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2015: More News

OIG Update has expanded its coverage. Here is more news that you won't hear in the monthly podcast.
View news from 2014.

From December

  • A laboratory in Wisconsin is to pay $8.5 million to settle allegations in a Medicare false billing case.
  • The former owner, operator and managers of a Southern California ambulance company were jailed – one of them for nine years - in $1.5 million false claims Medicare scheme. The three are to repay more than $800,000.
  • A registered nurse in Texas was convicted of Medicare fraud; authorities said she filed claims for services that were not provided or authorized.
  • A Texan was jailed for more than five years and must repay nearly $2 million in an "arthritis kit" false billing scheme.
  • A Texas mother and daughter were sent to prison - one for nearly five years - for billing Medicare and Medicaid for bogus ambulance services. Restitution of nearly $600,000 was ordered.
  • The owner of a North Carolina medical billing company was charged in a multimillion-dollar Medicaid theft scheme that authorities said involved aggravated identity theft.
  • A North Carolina pathology practice is to pay $500,000 to settle allegations it had improper financial ties with referring doctors.
  • A physician in Massachusetts was charged with fraudulent billing and illegally prescribing powerful painkillers to at-risk patients.
  • The clinical director of a home health agency in Massachusetts was jailed for three years in a multimillion-dollar Medicare false billing scam.
  • A Philadelphia-area home health company and its president were charged in a $100,000 Medicaid fraud scheme that authorities said involved alleged bogus records.
  • Three from Tennessee were indicted in a medical equipment kickback scheme. The defendants were charged with soliciting and receiving kickbacks, and conspiring to solicit and receive kickbacks, in exchange for making referrals for the purchase of medical equipment.
  • A Tennessee woman was charged with 'doctor shopping;" authorities allege that she obtained oxycodone and hydrocodone fraudulently.
  • An Illinois home healthcare company owner was indicted in a Medicare fraud and kickback scheme. Authorities allege that the owner paid for referrals of Medicare beneficiaries to her business.
  • An Illinois man admitted submitting fraudulent Medicaid claims for personal assistant services that he did not render.
  • An Illinois woman admitted falsely billing Medicaid for personal assistant services that she did not render.
  • An Illinois personal care assistant was sentenced for falsely claiming that he provided Medicaid services; he is to repay more than $6,600.
  • A Mississippi woman who submitted fraudulent hospice bills to Medicare was sentenced to three years in prison and must repay more than $1million.
  • The owner of two assisted-living facilities in Florida was charged with stealing residents' money, identity theft and false billing.
  • A 42-month prison term was imposed on a New York physician's assistant who took bribes in a massive New Jersey lab-referral scam, and a New York physician admitted taking part in the same scheme.
  • A New York hospital employee was charged with using forged prescriptions to get narcotics.
  • Two New York personal care aides admitted filing false timesheets, claiming they provided care that never occurred.
  • A nurse in New York admitted billing for hours of care she didn't provide to special needs patients.
  • A Connecticut dentist is to pay $55.000 to settle civil fraud allegations of false claims to Medicaid.

From November

  • A Florida hospice is to pay more than $3 million to settle allegations that it submitted healthcare claims for medically unnecessary care.
  • Milwaukee's Deaconess Home Health and its owner agreed to pay more than $3.7 million to settle criminal and civil healthcare fraud charges.
  • Atlas Healthcare, in Wisconsin, and its owners are to pay $435,000 to settle civil allegations of false Medicaid claims.
  • Rhode Island Dermatology and Cosmetic Center is to pay more than $150,000 to settle civil allegations of "upcoding."
  • A Maryland doctor, who wrote prescriptions for oxycodone and Adderall in the names of his patients so he could get drugs for himself, was sentenced and fined $40,000.
  • A former physician in Pennsylvania, who was charged in July in a "pill mill" case, is now also accused of healthcare fraud and conspiring to defraud the federal Food and Drug Administration.
  • A West Virginia nurse was put on probation for five years for stealing and using hydrocodone that was meant for patients. She also falsified records to conceal the theft.
  • The owner of a medical supply company in Los Angeles was convicted in a $4 million fraud scheme that involved billing Medicare for unneeded or never provided power wheelchairs and back and knee braces.
  • A podiatrist in California admitted submitting nearly $3 million in bogus claims. OIG Special Agent in Charge Gerald Roy said, "Providers overbilling and charging for phantom treatments are picking the pockets of taxpayers."
  • In Michigan, a doctor was imprisoned for seven years for fraudulent billing and writing bogus oxycodone prescriptions in a $2.3 million scam. Authorities said the illegal prescriptions fueled drug sales on the street.
  • A Detroit-area doctor was jailed for six years and must repay Medicare more than $2 million in an in-home physician services scam that he directed. The physician employed unlicensed workers who fraudulently posed as doctors -- and Medicare got the bill.
  • A husband and wife in New Jersey, owners of a mobile diagnostic testing company, admitted falsifying thousands of diagnostic reports in a multimillion-dollar healthcare fraud scheme. Despite having no medical license, one of the owners interpreted and wrote reports on patients, knowing that the reports would be used by doctors to make patient treatment decisions. To make the reports appear legitimate, the owners forged doctors' signatures. The couple were paid more than $4.3 million by Medicare and private insurance companies for the fraudulent reports. The money was used for personal expenses, including multiple residences and luxury vehicles.
  • A compounding pharmacist in New Jersey was jailed for 20 months for health care fraud and paying kickbacks for referrals. The man was also ordered to pay more than $1 million in criminal restitution, forfeiture and civil penalties. And he is to pay $160,000 in a civil settlement with OIG.
  • Two pharmacies, a pharmacist and two others were charged in a multimillion-dollar drug distribution scheme in New York. The defendants are accused of illegally distributing more than 500,000 oxycodone pills with a street value between $10 (million) and $15 million over five years. The defendants were also charged with money laundering and healthcare fraud.
  • A New York doctor was jailed for nearly four years in a New Jersey bribes-for-referrals lab scheme and must pay $425,000 in fines and forfeiture.
  • A New York doctor was convicted of allowing an unqualified employee, a nurse, to perform the duties of a physician.
  • Two respiratory therapists and three nurses, all former nursing home workers in New York, were jailed in the death of a 72-year-old patient and a subsequent cover-up.
  • Two former group home workers in New York were convicted of endangering developmentally disabled residents.
  • A physician's assistant in New York was charged with issuing prescriptions for pills that were to be exchanged for cash.
  • A New York nurse admitted defrauding Medicaid of more than $8,000. She billed for private nursing services that were never rendered.
  • In New York, the owner of an athletic club must repay more than $57,000, was put on three years' probation and ordered to serve 100 hours of community service for filing fraudulent healthcare claims with private insurers.
  • A Mississippi couple entered a guilty plea in Tennessee in a $400,000 medical equipment Medicare fraud scheme.
  • The CEO of a Chicago healthcare company pleaded guilty to fraudulently billing Medicare $1.8 million. In a plea agreement, he admitted that he personally altered patient files so the now-defunct company could fraudulently bill several patient visits to Medicare at the highest possible level, which is known as "upcoding."
  • A home health company office manager in New Orleans was jailed for four years and must repay more than $14 million in a Medicare fraud scheme that included kickbacks to patient recruiters and false bills.
  • A Miami-area pharmacy owner was jailed for 3 1/2 years and must repay more than $1.5 million in a Medicare Part D false billing scheme. The scam included unneeded and never provided prescriptions, which were not prescribed by a doctor, and misused beneficiary and physician Medicare identification numbers.
  • A Florida couple were charged with billing Medicaid more than $40,000 for durable medical equipment that was never given to beneficiaries.
  • A gynecologist in Florida was charged with billing Medicaid for medically unneeded procedures and drugs as well as services that were never rendered.
  • A Florida contractor was charged in a $100,000 Medicaid fraud; authorities assert that he billed for work that allegedly resulted in safety hazards.
  • Five in Missouri were charged in home health care fraud cases; each was accused of falsely billing Medicaid. Two of the five defendants have entered guilty pleas.
  • A North Carolina Medicaid provider admitted using stolen beneficiary information to file fraudulent claims in a $2 million scam.
  • The president of an ambulance company in North Carolina pleaded guilty to perjury in an investigation of false healthcare claims.
  • Five former owners of a clinical laboratory in Kentucky were charged with billing for medically unneeded or ineligible urine drug tests.
  • A Tennessee woman was charged with selling the painkiller hydrocodone that she obtained through Medicaid.
  • The owners, nursing director and patient recruiters of a Texas home health agency were charged in a $13 million healthcare fraud conspiracy. The owners allegedly billed Medicare for unneeded or never rendered services. Authorities also allege that the scam included kickbacks to doctors, the recruiters and beneficiaries.
  • In Houston, three more defendants, including a man authorities said was practicing medicine without a license, were charged in a wide-ranging $12 million conspiracy to commit healthcare fraud, which allegedly included paying kickbacks to patients in return for information that was used to bill Medicare and Medicaid for medically unnecessary tests. Six others were charged earlier.
  • A Houston man admitted paying Medicare beneficiaries so that he could use their information to file $6.6 million worth of false claims.
  • A Utah equipment provider will spend five years behind bars after pleading guilty to healthcare fraud conspiracy involving power wheelchairs. The scam included altering records to make it appear that Medicare coverage rules were met.
  • A former National Institutes of Health employee admitted fraudulently charging more than $21,000 on her government credit card in 16 days, purchasing a laptop computer, a video game console, a ring and other items. To conceal the scheme, the woman falsely reported that her credit card had been lost. She agreed to a forfeiture and to pay restitution of at least $22,338.67. Sentencing is scheduled for March.

From October

From September

From August

  • An Oklahoma health center is to pay $825,000 to settle civil allegations of false Medicaid billing.
  • A Chicago-area healthcare company CEO was charged with billing Medicare $1.2 million for fraudulent or nonexistent services to the elderly.
  • A Minnesota nursing home is to pay nearly $180,000 to resolve OIG claims linked to the employment of an individual who had been excluded from participating in federal health care programs.
  • A New Jersey doctor admitted billing for bogus office visits and altering patient records in a nearly $300,000 fraud scheme.
  • A New Jersey doctor who took more than $189,000 in bribes for lab referrals was sent to prison for 21 months, and he must forfeit over $207,000.
  • A New Jersey pediatrician was jailed for 21 months after billing Medicaid for bogus treatments; he is to repay more than $196,000.
  • Two New York doctors are together to pay more than $1.1 million to resolve civil claims that they performed medically unnecessary nerve conduction studies and billed Medicare for them.
  • A New Jersey ambulance provider - previously barred from Medicare participation - pleaded guilty in a fraud case.
  • An ex-nursing home worker in New York was charged with theft of thousands of dollars from a resident.
  • A home care agency clinical director in Massachusetts was convicted in a multimillion-dollar Medicare fraud scheme that included bogus certifications that care was needed, false billing and money laundering.
  • The owner of three Los Angeles clinics entered a guilty plea in a $4.5 million scam involving kickbacks, bogus tests and services, false documentation and false billing.
  • Three defendants were convicted in Los Angeles of billing Medicare at least $2.4 million for unneeded ambulance trips and for falsifying records.
  • A California oncologist paid $736,000 to settle allegations of improper billing for drugs from foreign distributor.
  • An Arizona doctor is to pay nearly $208,000 to settle civil claims of false billing for prostate procedures.
  • A Maryland doctor admitted writing prescriptions in the names of his patients and keeping the drugs for his own use.
  • A Nevada man was sentenced for billing Medicaid for services not rendered and misusing the provider identification numbers of others.
  • A South Carolina doctor and firms he founded were convicted of using millions in federal grant money for purposes other than research.
  • A Texas doctor was jailed for 10 years after taking part in a Medicare medical-tests billing scheme; he is to repay more than $1 million.
  • A Texas woman admitted taking part in a $5.5 million healthcare fraud scheme. She misused provider and beneficiary ID numbers to cheat Medicaid.
  • In another Texas case, a woman admitted using provider and beneficiary IDs to submit to Medicaid more than $1.5 million in fraudulent billing for psychotherapy.
  • A doctor's assistant was convicted in Texas of taking part in kickbacks-for-referrals scheme.
  • A former chiropractor in Louisiana, who billed for services, tests and supplies that were not delivered, and who is already in jail on another conviction, was sentenced to serve an additional two years and repay more than $183,000.
  • A New Orleans personal care services provider was accused of submitting false timesheets and service logs for Medicaid reimbursement.
  • A Kansas man, who billed Medicaid for personal care services to his grandmother that were not provided, entered a guilty plea and was ordered to pay restitution.
  • The owner of an Oklahoma City company was imprisoned for three years and must repay Medicare $2.5 million in a hospice scheme.
  • A Miami-area pharmacy owner admitted taking part in a $1.6 million Medicare scam; she stole or bought IDs used to bill for bogus prescriptions.
  • A Florida woman was charged with billing Medicaid more than $10,000 for unauthorized services.
  • The administrator and assistant administrator of a Florida assisted-living facility were sentenced after convictions on abuse and neglect charges.
  • A Tennessee woman was charged with Medicaid fraud involving alleged "doctor shopping" to obtain controlled substances.

From June

  • OIG noted in one review that New Jersey improperly claimed an estimated $8.4 million dollars from Medicaid for hospice services that did not meet requirements.
  • In a separate study, OIG found that Texas claimed $3.9 million dollars in unallowable federal reimbursement for some Medicaid physician-administered drugs.
  • Pharmacy benefit manager Medco is to pay $7.9 million to settle claims that it engaged in a kickback scheme with drugmaker AstraZeneca.
  • A skilled nursing facility in Texas is to pay nearly $78,000 to settle OIG allegations that it billed for services provided by an excluded provider.
  • Friendship Home Healthcare, based in Tennessee, is to pay $6.5 million to settle allegations of false claims to Medicare, Medicaid and TRICARE. The company allegedly forged documents and billed for the services of an excluded healthcare provider.
  • Two durable medical equipment suppliers are to pay $7.5 million to settle allegations of false claims. Authorities said that power wheelchair and accessory sales representatives altered prescriptions and other records to get healthcare claims paid.
  • A Georgia hospital is to pay more than $595,000 to settle claims that it paid an obstetric clinic for referrals of undocumented pregnant women.
  • A Michigan doctor admitted his role in billing Medicare $4.2 million dollars for in-home physician services that were performed by unlicensed workers.
  • A Tulsa physician is to pay $105,000 to settle civil claims that he billed for services of unlicensed employees.
  • A Pennsylvania doctor accused in a drug distribution case is now also charged with causing a death linked to oxycodone.
  • A Pennsylvania doctor was sent to jail and must pay restitution for filing false tax returns and fraudulent healthcare claims.
  • In a self-disclosure case, a health center in Pennsylvania is to pay $270,000 for employing an excluded individual for seven years.
  • Two doctors who each took more than $100,000 in bribes for referrals in a massive New Jersey laboratory scam were given 20-month jail terms. Together, the two doctors must also pay $236,000 in fines and forfeitures.
  • A New Jersey cardiology practice is to pay $3.6 million to resolve allegations that it billed for medically unnecessary tests.
  • The owner of a New Jersey diagnostic testing facility was jailed for 12 months in a scheme to bill for services not rendered and to enable a cardiologist to evade Medicare's pre-payment review of his claims.
  • Five medical practitioners were charged with taking bribes for referring patients to New Jersey imaging centers.
  • The Mayor of West New York, N.J., was charged with taking about $250,000 for referrals to medical imaging centers.
  • Two Connecticut ambulance companies are to pay $595,000 to settle civil claims that they improperly billed Medicare and Medicaid.
  • A Massachusetts woman was sent to jail for defrauding Medicaid and filing fraudulent insurance claims.
  • A New York doctor who illegally dispensed controlled substances and billed for services not rendered was jailed for 18 months.
  • A New York woman admitted submitting phony timesheets claiming care of disabled daughter by two of her other daughters. Surveillance video taken by state attorney general's office was used to prove that care paid for by Medicaid was not rendered.
  • Four New York nurses were charged with failing to properly monitor a disabled patient, who was hurt in a fall. The nurses were also charged with falsifying documentation.
  • A nurse in New York was charged with falsifying medication records to conceal neglect of four patients.
  • A Maryland nurse was charged in New York with using forged prescriptions to illegally obtain narcotic Percocet.
  • Six New York home health aides were charged with defrauding Medicaid; authorities alleged that credentials were faked and that identities were stolen.
  • A New York woman was accused of misrepresenting educational credentials to get a community center job in a $13,000 Medicaid scam.
  • A Missouri personal care aide who submitted bogus timesheets is to pay more than $20,000 in a civil false claims case.
  • A Chicago-area pharmacist was charged in a $2.4 million false billing scam; the case included allegedly fake prescriptions, prescriptions billed but not dispensed and prescriptions switched out for less-expensive supplements instead of FDA-approved drugs. Authorities also assert that the pharmacist obtained physician-sample drugs and submitted claims for dispensing them as if he had obtained them through commercial distribution channels.
  • The former owner of a healthcare company in the Chicago area, who billed for respiratory therapy never provided, was jailed for more than six years and must forfeit over $2.5 million.
  • A Chicago-area psychologist admitted filing $1.1 million in false, inflated claims, including for services to deceased patients.
  • An Illinois personal care aide is to pay more than $25,000 for fraudulently billing Medicaid.
  • Two defendants were sentenced to long prison terms in Idaho for trafficking in tens of thousands of oxycodone pills and heroin.
  • 16 defendants in Maryland were charged with conspiring to run "pill mills" out of purported pain clinics.
  • A Tennessee man was charged with selling prescription drugs that he obtained through Medicaid.
  • Two from the Los Angeles area who bilked Medicare by billing nearly $2 million for unneeded power wheelchairs were convicted.
  • The owner of a Los Angeles medical supply company was jailed for seven years in a $3.3 million Medicare fraud scheme that included medically unnecessary wheelchairs and cash kickbacks for fraudulent prescriptions; more than $1.7 million in restitution was ordered.
  • An Atlanta dentist is to pay more than $324,000 to settle civil allegations that he fraudulently billed Medicaid. Authorities said the dentist "upcoded" and fraudulently billed for work done by an assistant.
  • A dentist in Alabama was charged with billing Medicaid for services not rendered, improperly done or not performed at all.
  • Authorities contend that a Florida neurologist knowingly misdiagnosed patients, which prompted billing for allegedly unneeded services and drugs that were administered to patients. The doctor has agreed to pay $150,000 to resolve False Claims Act allegations.
  • A Florida oncologist was charged with buying unapproved drugs, giving them to patients and fraudulently billing Medicare.
  • A South Florida business owner agreed to be excluded as a provider from federal healthcare programs for five years and divest herself of five businesses to settle OIG claims of a kickbacks-for-referrals scam.
  • The United States is suing a Florida ambulance company, alleging a 10-year false claims/kickbacks scheme.
  • A Floridian was sent to prison for six years in a $350,000 pharmacy scam that included bogus prescriptions, prescriptions for dead patients and identity theft.
  • Two Florida women were charged with fraudulently billing Medicaid $94,000; bogus services and phony records were alleged.
  • The Carlsbad (N.M.) Mental Health Center and four top employees were charged with Medicaid fraud and conspiracy.
  • A mental health counselor in South Dakota admitted filing Medicaid false claims; he paid more than $28,000 in fines and restitution.

From May

  • Several Florida hospitals and an ambulance company are to pay $7.5 million to settle allegations that they took part in a medical transport scam.
  • A transportation company owner in New York was jailed and must repay more than $200,000 after doctoring forms to get higher Medicaid payouts.
  • A Philadelphia Medicare beneficiary admitted taking kickbacks as inducement to take part in ambulance fraud scheme.
  • A Miami doctor was jailed for five years in a $5.5 million Medicare scam; bogus records that he signed led to 2,800 false claims.
  • A Georgia health system is to pay $2.9 million to settle claims of inaccurate coding that led to improper billing.
  • Also in Georgia, a county hospital authority and nine doctors are to pay $520,000 to settle civil allegations of false claims to Medicare and Medicaid.
  • In North Carolina, a pharmacy company agreed to pay more than $5 million to settle claims that it improperly handed out gift cards to and waived co-pays for Medicare and Medicaid patients.
  • A Massachusetts doctor was charged with illegally prescribing opioids, including allegedly unnecessary prescriptions for at-risk patients.
  • A former Tufts New England Medical Center clinical care technician was charged with stealing the painkiller Dilaudid from intensive care patients.
  • A former Massachusetts provider is to pay $94,000 to settle claims that it billed Medicaid for habitation services that were not provided.
  • A Maine nursing home operator is to pay $300,000 to settle allegations of inflated Medicare physical therapy claims.
  • A Connecticut fraud enforcement official - a director of investigations - was charged with wire fraud.
  • A Maryland pharmacy owner was sentenced for healthcare fraud and trafficking in misbranded drugs and contraband cigarettes.
  • A home care company owner in Missouri is to pay a civil judgment of more than $120,000 in a Medicaid false claims case.
  • Three Missourians were charged with billing Medicaid for five months of personal care services that were not rendered.
  • A New York pharmacy technician admitted posing as a doctor to get narcotics illegally and using Medicaid to pay for them.
  • A New York nurse stands accused of diverting narcotics from a nursing home for her own use; authorities assert that she indicated the drugs had been given to patients.
  • An EMT in New York who used a charity "as his own personal piggy bank" was jailed and must repay more than $300,000. The defendant used the money he stole for travel, a luxury care service and theater tickets.
  • An executive of a New York nonprofit admitted using bid-rigging and kickbacks to steal from a program that helps seniors and the disabled.
  • A nurse's aide in New York was accused of striking a nursing home resident in her care.
  • A nurse's aide in Mississippi was charged with making a patient's pre-signed $500 check payable to herself.
  • A New Jersey woman was jailed for three years after lying to an insurer and submitting more than $500,000 in fraudulent claims.
  • A former home health aide in New Jersey was sentenced to three years in jail and must repay more than $12,000 for billing Medicaid for services he did not render.
  • The United States filed a civil fraud lawsuit against a Pennsylvania couple, alleging that they concealed the husband's exclusion as a healthcare provider while he ran a medical supplies firm.
  • The doctor/owner and an employee of a medical house call service in Dallas were charged in a $5.2 million Medicare fraud scheme. Authorities said the pair billed for services performed by an unqualified provider or not rendered at all.
  • A Houston doctor and a group home owner were indicted in another $5.2 million scam, this one involving alleged kickbacks and false billing.
  • A former health clinics CFO in Alabama admitted taking part in a scheme to defraud the federal government of millions of dollars; she must forfeit more than $900,000. Sentencing is set for September.
  • Four in Louisiana stand accused of Medicaid fraud; authorities said the defendants submitted false timesheets and service logs for care not rendered. The caregivers were charged with billing for services purportedly rendered while the beneficiaries were on a cruise.
  • And a Louisiana woman was jailed for 27 months and must repay nearly $1 million after fraudulently billing Medicare for psychotherapy services.
  • Eight people in Tennessee were charged with obtaining drugs through Medicaid, then selling them.
  • A Tennessee woman was accused of duplicating prescriptions for the painkiller hydrocodone and using Medicaid to pay for the forgeries.
  • In Idaho, a former pharmacy technician who stole and sold controlled substances was put behind bars.
  • And an Idaho dentist was jailed and fined for billing Medicaid for services he did not render.
  • The United States joined a California whistleblower lawsuit that alleged sleep clinics owners falsely billed Medicare for diagnostic tests.
  • A California nurse who owned a medical supply company was imprisoned for four years and must pay more than $4 million in restitution for her role in an $8.3 million Medicare fraud scheme. Authorities said the nurse paid kickbacks to get fraudulent prescriptions, then billed Medicare for medically unnecessary supplies, including power wheelchairs.
  • In another California case, a woman whose fraudulent wheelchair claims cost Medicare more than $3 million was imprisoned for 6 1/2 years, and restitution was ordered.
  • A Washington, D.C.-area equipment firm is to pay $300,000 to settle allegations that it overcharged Medicaid for power wheelchairs.
  • The administrator and biller of an Illinois physician group were convicted in a $4.5 million Medicare false claims scheme that included claiming to render services to patients who were dead.

From April

  • An Illinois home health agency was excluded from participation in federal healthcare programs; it employed a nurse barred from those programs, OIG alleged.
  • The United States has sued HCR ManorCare; the skilled-nursing chain allegedly rendered, then billed for, unneeded care.
  • In a self-disclosure, a Pennsylvania continuing-care retirement center is to pay more than $1.3 million to settle allegations that it billed for services that were not certified by a doctor.
  • The owner of two Detroit home health companies entered a guilty plea in a $12.6 million Medicare scam that included kickbacks and bogus services.
  • A Detroit-area home health agency owner pleaded guilty to fraud and money laundering in a $2.6 million Medicare scheme. False claims in the case were based on referrals linked to kickbacks that were paid to recruiters and doctors.
  • A Michigan doctor and three employees were charged with billing Medicaid for physician services performed by unlicensed workers.
  • A $29 million Michigan Medicare fraud conspiracy resulted in three long prison terms and court-ordered restitution of millions of dollars.
  • A Rhode Island home care company owner was charged with Medicaid fraud and stands accused of employing unlicensed nursing assistants.
  • An Oklahoma counselor was jailed for five years and must repay $194,000 in a false billing case; the counselor had claimed to work 24 hours in one day.
  • A Missouri pharmacist entered a guilty plea in a Medicaid prescription fraud scheme.
  • A Mississippi woman was charged with falsely claiming to be licensed physician assistant in an alleged $300,000 Medicaid scam.
  • A Florida man, a former employee of a care center, was charged with abusing a disabled adult, who sustained a broken neck.
  • Four people were charged in Florida with using gas cards and temporary housing to entice the homeless to cheat Medicaid.
  • The former office manager of a Miami rehabilitation center was convicted of writing fraudulent patient evaluations and falsely billing Medicare $3.3
  • A dentist who was a "front" for an excluded provider in Connecticut pleaded guilty in multimillion-dollar Medicaid fraud case.
  • An office manager in New York who stole more than $11,000 from assisted-living residents was jailed, and restitution was ordered.
  • A New York nurse was charged with stealing oxycodone pills for her own use from a nursing facility's emergency supply of patient pain medications.
  • A New York nonprofit serving people with disabilities is to repay Medicaid more than $363,000. The state said the provider used unqualified staff.
  • A New York EMT who used a charity "as his own personal piggy bank" was jailed and must repay $300,000. He used the money he stole for travel, theater tickets and use of a luxury car service.
  • A Maryland autism services provider agreed to pay $58,000 to resolve allegations that it billed for services that were never rendered.
  • A medical equipment provider in Nevada was sent to jail and must pay more than $21,000 for false claims, theft, records violations and ID misuse.
  • A Kentucky dentist admitted billing Medicaid for exams he didn't provide to patients; restitution was ordered.
  • Two direct-care workers in Louisiana were charged with billing Medicaid for healthcare services they did not render. One was accused of submitting false service logs and phony timesheets; authorities allege that the other submitted bogus service logs and double-billed the program.
  • Two defendants - one a Medicaid worker - were charged in Puerto Rico with records theft and aggravated identity theft.
  • A Utah cancer clinic admitted receiving and delivering misbranded drugs; the investigation found no evidence that patients were harmed, prosecutors said.
  • The owner of a respite center in Alaska was jailed for altering medical records that were requested as part of an audit.

From March

  • A California pharmacy agreed to pay more than $1.3 million to settle OIG allegations that it submitted fraudulent Medicare Part D claims.
  • In Los Angeles, a druggist admitted that he paid Medicare beneficiaries to fill prescriptions at his pharmacy in $644,000 scheme.
  • An oncologist in California agreed to pay $550,000 to settle allegations that he bought drugs from a company that did not have a license to distribute them in the United States, administered those drugs to his patients, then billed Medicare and others for the medications, some of which were not approved by the Food and Drug Administration.
  • A Colorado skilled nursing facility is to pay more than $242,000 to settle OIG allegations that the facility employed an excluded nurse.
  • An Alabama doctor and his practice are to pay $225,000 to settle OIG allegations of false claims for in-office testing.
  • An Alabama medical center settled OIG claims that the hospital failed to accept the transfer of patient who needed emergency surgery.
  • A Kansas hospital is to pay $45,000 to settle an OIG claim of inadequate screening of a woman whose baby was later stillborn.
  • A Tennessee hospital settled OIG allegations that the facility failed to treat a patient who was in severe pain with broken bones.
  • A Kentucky hospital settled OIG allegations that the facility failed to evaluate or treat a patient who had lost consciousness.
  • The Adventist Health System is to pay $5.4 million to resolve allegations that it rendered services not directly overseen by qualified employees. Adventist operates a large network of hospitals in the South and the Midwest.
  • A West Virginia compounding pharmacy and its pharmacist-owner, a Medicare beneficiary, admitted defrauding Medicare and Medicaid by dispensing less expensive compounded and generic drugs while billing for more expensive brand-name drugs and billing for drugs that were never dispensed or were expired.
  • A New York physician admitted false billing for unneeded treatments in a $14.2 million Medicare scam; the doctor is to repay more than $5.3 million, which is what Medicare paid as the result of the fraudulent claims.
  • A New York pharmacist was charged in a $5 million billing fraud; authorities allege that prescriptions were never dispensed to Medicare/Medicaid patients.
  • Another New Yorker admitted defrauding medical providers in a $200,000 insurance scheme. The man sought emergency room care and demanded a painkiller, then pocketed insurance payouts meant for healthcare providers.
  • A New York skilled nursing facility operator is to pay $3.5 million to resolve allegations of inflated claims for rehab therapy.
  • A former New York office manager who stole more than $11,000 from assisted-living residents was jailed, and restitution was ordered.
  • An Arkansas medical center is to pay $2.7 million to resolve civil allegations that it submitted improper short-stay patient claims.
  • A Georgia couple admitted falsely billing Medicaid for children's therapy; restitution of more than $1.4 million was ordered. Georgia Attorney General Sam Olens said the husband and wife "shamelessly took advantage of low-income families to scam Georgia Medicaid and line their own pockets."
  • A New Jersey drug repackager and company executives were charged with distributing oncology drugs contaminated with mold.
  • A doctor in New Jersey was charged with healthcare fraud. Authorities alleged that he billed for office visits that never occurred and altered patients' medical records to conceal the scheme.
  • Another New Jersey doctor was charged with running a "pill mill" and attempting to burn the building down to destroy his records.
  • A physician assistant admitted taking $72,000 in bribes in a massive lab referrals scheme in New Jersey.
  • A Maryland woman who posed as physician assistant -- treating patients and writing prescriptions - was sent to jail for three years. She used stolen identification to get a job at a pediatrician's office.
  • A Philadelphia doctor already charged in a "pill mill" case was indicted on 23 more counts of illegal drug distribution.
  • A heart-monitoring company in Pennsylvania is to pay $6.4 million to resolve claims that it overbilled for unneeded mobile cardiac services.
  • Two from Miami were each jailed for six years in a $63 million fraud scheme that included bogus records, forgery and false claims for intensive mental health treatment.
  • Three men were charged in Florida in an $11 million multistate drug diversion scheme. Authorities said the alleged scam centered on buying drugs from Medicaid beneficiaries and reselling them. Thousands of dollars in cash, weapons and luxury goods were seized during the investigation, authorities said.
  • Three in Florida were charged with providing fraudulent home health prescriptions and plans of care, then billing Medicare and Medicaid more than $2.4 million.
  • Two Florida doctors and their wives are to pay $1.13 million to settle allegations that they took kickbacks in return for referrals. Authorities allege that the women took salaries for phony marketing jobs to induce their husbands to make patient referrals to a home health care company.
  • A Florida company is to pay $1.1 million to settle allegations that it paid doctors for Medicare patient referrals. Recovery Home Care, in West Palm Beach, is alleged to have paid dozens of physicians thousands of dollars each month to perform patient chart reviews. According to the government's lawsuit, the physicians were overpaid for any work they did, and, in reality, the payments were used to induce the doctors to refer patients to Recovery Home Care.
  • A Florida dermatology practice is to pay nearly $800,000 to settle claims that it "upcoded" some bills and illegally billed for cosmetic services.
  • A Florida provider was charged with Medicaid overbilling, billing for services not rendered and failure to provide documentation.
  • A Florida personal care aide was charged with abuse of a disabled adult. Authorities said the aide injured an assisted-living resident.
  • A Missouri in-home healthcare provider is to pay more than $150,000 to settle allegations that it submitted false Medicaid claims.
  • The owner and executives of a now-closed Chicago hospital were convicted in a referral kickback conspiracy -- paying hundreds of thousands of dollars to induce physicians to refer Medicare and Medicaid patients.
  • A suspended Illinois doctor, caught in an undercover investigation, was jailed for 18 months for illegally dispensing drugs and falsely billing Medicare. A judge ordered restitution as well as forfeiture of cash and three luxury cars.
  • Two Chicagoans were given long prison terms and must pay restitution in a $1.5 million psychotherapy services fraud case.
  • A Chicago-area nurse was charged with billing for unneeded services for ineligible patients obtained through illegal referrals.
  • An Illinois woman admitted billing Medicaid for personal care services that she claimed to have rendered while jailed.
  • Two were convicted in Detroit in $1.6 million home health scam that included kickbacks, false records and bogus services.
  • A Michigan psychotherapy clinic owner was imprisoned for more than seven years and must repay more than $1.4 million in a false billing scam.
  • A vision care center owner in Oklahoma is to pay $150,000 to settle allegations that he filed false and inflated Medicaid claims.
  • A Kansas personal care aide was sent to jail and must pay more than $250,000 for falsely billing Medicaid. The provider billed Medicaid for more than 750 workdays that each exceeded 24 hours.
  • A Nevada Medicaid provider was jailed and must pay $265,000 after submitting false claims.
  • A Medicaid provider in Kentucky admitted submitting false timesheets for services she didn't render; restitution of more than $8,000 was ordered.
  • Three from Tennessee were charged in a wheelchair and back brace scheme that targeted Medicare beneficiaries.
  • A Tennessee man was charged with 21 counts of "doctor shopping" for controlled substances paid for by Medicaid.
  • A convicted Louisiana physician and two medical practices with which he was associated are to pay $650,000 to settle civil False Claims Act allegations.
  • A couple was charged with cheating Medicaid out of more than $400,000 in a group home scheme in Louisiana.
  • A Louisiana woman, a former chief operating officer, was charged with running a scheme to place ineligible patients in hospice care.
  • The former owner of a Texas company pleaded guilty in a $5 million dollar fraud after he and his co-conspirators billed Medicare for unneeded or never provided medical equipment.
  • A Houston-area equipment firm owner was convicted in $3.4 million Medicare false claims case.

From February

  • A Georgia physician is to pay more than $305,000 to settle OIG allegations that he submitted false Medicare claims for in-office urine drug testing.
  • An Alabama hospital is to pay nearly $112,000 to settle OIG allegations that it employed an individual who had been excluded from participation as a provider in federal healthcare programs.
  • A hospital in Tennessee that allegedly transferred an unstable patient for insurance reasons reached a $40,000 settlement with OIG.
  • A group home in Arizona settled OIG allegations that it employed an excluded nurse.
  • Minnesota-based device manufacturer Medtronic is to pay $2.8 million to resolve civil allegations that it caused doctors to file false claims to federal healthcare programs for investigational medical procedures to alleviate chronic pain that were not reimbursable.
  • ev3, a Minnesota-based device maker, is to pay $1.25 million to resolve allegations of false Medicare claims for inpatient admissions.
  • A Midwest hospice chain is to pay $4 million dollars to settle allegations that it billed Medicare for ineligible patients.
  • Alleged kickbacks for referrals will cost a hospital physician organization in Massachusetts nearly $1.8 million.
  • A Kentucky physician is to pay more than a half-million dollars for treating patients with misbranded drugs and fraudulently billing Medicare.
  • A Kentucky optometry practice is to pay $800,000 to settle civil claims that it billed for worthless eye exams in nursing homes.
  • A Kentucky ambulance company is to pay $948,000 to settle civil allegations that it billed federal healthcare programs for medically unnecessary services over several years.
  • An Iowa home care company has agreed to pay $5.63 million dollars to settle allegations of false Medicare/Medicaid billing.
  • A drug wholesaler in Missouri was jailed for two and a half years and must pay a fine and forfeiture of $300,000 for smuggling misbranded and adulterated drugs into the United States.
  • Also in Missouri, a former chiropractor was jailed for 15 months and must repay $879,582; he billed Medicare for administering medically unnecessary nerve-block injections.
  • An unlicensed Detroit physician was convicted of taking part in a $4.69 million Medicare fraud scheme. He treated patients, wrote prescriptions and took cash for referrals.
  • A Texas chiropractor was jailed and must repay more than $126,000 in a Medicare false claims case.
  • A Texas couple was convicted in a $9 million fraud scheme that included billing Medicare for testing that was never done using the billing number of a doctor who was in jail.
  • An ambulance company owner in Texas admitted ID theft and billing Medicare and Medicaid for services that were not rendered. He could get more than 10 years in prison and pay as much as 550,000.
  • A California ambulance company general manager was jailed for six and a half years and must repay more than $1.3 million for his role in a $5.5 million Medicare scam that involved billing Medicare for ambulance trips for ineligible patients.
  • An Illinois doctor could get up to 140 years in prison after writing illegitimate prescriptions for controlled substances.
  • Six Floridians were charged in a $170,000 Medicaid fraud that allegedly included sneaky ways to overbill.
  • A Florida healthcare worker was accused of claiming 465 hours of respite care when she allegedly provided only 13 hours.
  • A Minnesota daycare owner admitted stealing childcare subsidies from the Department of Health and Human Services by inflating the number of children who received services.
  • A former CEO of two nonprofit health clinics for the poor and homeless in Alabama was charged in a 112-count indictment with defrauding agencies that received government funding.
  • A North Carolina couple was sentenced to a year's home detention and must pay more than $342,000 in a Medicare kickback scheme.
  • A Louisiana personal care agency owner and his wife were convicted in a $7 million Medicare false documentation case.
  • A Louisiana chiropractor admitted fraudulent billing for services not rendered or not authorized. He billed for bogus braces, X-rays and allergy tests and illegally used physician provider numbers.
  • A personal-care business bookkeeper was charged with stealing more than $42,000 from an elderly Louisiana Medicaid beneficiary.
  • A former operator of HIV/AIDS clinics in New York City pleaded guilty in $12 million fraud scheme.
  • Nurses at a Compassionate Care hospice in New York often missed visits with patients and faked files, authorities said, but Medicare and Medicaid were, nevertheless, billed for the services. Compassionate Care is to pay the United States nearly $5 million and the state of New York almost $1.7 million to settle the civil allegations.
  • A New York physician admitted illegally issuing prescriptions for controlled substances and healthcare fraud; he could get 11 years in prison.
  • A Medicaid worker in New York City was sent to jail for more than five years for diverting over a million dollars to his friends and to himself.
  • A New York nurse's aide admitted "Snapchating" and sharing an inappropriate photo of an elderly patient.
  • A New Jersey doctor who admitted billing Medicare and Medicaid for phantom physical therapy services is to pay $900,000. Sentencing, set for May 2015, could bring a term of as much as 10 years in prison.
  • Another New Jersey physician admitted that he fraudulently billed Medicaid for more than 1,000 procedures to repair wounds that he never performed. Authorities said the doctor made nearly $200,000 on the bogus treatments.
  • A Pennsylvania doctor and his receptionist were charged with running a "pill mill." Authorities said they used phony appointments with the doctor to exchange drugs for cash.
  • A Pennsylvania psychiatrist was charged with practicing and writing prescriptions on a suspended license, then billing Medicaid.
  • A Medicaid beneficiary from Philadelphia and her son and daughter were charged with billing Medicaid for bogus services, including at times when the son was in jail.
  • A former finance manager of a tribal clinic in Montana was convicted of embezzling more than $156,000 meant to be used to run the clinic. It was the second time she had been convicted of embezzlement.

From January

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