraud Scheme
A second Detroit-area physician pleaded guilty today for his role in a $17.1 million Medicare fraud scheme involving medically unnecessary physician visits and drug prescriptions.
March 31, 2017; U.S. Attorney; Southern District of Texas
McAllen Area Durable Medical Equipment Company Owner Convicted of Health Care Fraud
McALLEN, Texas - The owner of a durable medical equipment company has entered a guilty plea to defrauding Medicaid of more than $3 million, announced Acting U.S. Attorney Abe Martinez.
March 30, 2017; U.S. Department of Justice Medicare Fraud Strike Force Case
Home Health Agency Owner Pleads Guilty to Conspiring in $17 Million Medicaid Fraud Scheme
The owner and operator of five Houston-area home health agencies pleaded guilty to conspiring to defraud Medicare and the State of Texas's Medicaid-funded Home and Community-Based Service and Primary Home Care programs of more than $17 million. He also pleaded guilty to conspiring to launder money. These health care programs provided qualified individuals with in-home attendant and community-based services that are known commonly as "provider attendant services" (PAS). This case marks the largest PAS fraud case charged in Texas history.
March 29, 2017; U.S. Attorney; District of Maryland
Owner of Medical Equipment Provider Sentenced to 12 Years In Federal Prison For Collecting A Debt By Extortion and for Tax and Health Care Fraud Conspiracies
Baltimore, Maryland - U.S. District Judge Marvin J. Garbis sentenced Harry Crawford, age 57, of Baltimore, Maryland, on March 28, 2017, to 12 years in prison, followed by three years of supervised release. Crawford previously pleaded guilty to collection of a debt by extortionate means from victim David Wutoh; conspiracy to commit health care fraud; and conspiracy to defraud the United States, for not reporting income from the health care fraud scheme on his taxes.
March 24, 2017; U.S. Attorney; Northern District of Texas
Federal Jury Convicts Doctor of $40 Million Medicare Fraud
DALLAS - Following a five-day trial before U.S. District Judge Jane Boyle, a federal jury has convicted Noble U. Ezukanma, 57, of Fort Worth, Texas, of seven counts of health care fraud offenses, announced U.S. Attorney John Parker of the Northern District of Texas.
March 23, 2017; U.S. Department of Justice
Miami-Based Physician Charged for Role in Pain Pill Diversion and Medicare Fraud Scheme
A physician licensed in Puerto Rico, who was practicing medicine in Miami, was charged in a 16-count indictment unsealed today for his alleged participation in a multi-faceted $20 million health care fraud scheme involving the submission of false and fraudulent claims to Medicare and Medicaid and the illegal distribution of oxycodone and other controlled substances.
March 23, 2017; U.S. Attorney; Northern District of Alabama
NW Alabama Pharmacies Owner Sentenced to Six Month's Home Confinement for Obstructing Medicare Audit; Ordered to Pay $2.5 million Fine
BIRMINGHAM - A federal judge today sentenced the owner of two northwest Alabama pharmacies to six month's home confinement for obstructing a Medicare audit, ordered him to pay a $2.5 million fine and prohibited him from working in a pharmacy during his year on probation.
March 23, 2017; U.S. Attorney; Western District of Wisconsin
Osceola Nutritional Supplement Provider & CEO Sentenced
Madison, Wis. - Jeffrey M. Anderson, Acting United States Attorney for the Western District of Wisconsin, announced that Gottfried Kellermann, 76, Osceola, Wis., was sentenced today by U.S. District Judge James D. Peterson to a six-month period of home confinement, a $50,000 fine, and five years of probation, for intentionally violating Clinical Laboratory Improvement Amendments regulations. Kellerman's co-defendant, NeuroScience, Inc., was sentenced to a five-year period of probation and a $140,000 fine for conspiring to defraud the United States. The defendants pleaded guilty to these charges on October 14, 2016.
March 22, 2017; U.S. Attorney; Northern District of Illinois
Chicago Chiropractor Indicted for Allegedly Billing $10 Million to Medicare and Private Insurers for Nonexistent Treatment
CHICAGO - A Chicago chiropractor with a clinic in the West Lawn neighborhood has been indicted on federal fraud charges for allegedly submitting at least $10 million in bogus claims to Medicare and private insurers.
March 22, 2017; U.S. Attorney; Eastern District of Michigan
Two Physicians Found Guilty For Distributing Oxycodone
Dr. Anthony Conrardy, age 61, and Dr. William McCutchen, III, age 46, were found guilty yesterday of unlawfully distributing Schedule II narcotics by a federal jury in Detroit, MI, acting United States Attorney Daniel L. Lemisch announced today. Dr. Anthony Conrardy was convicted of five counts of unlawfully distributing Oxycodone and Dilaudid, and Dr. William McCutchen, III was convicted of four counts of unlawfully distributing Oxycodone.
March 17, 2017; U.S. Department of Justice Medicare Fraud Strike Force Case
Houston-Area Registered Nurse Pleads Guilty to Conspiring to Defraud Medicare of More than $5 Million
A Houston-Area registered nurse pleaded guilty today for his role in a Medicare fraud scheme that resulted in losses to Medicare of more than $5 million.
March 17, 2017; U.S. Attorney; District of Puerto Rico
Doctor Sentenced To Seven Years In Prison For Health Care Fraud
SAN JUAN, P.R. - Doctor Juan José Tull-Abreu was sentenced to serve 63 months of imprisonment for health care fraud, and a consecutive term of 24 months for aggravated identity theft, for a total term of imprisonment of 87 months, announced United States Attorney for the District of Puerto Rico, Rosa Emilia Rodríguez-Vélez.
March 16, 2017; U.S. Attorney; Eastern District of Washington
Spokane Area Cardiologist, Dr. Romeo Pavlic, to Pay $300,000 Resolving Alleged False Health Care Claims
Spokane, WA - Today, the United States Attorney's Office (USAO) for the Eastern District of Washington announced a settlement agreement with Dr. Romeo Pavlic and various companies he owns. The settlement resolves allegations that for years Dr. Pavlic, a Spokane-area cardiologist, falsely billed Medicare and Medicaid by repeatedly and falsely claiming to have provided services and tests to vulnerable patients when in fact he had not.
March 14, 2017; U.S. Department of Justice Medicare Fraud Strike Force Case
South Florida Home Health Owner Charged for Role in $15 Million Medicare Fraud Scheme
A South Florida home health care owner was charged in an indictment unsealed today for his alleged participation in a $15 million health care fraud scheme involving fraudulent claims for home health services.
March 14, 2017; U.S. Attorney; District of Connecticut
Stamford Dental Office Manager Pleads Guilty to Defrauding Insurance Companies
Deirdre M. Daly, United States Attorney for the District of Connecticut, today announced that ELENA ILIZAROV, 44, of Stamford, waived her right to be indicted and pleaded guilty yesterday before U.S. District Judge Victor A. Bolden in Bridgeport to one count of wire fraud stemming from her use of an identity theft victim's personal identifying information to submit fraudulent bills to private insurance companies offering dental insurance.
March 13, 2017; U.S. Department of Justice
Charles River Laboratories International Inc. Agrees to Pay United States $1.8 Million to Settle False Claims Act Allegations
Charles River Laboratories International Inc. has agreed to pay the U.S. government $1.8 million to settle claims that it violated the False Claims Act by improperly charging for labor and other associated costs that were not actually provided on certain National Institutes of Health contracts, the Justice Department announced today. Charles River is a for-profit corporation headquartered in Wilmington, Massachusetts.
March 10, 2017; U.S. Attorney; Middle District of Pennsylvania
Lancaster County Woman Guilty Of Healthcare Fraud
HARRISBURG- The United States Attorney's Office for the Middle District of Pennsylvania announced that Tammie Sensenig, age 45, of Lancaster, Pennsylvania, pleaded guilty March 8, 2017, before United States Magistrate Judge Martin C. Carlson to a criminal information charging her with healthcare fraud.
March 7, 2017; U.S. Attorney; Middle District of Florida
Tampa Man Pleads Guilty To Paying Health Care Kickbacks
Tampa, FL - United States Attorney A. Lee Bentley, III announces that Anthonio Miller (26, Tampa) today pleaded guilty to conspiracy to pay kickbacks in connection with a federal health care benefit program. He faces a maximum penalty of five years in federal prison.
March 6, 2017; U.S. Department of Justice
California Clinic Owner Sentenced to 63 Months in Prison for Role in Occupational Therapy Fraud Scheme
A rehabilitation clinic operator in Los Angeles County was sentenced to 63 months in prison today for his role in a $3.4 million Medicare fraud scheme that involved billing for occupational therapy services that were not medically necessary and not provided.
March 6, 2017; U.S. Attorney; Southern District of Texas
Clinic Manager Heads to Prison for Health Care Fraud
HOUSTON - The 47-year-old owner and operator of Elite P. Care Medical Services has been sentenced for her role in a health care fraud conspiracy that billed Medicare and Medicaid for more than $1 million in fraudulent health care claims, announced U.S. Attorney Kenneth Magidson.
March 6, 2017; U.S. Attorney; District of New Jersey
Bergen County Doctor Convicted Of Taking Bribes In Test-Referral Scheme With New Jersey Clinical Lab
NEWARK, N.J. - A family doctor practicing in Bergen County, New Jersey, was convicted today of all 10 counts of an indictment charging him with accepting bribes in exchange for test referrals as part of a long-running and elaborate scheme operated by Biodiagnostic Laboratory Services LLC (BLS), of Parsippany, New Jersey, its president and numerous associates, U.S. Attorney Paul J. Fishman announced.
March 6, 2017; U.S. Attorney; District of Vermont
Brandon Woman Sentenced for Medicaid Fraud
The Office of the United States Attorney for the District of Vermont announced that Misti Baker, 36, of West Rutland, Vermont, was sentenced on Friday by United States District Court Judge Geoffrey W. Crawford for healthcare fraud. Judge Crawford sentenced Baker to time served plus two years of supervised release and ordered her to pay $77,306.57 in restitution.
March 3, 2017; U.S. Department of Justice
Unlicensed Medical Professional Convicted for Role in $1.3 Million Medicare Fraud Scheme
A federal jury in Houston convicted an unlicensed medical professional who was posing as a physician yesterday for his participation in a $1.3 million Medicare fraud scheme.
March 3, 2017; U.S. Attorney; Southern District of Florida
Two Women Plead Guilty to Orchestrating $20 Million Medicare Fraud Scheme at Seven Miami Area Home Health Agencies
Two Miami residents pleaded guilty today to fraud charges stemming from their roles in a $20 million home health care fraud scheme.
March 3, 2017; U.S. Attorney; District of Maryland
Biller for Medical Equipment Provider Sentenced to Four Years in Federal Prison for Health Care Fraud, Aggravated Identity Theft and Defrauding the IRS by Failing to File Tax Returns
Baltimore, Maryland - U.S. District Judge Marvin J. Garbis sentenced Elma Myles, age 52, on March 2, 2017, to four years in prison, in connection with her role in a health care fraud scheme, aggravated identity theft, and conspiracy to defraud the United States for failing to file income tax returns. Judge Garbis also ordered Myles to pay restitution of $1,207,585.38 to Medicaid.
March 3, 2017; U.S. Attorney; Western District of Virginia
Personal Care Attendant Pleads Guilty to Making a False Statement as it Relates to a Health Care Benefit
Charlottesville, VIRGINIA - A personal care attendant, who for four years lied about the amount of hours she worked for a homebound retiree, pled guilty yesterday in the United States District Court for the Western District of Virginia in Charlottesville to federal false statement charges, Acting United States Attorney Rick A. Mountcastle and Virginia Attorney General Mark R. Herring announced.
March 2, 2017; U.S. Department of Justice
Third Detroit-Area Physician Pleads Guilty in $5.4 Million Dollar Health Care Fraud Scheme
A Detroit-area physician pleaded guilty today for his role in a $5.4 million Medicare fraud scheme involving phony physician visits and drug prescriptions.
March 2, 2017; U.S. Attorney; Southern District of Texas
All 12 Convicted in Health Care Fraud Conspiracy Involving Area Mental Health Centers
HOUSTON - A federal jury has convicted the final defendant of 12 involved in a conspiracy to pay and receive kickbacks relating to the Medicare program, announced U.S. Attorney Kenneth Magidson. The jury deliberated for four hours following a three-day trial before convicting Cheryl Waller, 70, of Houston, of one count of conspiracy to pay and receive kickbacks and one count of receiving kickbacks.
March 1, 2017; U.S. Attorney; Southern District of New York
Cardiologist, Neurologist, And Others Charged In $50 Million Health Care Fraud Scheme, And Civil Suit Filed Against Clinic And Participants In The Fraud
Preet Bharara, the United States Attorney for the Southern District of New York, William F. Sweeney Jr., the Assistant Director-in-Charge of the New York Field Office of the Federal Bureau of Investigation ("FBI"), Scott J. Lampert, Special Agent-in-Charge of the New York Regional Office of the United States Department of Health and Human Services Office of the Inspector General ("HHS-OIG"), and James P. O'Neill, the Commissioner of the New York City Police Department ("NYPD"), announced today criminal and civil actions relating to a 12-year scheme to defraud Medicaid, Medicare, and other private health insurance companies out of more than $50 million. Today's actions include the unsealing of an Indictment charging ASIM HAMEEDI, FAWAD HAMEEDI, MICHELLE LANDOY, DESIREE SCOTT, EMAD SOLIMAN, and ARIF HAMEEDI with, among other things, health care fraud, identity theft, and making false statements, and the filing of a civil fraud lawsuit against CITY MEDICAL ASSOCIATES, P.C., and ASIM HAMEEDI, among others, seeking treble damages and civil penalties under the False Claims Act for the fraudulent claims for reimbursement submitted by CITY MEDICAL ASSOCIATES to Medicare and Medicaid between 2003 and November 2015.

February 2017

February 28, 2017; U.S. Attorney; Northern District of Texas
Sixteen Individuals Charged in $60 Million Medicare Fraud Scheme
DALLAS - An indictment returned by a federal grand jury in Dallas last week, and unsealed today, charges 16 individuals with offenses related to their participation in a health care fraud scheme, announced John Parker, U.S. Attorney for the Northern District of Texas.
February 24, 2017; U.S. Department of Justice
Administrator of Miami-Area Home Health Agency Sentenced to 126 Months in Prison for Involvement in $2.5 Million Medicare Fraud Scheme
Today, the administrator of a Miami-area home health agency was sentenced to a 126 month prison term for his role in a $2.5 million Medicare fraud scheme.
February 24, 2017; U.S. Attorney; Southern District of Texas
Jury Convicts Rio Grande Valley Area Durable Medical Equipment Company Owner of Health Care Fraud
McALLEN, Texas - A McAllen federal jury has convicted the owner of an area durable medical equipment (DME) company owner on all counts for her scheme to defraud Texas Medicaid through fraudulent billings, announced U.S. Attorney Kenneth Magidson. The jury deliberated for six hours following a seven-day trial before convicting Maria Garza, 41, of McAllen, on all 18 counts as charged.
February 22, 2017; U.S. Attorney; District of Puerto Rico
Owner Of Durable Medical Equipment Company And Three Physicians Charged With Health Care Fraud And Aggravated Identity Theft
SAN JUAN, P.R. - On February 13, 2017, a Federal Grand Jury in the District of Puerto Rico returned a superseding indictment charging Dr. Dante A. Rodríguez-Rivera, Javier Efraín Siverio-Echevarría, Dr. George D. Alcántara-Cardi, Dr. Martha Nieves, Javier Antonio Aguirre- Estrada, and Carlos Maldonado-López with multiple counts of conspiracy to commit health care fraud, health care fraud and aggravated identity theft. The defendants were arrested today, announced Rosa Emilia Rodríguez Vélez, United States Attorney for the District of Puerto Rico, Scott Lampert, the Special Agent in Charge of the Office of the Inspector General for the U.S. Department of Health and Human Services ("HHS-OIG"), and Douglas A. Leff, Special Agent in Charge of the Federal Bureau of Investigation's Puerto Rico Field Office ("FBI").
February 23, 2017; U.S. Attorney; Eastern District of Pennsylvania
Doctor Pleads Guilty To Selling Prescriptions Of Suboxone And Klonopin
PHILADELPHIA - Dr. Alan Summers, 78, of Ambler, PA, pleaded guilty to an indictment charging him in a scheme to sell commonly abused prescription drugs in exchange for cash payments. Dr. Summers pleaded guilty to conspiracy to distribute controlled substances, distribution of controlled substances, health care fraud, and money laundering, and was announced by Acting United States Attorney Louis D. Lappen, Drug Enforcement Administration Special Agent-in-Charge Gary Tuggle, and Special Agent-in-Charge Nick DiGuilio with Health and Human Services Office of Inspector General.
February 22, 2017; U.S. Attorney; Western District of Virginia
Bristol, Virginia Woman Pleads Guilty to Conspiracy to Commit Healthcare Fraud
Abingdon, VIRGINIA - A Bristol woman, who along with her husband and another woman, was accused of healthcare fraud charges, has pled guilty to federal conspiracy charges, Acting United States Attorney Rick A. Mountcastle, Virginia Attorney General Mark R. Herring and Nick DiGiulio, Special Agent in Charge, Philadelphia Regional Office for U.S. Health and Human Services - Office of Inspector General announced today.
February 16, 2017; U.S. Attorney; District of New Jersey
Oncology Practice, Doctor And Practice Manager Pay $1.7 Million To Resolve Allegations They Billed Medicare For Illegally Imported Drugs
NEWARK, N.J. - A Monmouth County doctor, his oncology practice, and his wife, who managed the practice, have agreed to pay the United States $1.7 million to resolve allegations that they illegally imported and used unapproved chemotherapy drugs from foreign distributors and illegally billed Medicare, U.S. Attorney Paul J. Fishman announced today.
February 15, 2017; U.S. Attorney; Northern District of Georgia
Atlanta-area Dentist Sentenced for nearly $1 Million in Medicaid Fraud
ATLANTA - Dr. Oluwatoyin Solarin has been sentenced to one year, six months in federal prison for filing false claims with the Georgia Medicaid program totaling nearly $1 million.
February 13, 2017; U.S. Attorney; Eastern District of Texas
Former CEO of Nebraska Pharmaceutical Benefits Manager Guilty in Kickback Scheme
TYLER, Texas - The former CEO of a Nebraska pharmaceutical benefits manager has pleaded guilty to engaging in illegal kickbacks in the Eastern District of Texas, announced Acting United States Attorney Brit Featherston today.
February 10, 2017; U.S. Attorney; Southern District of Florida
Plantation Physician and Physician Practice to Pay $750,000 to Resolve False Claims Act Allegations Involving Medically Unnecessary Sinus and Throat Procedures
Dr. Paul B. Tartell, an ENT physician practicing in Plantation, Florida and his practice Paul B. Tartell, M.D., P.L., d/b/a South Florida Sinus & Allergy Center, have agreed to pay $750,000 to resolve allegations that he violated the False Claims Act by billing for surgical endoscopies with debridement and laryngeal stroboscopies that were not provided or not medically necessary.
February 10, 2017; U.S. Attorney; Western District of Louisiana
Federal jury finds Shreveport mental health facility administrator guilty of kickback scheme
SHREVEPORT, La. - United States Attorney Stephanie A. Finley announced that a federal jury found a former Shreveport mental health facility administrator guilty Thursday of taking part in a kickback scheme.
February 9, 2017; U.S. Attorney; Western District of Texas
El Paso Behavioral Health Facility Pays $860,000 to Resolve False Claims Act Allegations Under Civil Settlement with United States
Today, University Behavioral Health of El Paso, LLC ("UBH") paid $860,000 under a civil settlement with the Department of Justice to resolve allegations under the False Claims Act that the hospital paid unlawful remuneration under the Anti-Kickback Act and violated the Stark Law when it improperly paid a physician who made referrals to the hospital pursuant to a personal services agreement.
February 8, 2017; U.S. Attorney; District of Massachusetts
Healthcare Sales Representative Sentenced for Obstructing Federal Investigation
BOSTON - A sales representative for multiple healthcare companies was sentenced today in U.S. District Court in Boston in connection with obstructing an investigation into kickbacks paid to medical professionals.
February 7, 2017; U.S. Attorney; Southern District of Florida
Dr. Gary Marder and the United States Consent to a Final Judgement of Over $18 Million to Settle False Claims Act Allegations
Gary L. Marder, D.O., a physician residing in Palm Beach County and the owner and operator of the Allergy, Dermatology & Skin Cancer Centers in Port St. Lucie and Okeechobee, and the United States of America have stipulated to a consent final judgment of over $18 million to settle False Claims Act allegations against Dr. Marder. Co-defendant, Robert I. Kendall, M.D., a physician practicing in Coral Gables, has also agreed to pay the United States $250,000 to settle allegations that he violated the False Claims Act.
February 7, 2017; U.S. Attorney; Eastern District of Pennsylvania
Delaware County Podiatrist Sentenced to 8 Years in Prison for Health Care Fraud
PHILADELPHIA - Today, a federal judge sentenced Stephen A. Monaco, a former podiatrist, to 97 months' imprisonment for defrauding Medicare, Medicaid and private victim insurance companies, announced Acting United States Attorney Louis D. Lappen. Defendant Monaco pleaded guilty to health care fraud on August 23, 2016, and surrendered his DEA license.
February 6, 2017; U.S. Department of Justice
Healthcare Service Provider to Pay $60 Million to Settle Medicare and Medicaid False Claims Act Allegations
A major U.S. hospital service provider, TeamHealth Holdings, as successor in interest to IPC Healthcare Inc., f/k/a IPC The Hospitalists Inc. (IPC), has agreed to resolve allegations that IPC violated the False Claims Act by billing Medicare, Medicaid, the Defense Health Agency and the Federal Employees Health Benefits Program for higher and more expensive levels of medical service than were actually performed (a practice known as "up-coding"), the Department of Justice announced today. Under the settlement agreement, TeamHealth has agreed to pay $60 million, plus interest.
February 6, 2017; U.S. Attorney; Southern District of New York
Clinic Manager Pleads Guilty In $70 Million Scheme To Defraud Medicare And Medicaid
Preet Bharara, the United States Attorney for the Southern District of New York, announced that EDUARD ZAVALUNOV, a manager of two health care clinics in Queens, New York, pled guilty today before U.S. District Judge Ronnie Abrams to conspiracy to commit wire fraud, mail fraud, and health care fraud, for his role in a massive health care fraud scheme through which three medical clinics in Brooklyn and Queens submitted over $70 million in fraudulent claims to Medicaid and Medicare.
February 1, 2017; U.S. Department of Justice
Former Executive of Tenet Healthcare Corporation Charged for Alleged Role in $400 Million Scheme to Defraud
A former senior executive of Tenet Healthcare Corporation, was indicted for his alleged role in an over $400 million scheme to defraud. The indictment alleges that the scheme to defraud victimized the U.S. government, the Georgia and South Carolina Medicaid Programs, and prospective patients of Tenet hospitals.
February 1, 2017; U.S. Attorney; Middle District of Florida
Fort Myers Urologist Agrees To Pay More Than $3.8 Million For Ordering Unnecessary Medical Tests
Fort Myers, FL - United States Attorney A. Lee Bentley, III announces that Meir Daller, M.D. has agreed to pay $3.81 million to the government to resolve allegations that he violated the False Claims Act by causing claims to be submitted to federal health care programs for laboratory tests that were not medically necessary.
February 1, 2017; U.S. Attorney; Eastern District of Kentucky
Pain Management Physician Resolves False Claims Act Allegations
LEXINGTON, Ky. - Pain management physician Dr. Robert Windsor has agreed to the entry of a $20 million consent judgment to resolve allegations that he violated the False Claims Act by billing federal health care programs for surgical monitoring services that he did not perform and for medically unnecessary diagnostic tests. Dr. Windsor owned pain management clinics in Georgia and Kentucky that operated under the umbrella of National Pain Care, Inc., including clinics in Lexington, London, Somerset, Hazard, Prestonsburg, and Pikeville, Kentucky.
February 1, 2017; U.S. Attorney; Northern District of Iowa
Iowa Nursing Facility, Its Ownership, and Its Management Agree to Pay $100,000 to Resolve Allegations that Residents Received Worthless Care
The Abbey of Le Mars, Inc., and other individuals with financial interests in the Abbey's operations, agreed to pay $100,000 to settle allegations they violated the False Claims Act by submitting or causing claims to be submitted to Medicaid when the care provided to nursing facility residents was so grossly substandard that the care was worthless and effectively without value.

January 2017

January 31, 2017; U.S. Attorney; Southern District of Texas
Seven Sentenced in $6 Million Health Care Fraud Scheme
HOUSTON - The final seven of eight convicted in a $6 million fraudulent Medicare billing scheme have been ordered to federal prison, announced U.S. Attorney Kenneth Magidson.
January 31, 2017; U.S. Attorney; Southern District of Texas
San Benito Man Heads to Prison for Posing as Licensed Vocational Nurse
McALLEN, Texas - A San Benito man has been ordered to federal prison following his conviction of aggravated identity theft, announced U.S. Attorney Kenneth Magidson. Juan Manuel Perez, 36, pleaded guilty Nov. 3, 2016.
January 27, 2017; U.S. Department of Justice Medicare Fraud Strike Force Case
Three Individuals Plead Guilty in $55 Million Health Care Fraud Scheme at Two Brooklyn Medical Clinics
Three individuals pleaded guilty this week in connection with a health care fraud scheme involving two Brooklyn, New York clinics that caused approximately $55 million in false and fraudulent claims to Medicare and Medicaid.
January 27, 2017; District of Idaho
Fruitland Woman Pleads Guilty During Trial to Health Care Fraud and Aggravated Identity
BOISE - Cherie R. Dillon, 61, of Fruitland, Idaho, pleaded guilty today to 24 counts of health care fraud and 24 corresponding counts of aggravated identity theft for fraudulently billing dental services to health care benefit programs, U.S. Attorney Wendy J. Olson announced. Dillon was indicted on February 9, 2016, by a federal grand jury in Boise. Dillon's plea came at the close of the government's case after four days of trial in front of Chief U.S. District Court Judge B. Lynn Winmill.
January 25, 2017; U.S. Department of Justice Medicare Fraud Strike Force Case
Clinical Psychologist and Owner of Psychological Services Centers Convicted in $25 Million Psychological Testing Scheme Carried Out Through Eight Companies in Four Gulf Coast States
Two owners of psychological services companies, one of whom was a clinical psychologist, were convicted yesterday for their involvement in a $25.2 million Medicare fraud scheme carried out through eight companies at nursing homes in four states in the Southeastern United States.
January 25, 2017; U.S. Attorney; Central District of Illinois
Co-owner of Chicago Medical Transport Company Sentenced to Five Years in Prison for Overbilling Illinois Medicaid $4.7 Million
SPRINGFIELD, Ill. - A Chicago man has been sentenced to five years in prison for fraudulent overbilling an estimated $4.7 million to Illinois' Medicaid program for non-emergency medical transport. Gregory D. Toran, 68, of Hazel Crest, Ill., was also ordered to pay $4.7 million in restitution. U.S. District Judge Sue E. Myerscough, who sentenced Toran on Jan. 23, allowed Toran to remain on bond until the federal Bureau of Prisons directs him to self-report to a prison facility to begin his prison sentence.
January 25, 2017; U.S. Attorney; Southern District of Texas
Jury Convicts Local Doctor in $13 Million Health Care Fraud Scheme
HOUSTON - The final defendant charged in a $13 million Medicare and Medicaid health care fraud case has been found guilty on all eight counts as charged, announced U.S. Attorney Kenneth Magidson. A federal jury convicted Dr. Faiz Ahmed, 64, of Houston, today following a six-day trial and approximately five hours of deliberations.
January 23, 2017; U.S. Attorney; Northern District of Ohio
Mother and son convicted of $7 million healthcare fraud scheme
A mother and son were convicted of crimes related to a $7 million home healthcare fraud conspiracy in which they provided forged documents and fraudulent forms to bill for services that were not provided.
January 23, 2017; U.S. Attorney; Eastern District of Texas
U.S. Intervenes in East Texas False Claims Act Lawsuit Alleging Kickbacks for Ambulance Services
SHERMAN, Texas - The United States has filed a complaint intervening in an alleged kickback scheme in the Eastern District of Texas, announced Acting U.S. Attorney Brit Featherston today.
January 20, 2017; U.S. Attorney; District of Minnesota
Twin Cities Child Care Provider Charged with Stealing Hundreds of Thousands from Low-Income Assistance Program
United States Attorney Andrew M. Luger today announced an indictment charging FOZIA SHEIK ALI, 50, for fraudulently obtaining at least hundreds of thousands of dollars for child care services that had not been provided. ALI is charged with wire fraud and theft of public money. The indictment was unsealed late yesterday in U.S. District Court in Minneapolis, Minn.
January 20, 2017; U.S. Attorney; Southern District of Texas
Rio Grande Valley Area Doctor Charged in Illegal Kickback Scheme
McALLEN, Texas - A Rio Grande Valley area doctor has been taken into custody for his scheme to solicit and obtain illegal kickbacks in exchange for Medicare patient referrals, announced U.S. Attorney Kenneth Magidson.
January 19, 2017; U.S. Attorney; Eastern District of Pennsylvania
University Of Pennsylvania Health System Agrees To Settle Voluntary Disclosure Of Improper Medicare Billing For Unnecessary Stent Procedures
The United States announces that it has settled allegations under the False Claims Act with the University of Pennsylvania Health System ("UPHS") for improperly billing Medicare for stent procedures two interventional cardiologists performed at Pennsylvania Hospital between 2008 and 2012. UPHS voluntarily disclosed the allegations to the U.S. Attorney's Office and has agreed to pay $845,000 to resolve the matter. The cardiologists no longer work at Pennsylvania Hospital.
January 19, 2017; U.S. Attorney; Southern District of New York
Manhattan U.S. Attorney Announces $50 Million Settlement With Walgreens For Paying Kickbacks To Induce Beneficiaries Of Government Healthcare Programs To Fill Their Prescriptions At Walgreens' Pharmacies
Preet Bharara, the United States Attorney for the Southern District of New York, Scott J. Lampert, Special Agent in Charge of the New York Office of the U.S. Department of Health and Human Services, Office of Inspector General ("HHS-OIG"), and Craig Rupert, Special Agent in Charge of the Northeast Field Office of the Defense Criminal Investigative Service, Department of Defense, Office of Inspector General ("DoD-OIG"), announced today a $50 million settlement in a civil fraud lawsuit against WALGREEN CO. ("WALGREENS"), a nationwide retail pharmacy chain that owns and operates thousands of retail pharmacies throughout the United States. The settlement resolves claims that WALGREENS violated the federal Anti-Kickback Statute ("AKS") and False Claims Act ("FCA") by enrolling hundreds of thousands of beneficiaries of government healthcare programs ("government beneficiaries") in its Prescription Savings Club program ("PSC program").
January 19, 2017; U.S. Attorney; Southern District of Texas
Another RGV Durable Medical Equipment Company Owner Indicted for Health Care Fraud
McALLEN, Texas - The owner of a Rio Grande Valley area durable medical equipment (DME) company has been arrested for her scheme to defraud Texas Medicaid through fraudulent billings, announced U.S. Attorney Kenneth Magidson.
January 18, 2017; U.S. Attorney; District of New Jersey
Salesman For New Jersey Clinical Lab Sentenced To 20 Months In Prison For Bribing A Doctor In Test-Referral Scheme
NEWARK, N.J. - A Berkeley Heights, New Jersey, man was sentenced today to 20 months in prison for bribing a doctor in exchange for test referrals as part of a long-running and elaborate scheme operated by Biodiagnostic Laboratory Services LLC (BLS), of Parsippany, New Jersey, its president and numerous associates, U.S. Attorney Paul J. Fishman announced.
January 17, 2017; U.S. Attorney; Western District of Missouri
Former Physician Pleads Guilty to Health Care Fraud Scheme
KANSAS CITY, Mo. - Tammy Dickinson, United States Attorney for the Western District of Missouri, announced that a former Kansas City, Mo., physician who lost his medical license due to an earlier fraud scheme, pleaded guilty in federal court today to his role in a fraud scheme that involved disability examinations of veterans.
January 13, 2017; U.S. Attorney; District of Kansas
Medical Imaging Provider Sentenced for Federal Health Care Fraud
TOPEKA, KAN. B A man who owned a medical imaging business was sentenced Thursday to 18 months in federal prison for health care fraud, U.S. Attorney Tom Beall said. In addition, the defendant was ordered to pay more than $1.5 million in restitution to Medicare and Medicaid.
January 13, 2017; U.S. Department of Justice
Medstar Ambulance to Pay $12.7 Million to Resolve False Claims Act Allegations Involving Medically Unnecessary Transport Services and Inflated Claims to Medicare
Medstar Ambulance Inc., including four subsidiary companies and its two owners, Nicholas and Gregory Melehov, have agreed to pay $12.7 million to resolve allegations that the Massachusetts-based ambulance company knowingly submitted false claims to Medicare, the Department of Justice announced today.
January 12, 2017; U.S. Attorney; Eastern District of Washington
Confederated Tribes of the Colville Reservation Enter Into False Claims Act and Voluntary Compliance Agreements Regarding Challenged Youth Counseling Services
Spokane, WA - Today, the Confederated Tribes of the Colville Reservation (CCT) and the United States of America, acting through the U.S. Department of Justice (DOJ) and on behalf of the Office of Inspector General of the Department of Health and Human Services (OIG-HHS), announced a voluntary settlement agreement reached by the parties relative to allegations that the Colville Tribes submitted false claims to Medicaid seeking the reimbursement of mental health counseling services that was purportedly provided by the Tribe's Behavioral Health Unit - Youth Counseling services.
January 12, 2017; U.S. Department of Justice Medicare Fraud Strike Force Case
Home Health Agency Administrator Pleads Guilty in $7.8 Million Medicaid Fraud
The administrator of five Houston-area home health agencies pleaded guilty today to conspiring to defraud the State of Texas' Medicaid-funded Home and Community-Based Service and the Primary Home Care Programs of more than $7.8 million. These programs provide qualified individuals with in-home attendant and community-based services that are known commonly as "provider attendant services" (PAS), and this case marks the largest PAS fraud case charged in Texas history.
January 12, 2017; U.S. Attorney; District of Connecticut
Connecticut Home Health Agency and its Owners Pay $5.25 Million to Settle False Claims Act Violations
United States Attorney Deirdre M. Daly and Connecticut Attorney General George Jepsen today announced that Family Care Visiting Nurse and Home Care Agency, LLC (Family Care VNA), and David A. Krett and Rita C. Krett, R.N., B.S.N., owners of Family Care VNA, have entered into a civil settlement with the federal and state governments in which they will pay approximately $5.25 million to resolve allegations that they violated the federal and state False Claims Acts. Family Care VNA has offices in Stratford, Woodbridge, Norwalk and Meriden, and provides home health services in Fairfield, New Haven, Hartford and Middlesex Counties.
January 12, 2017; U.S. Attorney; Western District of Missouri
KC Daycare Center owner, Director Indicted for $556,000 Fraud Scheme
KANSAS CITY, Mo. - Tammy Dickinson, United States Attorney for the Western District of Missouri, announced that the owner and the director of a Kansas City, Mo., day care center were indicted by a federal grand jury today for their roles in a conspiracy to file false attendance reports in order to fraudulently receive as much as $556,000 in federal benefits.
January 12, 2017; U.S. Attorney; Western District of Missouri
Additional Charges Against Nigerian immigrant for Day Care Fraud Linked to International Scheme
KANSAS CITY, Mo. - Tammy Dickinson, United States Attorney for the Western District of Missouri, announced that additional charges have been filed against the Nigerian owner of a day care center in Kansas City, Mo., who was indicted last summer for engaging in a fraud scheme.
January 11, 2017; U.S. Department of Justice
Shire PLC Subsidiaries to Pay $350 Million to Settle False Claims Act Allegations
The Justice Department announced today that Shire Pharmaceuticals LLC and other subsidiaries of Shire plc (Shire) will pay $350 million to settle federal and state False Claims Act allegations that Shire and the company it acquired in 2011, Advanced BioHealing (ABH), employed kickbacks and other unlawful methods to induce clinics and physicians to use or overuse its product "Dermagraft," a bioengineered human skin substitute approved by the FDA for the treatment of diabetic foot ulcers. Shire plc is a multinational pharmaceutical firm headquartered in Ireland, with its United States operational headquarters in Lexington, Massachusetts. Shire sold the assets associated with Dermagraft in early 2014.
January 10, 2017; U.S. Attorney; Central District of California
Brea Man Who Operated Physical Therapy Clinics Sentenced to Over 10 Years in Federal Prison in $3 Million Medicare Fraud Scheme
SANTA ANA, California - A Brea man who operated rehabilitation clinics in Walnut, Torrance and Los Angeles and defrauded Medicare out of approximately $3 million by billing for unneeded or unnecessary services has been sentenced to 121 months in federal prison.
January 10, 2017; U.S. Attorney; District of New Jersey
Passaic County, New Jersey, Doctor Charged With Taking Bribes In Test-Referral Scheme With New Jersey Clinical Lab
NEWARK, N.J. - A doctor practicing in Passaic County, New Jersey, was charged today with accepting bribes in exchange for test referrals as part of a long-running and elaborate scheme operated by Biodiagnostic Laboratory Services LLC (BLS), of Parsippany, New Jersey, its president and numerous associates, U.S. Attorney Paul J. Fishman announced.
January 9, 2017; U.S. Department of Justice
Detroit-Area Neurosurgeon Sentenced to 235 Months in Prison for Role in $2.8 Million Health Care Fraud Scheme
A Detroit-area neurosurgeon was sentenced yesterday to 235 months in prison for his role in $2.8 million health care fraud scheme in which he caused serious bodily harm to patients by performing unnecessary invasive spinal surgeries.
January 9, 2016; U.S. Attorney; Northern District of Texas
Texas Dental Management Firm, 21 Affiliated Dental Practices, and Their Owners and Marketing Chief Agree to Pay $8.45 Million to Resolve Allegations of False Medicaid Claims for Pediatric Dental Services
DALLAS - Texas-based MB2 Dental Solutions (MB2) and 21 pediatric dental practices affiliated with MB2, along with their owners and marketing chief, have agreed to pay the United States and the State of Texas Medicaid program $8.45 million to resolve allegations that they violated the False Claims Act by knowingly submitting, or causing the submission of, claims for pediatric dental services that were not rendered, were tainted by kickbacks, or falsely identified the person who performed the service, announced U.S. Attorney John Parker of the Northern District of Texas.
January 6, 2017; U.S. Attorney; Southern District of New York
Owner Of Utah-Based Pharmaceutical Distributer Pleads Guilty To $100 Million Health Care Fraud Scheme
Preet Bharara, the United States Attorney for the Southern District of New York, announced that RANDY CROWELL, a/k/a "Roger," pled guilty today before United States District Judge Edgardo Ramos to fraudulently distributing more than $100 million worth of prescription drugs obtained on a nationwide black market. CROWELL used a Utah-based wholesale distribution company to sell illicitly procured drugs to pharmacies, which in turn dispensed them to unsuspecting customers. As part of his guilty plea, CROWELL agreed to forfeit more than $13 million in personal profits from the scheme.
January 5, 2017; U.S. Attorney; Northern District of Georgia
Sandy Springs Podiatrist and Office Manager charged with Illegal Distribution of Fentanyl, Oxycodone, and Other Drugs
ATLANTA - Dr. Arnita Avery-Kelly, a licensed podiatrist, and Brenda Lewis, Avery-Kelly's office manager, have been arraigned on federal charges of illegal distribution of opioid pain killers and other drugs at clinic locations purporting to provide podiatric care in Sandy Springs, and Lithonia, Georgia. Dr. Avery-Kelly and Ms. Lewis were indicted by a federal grand jury on December 21, 2016.

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