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2016: More News

OIG Update has expanded its coverage. Here is more news that you won't hear in the monthly podcast.
View news from 2015.

From December

  • Eyeland Optical Centers has agreed to pay more than $135,000 to settle allegations of false claims to Medicaid.
  • The operator of “clean and sober” residential facilities in Washington state was imprisoned for six years for drug trafficking.
  • Three people were given long prison terms in a $3 million home health fraud conspiracy in Cleveland.
  • A Michigan man admitted acting as an unlicensed doctor in a $6.3 million Detroit in-home physician services scheme.
  • A New Jersey woman admitted taking part in a $1 million Medicare scheme that deceived seniors into submitting to unneeded DNA tests. The woman paid kickbacks to healthcare professionals to fraudulently authorize the tests, and she wrongfully gained access to beneficiaries’ personal information.
  • The convicted owner of a New Jersey mobile testing company was sued over alleged violations of the False Claims Act.
  • A New York doctor was charged with accepting $65,000 in bribes for test referrals to a New Jersey clinical lab.
  • Three New Yorkers were charged with submitting more than $50,000 in false claims to Medicaid; bogus timesheets are alleged in the home-health case.
  • Three people in Virginia were charged in a healthcare conspiracy. Authorities said that a provider and the parents of a Medicaid recipient allegedly worked a deal that cheated the program. The indictment in the case says that the provider, with the knowledge of the child’s parents, submitted timesheets to two Medicaid contractors through which she was paid, claiming that services were being rendered, which they were not. The provider allegedly paid the parents about $200 every two weeks. According to the indictment, Virginia Medicaid paid the contractors more than $350,000 based on the timesheets, of which the provider received more than $200,000.
  • A Maryland man was imprisoned for more than 31 years in extortion related to a murder; the victim owed him money.
  • The manager of an assisted-living facility in Maryland admitted stealing IDs of elderly residents to get credit cards and using them to purchase more than $74,000 worth of goods.
  • A Dallas woman, targeted in a nationwide healthcare fraud sweep, is among five defendants to have pleaded guilty in Medicare fraud schemes involving physician house calls and home health care, authorities said.
  • A former executive with a nonprofit that provides Head Start services in Dallas admitted embezzling $115,000.
  • A nursing assistant in Florida was charged with Medicaid fraud and theft; authorities assert that she submitted timesheets for services not rendered.
  • Two Floridians were charged in a multimillion-dollar drug diversion scheme.
  • A home health agency administrator in the Miami area was convicted of conspiracy in a $2.5 million Medicare scheme. Authorities said the scam included bogus services, kickbacks to physicians and recruiters, and false claims.
  • A Florida orthopedic surgery practice is to pay more than $4.4 million to resolve civil allegations it filed questionable claims.
  • A Connecticut man admitted billing Medicaid for bogus psychotherapy services in a $1.6 million scam.
  • A Massachusetts resident was sentenced for defrauding Medicaid of about $82,000 while serving as a caretaker for his brother.
  • In separate cases, four Tennessee residents were charged with drug-related Medicaid fraud; a fifth was charged with theft of services.
  • A pain management physician in Georgia agreed to a consent judgment of $430,000 to resolve civil allegations that he billed for medically unneeded services.
  • An Iowa dental clinic and its owners are to pay more than $300,000 to settle allegations of unneeded or never-provided procedures.

From November

  • A New York man was charged with distributing fentanyl that caused a death and possession with intent to distribute fentanyl.
  • A New Yorker was charged with defrauding Medicaid, allegedly by billing for sham substance abuse treatment. Authorities said the clinic owner induced patients into bogus treatment and pocketed millions of dollars.
  • A New York medical practice is to pay $5.31 million to resolve a civil fraud lawsuit alleging false claims to Medicare and Medicaid. Authorities contended that the practice unlawfully waived copayments routinely and fraudulently billed Medicare for them. It was also alleged that false claims were systematically submitted for services that were not provided or were not permitted under Medicare and Medicaid rules.
  • Another New Yorker admitted falsifying timesheets for home health services that were never provided.
  • A physician in New Jersey, who admitted concealing more than $3.6 million to evade taxes and paying kickbacks for referrals, also had his medical license revoked after the New Jersey Board of Medical Examiners found that he indiscriminately prescribed a spray form of the painkiller fentanyl, endangering the health and welfare of his patients. Sentencing is scheduled for early in 2017.
  • A cardiac monitoring company in New Jersey is to pay more than $1.35 million to settle allegations of kickbacks to physicians.
  • Three former district managers for Warner Chilcott were sentenced in a scheme designed to boost sales of the firm’s osteoporosis drug.
  • CleanSlate addiction treatment centers is to pay $750,000 to resolve civil claims of unlicensed prescribing and improper billing. Clean Slate operates 17 clinics in Massachusetts and other states.
  • A licensed occupational therapist in California admitted taking part in a $2.6 million scam involving services not provided.
  • A Californian who operated physical therapy clinics was convicted of defrauding Medicare of millions of dollars.
  • A doctor in California was found guilty of “structuring” – making nearly $500,000 in cash deposits to avoid financial transaction reporting rules.
  • In Nevada, two Medicaid providers were jailed, and they paid more than $18,000 in restitution; authorities said the providers billed for services never provided.
  • In a self-disclosure, Einstein Healthcare Network and Einstein Practice Plan in Pennsylvania are to pay nearly $1 million to settle allegations of improper billing.
  • A Marylander pleaded guilty to misusing a Social Security number to fraudulently get a medical license. Authorities said the man used four Social Security numbers under three names.
  • A Massachusetts provider of adult day healthcare is to pay more than $200,000 to resolve allegations of false Medicaid billing.
  • A husband and wife in Missouri were charged in a 40-count indictment, alleging a million-dollar-plus healthcare and payroll tax fraud. The dental clinic case includes alleged billing for devices and services that did not meet Medicaid requirements.
  • A Kansas home health agency and its owner are to pay nearly $2 million to settle allegations of kickbacks for referrals.
  • A counseling services provider in Georgia was convicted in $3 million Medicaid false billing scam that included creating fraudulent records and patient recruiting.
  • A Florida oncologist was convicted of buying unapproved cancer medications from foreign sources and defrauding Medicare. The doctor falsely indicated that Food and Drug Administration-approved versions of the medications had been administered, when she knew that misbranded drugs had been given to patients. Authorities said the physician intended to generate profits from the difference between the Medicare reimbursement rates for the FDA-approved drugs and the discounted prices of the misbranded versions.
  • The former owner of a Miami pharmacy was found guilty of stealing doctor and beneficiary Medicare IDs and fraudulently billing $700,000.
  • Two Florida pharmacies together must pay $750,000 to settle allegations that they billed for never-dispensed prescription drugs.
  • Ten owners of assisted-living facilities in Florida were charged in a 30-count indictment with fraud and taking kickbacks.
  • A Miami resident was charged in a Medicaid drug diversion and money laundering scheme.
  • A home health agency owner, operating out of Houston, was convicted in a $13 million Medicare fraud conspiracy that included kickbacks, money laundering, false records and false claims.
  • A Houston ambulance company owner was sent to prison for 30 years in $1.3 million Medicare/Medicaid fraud scheme. Authorities said the scam included bogus records, forgery and fraudulent billing.
  • A Texas man admitted posing as a nurse, using the license number of someone with the same name as his. While representing himself as a licensed vocational nurse, he conducted patient home visits and provided medical services while working for healthcare company. The man pleaded guilty to aggravated identity theft.
  • A Kentucky cardiologist was convicted of billing for invasive procedures that were not medically necessary.
  • A former pharmacy manager in Tennessee admitted taking part in a $4.4 million Hepatitis C drug scheme that involved falsified records used to bill Medicaid.
  • A Tennessee woman was charged a second time with “doctor shopping.” Authorities say she went to several doctors in a short time to fraudulently obtain painkillers paid for by Medicaid.
  • Another Tennessee woman was also charged a second time with Medicaid fraud; “doctor shopping” for prescription drugs was alleged.

From October

  • OIG found that North Carolina claimed millions in unallowable school-based Medicaid administrative costs
  • Former executives of a major nursing home chain, American Senior Communities, were charged in a $16 million fraud and kickback scheme.
  • A mother and son admitted running a $16 million Medicare fraud scheme at two Miami pharmacies.
  • A Florida physician was charged in a $13.8 million Medicare false billing scheme; allegations include fraudulent authorization of unneeded treatment.
  • A Florida pain clinic is to pay $7.4 million to resolve civil allegations that it performed unneeded drug screening.
  • An eye center in Florida and its owner, a doctor, are to pay $1 million to resolve allegations that they violated the False Claims Act. Authorities allege: overbilling for visits to patients in nursing homes; billing for more than 12 hours and more than 20 hours of services in a single 24-hour period, with many of the procedures found to be medically unnecessary with little benefit to the patients; billing for procedures purportedly performed at the eye center while the doctor was out of country; and billing at the most profitable rates regardless of a procedure's proper billing code.
  • A former home health agency owner and manager in the Miami area was sent to prison for 20 years and must repay more than $36 million and forfeit the same amount. The $57 million false billing scheme included bogus services and kickbacks for referrals.
  • The owner of another Florida home health agency was convicted in a multimillion-dollar health care fraud and money laundering scheme.
  • In another home health case, this one in Illinois, a company owner admitted paying 20 medical directors nearly $800,000 in kickbacks for referrals. He also is to pay $6.8 million to resolve civil false claim and kickback allegations. He could receive a prison sentence of up to five years.
  • In Massachusetts, a home health agency was charged with defrauding the state Medicaid program of more than $800,000. Authorities contend that the agency overbilled and submitted false bills for unauthorized services that weren't rendered.
  • A Louisiana doctor was charged with illegally dispensing oxycodone and threatening to kill law enforcement officers.
  • Three Louisiana women were arrested on Medicaid fraud charges, accused of submitting falsified service documents.
  • Two New Jersey companies are to pay more than $12 million to resolve allegations that they used "cold calls" to sell expensive diabetic medical equipment and billed Medicare illegally for those products. Authorities said the alleged phone scheme violated the Medicare Anti-Solicitation Statute.
  • A physician in New Jersey was put behind bars for one year for taking thousands of dollars in cash bribes for referrals. The judge fined the doctor $1,000 and entered a forfeiture judgment of $25,000.
  • A New Jersey chiropractor was charged with accepting tens of thousands of dollars in illegal kickbacks.
  • A New Jersey optometrist was charged with submitting claims for medical services that were never rendered.
  • A former South Carolina hospital CEO is to pay $1 million and agreed to a four-year exclusion from federal healthcare programs. The case involved illegal payments to referring doctors, authorities said.
  • A medical practice in South Carolina entered a guilty plea and was given probation in a case involving misbranded drugs; and it agreed to pay $300,000 to settle a parallel civil case.
  • A Los Angeles nursing home and two doctors paid more than $3.5 million to resolve civil allegations that they took part in an illegal patient-transfer scam. Authorities allege that kickbacks were paid for referrals and that unneeded care was billed to Medicare and Medicaid. The alleged Skid Row scam moved people from hospital to nursing home and back "purely for profit," said OIG Special Agent in Charge Chris Schrank.
  • Three orthopedic clinics in California together are to pay $2.39 million to settle allegations of billing for products reimported from foreign countries. Reimported products are not reimbursable by federal and state health care programs.
  • A pharmacist in New York was sent to prison for 2 to 6 years and must forfeit more than $5 million for his role in a $150 million Medicaid scam that sold diverted HIV medications to unsuspecting New Yorkers.
  • Another New York pharmacist was jailed for 43 months in a Medicare/Medicaid and tax fraud case in which he billed for prescriptions he never dispensed to patients and filed false tax returns. The pharmacist was ordered to repay $2.7 million, forfeit the same amount and repay the Internal Revenue Service $736,000.
  • A New York hospital group is to pay nearly $3 million to settle a civil fraud lawsuit over repayment of Medicaid funds.
  • A podiatrist in Pennsylvania admitted scheming to defraud Medicare, Medicaid and private insurers in a $5 million fraudulent-billing case. The doctor acknowledged submitting claims for procedures that were not performed.
  • Also in Pennsylvania, a licensed professional counselor was charged with defrauding Medicaid of more than $100,000, allegedly submitting hundreds of claims for services that he never rendered.
  • Pennsylvania reached a $2 million settlement with a nursing home chain accused of misleading consumers by failing to render basic services to patients.
  • An ambulance company owner in Pennsylvania was sent to jail for 10 months and must repay Medicare nearly $67,000 for submitted false claims for transport.
  • In Texas, a physician was charged with seeking and obtaining kickbacks for patient referrals to home health agencies. The doctor is alleged to have signed forms for patients he did not treat and sent the forms to home health agencies, claiming he had provided treatment. Some of the patients were deceased on the dates on which the physician claims to have provided treatment or services, according to the indictment.
  • After his appeal, another Texas doctor was resentenced in a Medicare/Medicaid false claims case to more than 11 years in prison; he must repay more than $145,000.
  • A Houston doctor was ordered to federal prison for engaging in a conspiracy to defraud Medicare of more than $6.6 million.
  • In another Texas case, a medical equipment company owner and biller admitted billing for supplies not provided or not authorized by a doctor.
  • An Idaho doctor was sent to prison for eight years for illegally distributing controlled substances; he is to pay an $80,000 fine and forfeit $8,000.
  • A Connecticut pediatric dentist is to pay more than $1.3 million to resolve civil allegations that uncertified dental assistants took x-rays.
  • Another dentist, this one in Cleveland, was jailed for one year and must repay Medicaid nearly $344,000 in a fraudulent-billing case. He submitted claims for services that were not pre-authorized, as required, and/or were not provided. Court documents indicated that the dentist billed for an excessive number of fillings on the same teeth, when he had not done fillings, filed claims for fillings on teeth that had been pulled, and submitted claims for fillings on patients who had dentures.
  • A medical center in Arizona is to pay $5.85 million to resolve claims that it violated the False Claims Act by misreporting data. OIG Special Agent in Charge Christian J. Schrank said: "Falsifying records and extracting unwarranted funds from Medicare will be detected and stopped. Medicare funds are intended to care for patients, not line the pockets of providers who submit false claims."
  • A Tennessee pharmacist was charged with fraud. Authorities allege that he sold bogus prescriptions and billed Medicaid for medications that patients never received.
  • A Tennessee woman was charged with healthcare fraud; authorities alleged that she failed to accurately report household and income information so that she could qualify for Medicaid.
  • A Tennessee woman was charged with falsely claiming child as a dependent to obtain Medicaid insurance benefits.
  • A Tennessee resident was charged with Medicaid fraud, accused of "doctor shopping" for painkiller hydrocodone.

From September

  • The University of Connecticut Health Center has agreed to pay nearly $185,000 to settle allegations that it overbilled Medicare.
  • A doctor in Pennsylvania and his practice are to pay $930,000 to settle allegations that he and the practice submitted claims for services to nursing home residents that were not medically necessary, not authorized or requested by patients, not supported by patient medical records, or were provided in connection with improper standing orders.
  • A Pennsylvania physician admitted dispensing a controlled substance in exchange for cash and submitting false claims to Medicaid.
  • A previously convicted physician in Michigan is to pay an additional $200,000 to resolve False Claims allegations that he wrote prescriptions for unneeded controlled medications and billed for unnecessary services.
  • A Californian was jailed for 18 months for “laundering” more than $700,000 dollars in healthcare fraud proceeds. He is the final defendant to be sentenced in a multimillion-dollar healthcare fraud & money laundering case.
  • A New York man was charged with filing allegedly bogus timesheets for his girlfriend, an aide he had hired to care for a relative. Authorities said the care was not rendered, alleging that for some 500 hours in 2015 when the girlfriend was supposed to be caring for the relative she was working another job or the relative was in an adult day care program. On the basis of the timesheets, Medicaid was billed for about $9,000, authorities said.
  • A former group home worker in New York was charged with abuse; it is alleged that he bound a disabled resident so she couldn’t get out of bed.
  • In separate cases, four in New York have been charged with taking degrading photos and video of nursing home residents.
  • A part-time chiropractor in New York was charged with submitting false claims to Medicare.
  • A former employee of a pain clinic in Rhode Island was charged with fraud; patient records were falsified to get Medicare and other insurance payments, authorities said.
  • A Rhode Island nursing home operator is to pay $2.2M to resolve allegations of inflated Medicare claims.
  • A Chicago telemarketer was convicted of taking kickbacks for referring patients to home health agencies.
  • A Marylander was sentenced to a year in prison for conspiring in a scheme involving forged prescriptions.
  • A former nursing home worker in Florida was charged with financial exploitation of three elderly and disabled residents.
  • A Florida woman who worked at a group-homes company was accused of stealing more than $12,000 from seven different residents.
  • A Nevada woman is to pay more than $15,000 for creating false records supporting Medicaid services she did not provide.
  • A woman in Tennessee was accused of using Medicaid to obtain morphine, then selling some of it to an undercover officer.
  • A Tennessee woman was charged with selling prescription drugs she obtained through Medicaid.
  • Six defendants from Tennessee were charged with using Medicaid to fraudulently obtain prescription drugs.
  • A Tennessean was charged a second time with “doctor shopping” to obtain controlled substances.
  • A Tennessee man was charged with falsely reporting income and resources to obtain Medicaid benefits.
  • A social worker in Missouri admitted fraudulently billing Medicaid for therapy that was not provided; she is to repay $20,000.

From August

From July

  • The owner of two Alabama pharmacies agreed to plead guilty to obstructing a Medicare audit; he is to pay $2.5 million.
  • 10 companies and individuals in Texas are to pay $1.125 million to resolve civil false claims allegations linked to transport of Medicaid recipients.
  • A New Jersey doctor will spend a year in prison for taking more than $174,000 in bribes for referrals to a mobile diagnostic company. The physician is to pay more than $180,000 dollars in fines and forfeiture.
  • Another physician in New Jersey admitted taking thousands of dollars in bribes in return for referrals to two blood and DNA testing labs.
  • A nurse's aide in New York was charged with punching an 87-year-old nursing home resident in the face, causing multiple fractures.
  • A nurse's aide admitted using a credit card stolen from a nursing home patient in New York to go on a $5,000 spending spree.
  • A Massachusetts transportation company is to pay more than $700,000 to resolve allegations that it filed claims for unneeded wheelchair van rides.
  • An ambulance company owner in Pennsylvania admitted creating false documentation for services, then fraudulently billing Medicare.
  • An ophthalmologist in Massachusetts is to pay $55,000 to resolve allegations of false claims to Medicare.
  • A Kentucky doctor was charged with fraudulent possession of a controlled substance, wire fraud and making false statements.
  • Another physician in Kentucky admitted wire fraud, making false statements and devising a scam to illegally obtain prescription pain medications.
  • A U.S. District Court ordered a $4.5 million civil judgment against a Kentucky woman and her medical device companies in grant fraud case.
  • A group medical practice in Indiana was charged with giving patients unnecessary treatments and filing false claims. Among other alleged offenses, the practice was also accused of conspiring to dispense controlled substances in violation of the Controlled Substances Act.
  • A Georgia dentist was charged with filing false Medicaid claims, money laundering and trying to evade banking reporting rules.
  • Two Floridians - one with a doctorate in psychology - were charged in a $360,000 mental health therapy scam.
  • A certified nursing assistant, a home health aide and a caretaker for two patients were charged in Florida with defrauding Medicaid of more than $129,000; they are alleged to have billed for services not rendered.
  • A St. Louis personal care attendant routinely claimed that she rendered care to different Medicaid patients in their homes at the same times and on the same dates, causing Medicaid to be falsely billed for her services. The woman was ordered to pay $25,000.
  • An Alaska woman was charged in a $337,000 Medicaid scam; authorities say personal care services were claimed but not rendered.
  • A Nevada resident was sentenced for fraud; he admitted creating false college transcripts and using them to obtain status as a Medicaid provider.
  • A Tennessean was charged with "doctor shopping" to obtain prescriptions for oxycodone or clinical visits paid for by Medicaid.
  • A Tennessee woman must repay nearly $17,000 after admitting that she falsely reported income to obtain Medicaid benefits.
  • Two Louisiana nurses admitted fraudulently recertifying patients for home health care.
  • The Louisiana Medicaid Fraud Control Unit arrested six people on a number of Medicaid fraud charges, the state's attorney general announced.

From June

From May

  • New York City is to pay $4.3 million to settle civil claims linked to improper Medicare payments the city received for fire department ambulance transportation.
  • A hospital in Puerto Rico paid $2.5 million to settle a Medicare questionable-billing case; the hospital agreed to enter a compliance agreement with OIG.
  • Bon Secours Health System and an oncologist are to pay $400,000 to settle civil fraud allegations. Authorities contend that the oncologist used diagnosis codes indicating a breast mass was present when there was none.
  • The University of Pennsylvania is to pay $75,787 to resolve allegations that Penn Care at Home submitted claims to Medicare for services not rendered and for services that were not reasonable or necessary.
  • Three doctors in Pennsylvania were charged with selling prescriptions for commonly abused drugs in exchange for cash.
  • A doctor in West Virginia was imprisoned for eight years and must pay more than $63,000 in fines and restitution for illegally prescribing hydrocodone and filing fraudulent claims.
  • An adult day healthcare center in Virginia is to pay nearly $386,000 to settle allegations that it submitted false Medicaid claims.
  • Two Virginians were sentenced to jail for submitting false timesheets to Medicaid; together they must also repay more than $56,000.
  • A healthcare sales representative admitted obstructing a federal investigation; he falsely denied that he paid kickbacks.
  • An Illinois physician admitted overbilling Medicare and billing for treatment of patients who were already deceased.
  • An Illinois chiropractor admitted submitting $500,000 in false and fraudulent billing to Medicare, Medicaid, Tricare, the Federal Employees Health Benefit Program, Blue Cross Blue Shield of Illinois and Coventry Insurance for services not rendered. The submissions claimed that a physician had provided services to patients at the chiropractor's office. But the doctor was out of the country when the services were claimed to have been provided.
  • Two doctors in California were convicted of falsely certifying "patients" as terminally ill in an $8.8 million hospice fraud scheme.
  • Another doctor in California admitted submitting more than $2.4 million in fraudulent Medicare claims for office visits that never occurred.
  • A California oncologist and his wife, who was the doctor's office administrator, paid $300,000 to settle allegations that they billed Medicare for drugs from unlicensed foreign source.
  • A podiatrist in California was jailed for three years and fined $10,000 in a false billing scam.
  • Two Georgia dermatologists and their practice are to pay $1.9 million to settle allegations of false claims for some services.
  • A Georgia dentist was indicted in a healthcare fraud case; he allegedly received an overpayment of nearly $800,000.
  • 25 people from the Miami area were charged in three separate cases in a $26 million Medicare Part D pharmacy scam that, authorities allege, included sham pharmacy owners who were directed, among other things, to file fraudulent claims.
  • A Florida dentist was charged with billing Medicaid more than $14,000 for services not rendered, including for dead beneficiaries.
  • A Florida couple was jailed and must pay fines and restitution of more than $40,000 for Medicaid fraud and grand theft.
  • A medical technician in Florida was charged with physically abusing a mentally disabled patient.
  • A former care facility employee in Florida was charged with smashing a disabled adult's head into van window.
  • A Florida man who worked with the developmentally disabled was charged with punching a patient in the face.
  • A former caregiver at group home in Florida was charged with abuse of disabled adult, who authorities said was punched in the face.
  • Two former clinic owners in Houston were convicted in a $5.4 million Medicare fraud scheme. The case included bogus services, phony patient files and marketers who were paid to bring patients to the clinic.
  • An equipment company owner was convicted in a $3.2 million false billing scheme in the New Orleans area. The owner paid patient recruiters for the names and Medicare numbers of beneficiaries and used that information to bill Medicare, claiming falsely to have provided power wheelchairs, accessories and orthotics. The woman also billed Medicare as if she had provided patients with high-cost back and knee braces, when, in fact, they received much cheaper versions of the braces - a practice known as "upcoding."
  • The former owner of a Utah equipment company was jailed for five years and must repay $4 million in a Medicare scam involving power wheelchairs.
  • An Illinois chiropractor admitted submitting $500,000 in false and fraudulent billing to Medicare, Medicaid, Tricare, the Federal Employees Health Benefit Program, Blue Cross Blue Shield of Illinois and Coventry Insurance for services not rendered. The submissions claimed that a physician had provided services to patients at the chiropractor's office. But the doctor was out of the country when the services were claimed to have been provided.
  • An unlicensed New Jersey chiropractor was charged as the mastermind of an alleged $3.9 million fraud scheme.
  • The owner of a blood diagnostic company in New Jersey was jailed for nine months for paying a doctor cash for referrals.
  • A mother and daughter in New York, who were home care providers, were charged with submitting phony timesheets for care not rendered.
  • A certified nurse's aide in New York was charged in the theft of a nursing home patient's wedding ring.
  • A Missouri physician admitted that he knowingly misstated the significance of his patients' conditions to ensure that his healthcare claims would be paid. He is to pay restitution of more than $76,000 and surrender his medical license. A sentencing date had not been scheduled.
  • A former bookkeeper for a Missouri nursing home was jailed for five years for writing checks on residents' accounts and keeping the money.
  • A Philadelphia man was charged in a disability benefits fraud scheme that authorities said resulted in a loss to the Social Security Administration of $145,166.24 and a loss to the Department of Health and Human Services of $181,851.86.
  • A Philadelphia ambulance company owner was charged with making false statements in a healthcare matter; falsified reports are alleged.
  • A Tennessee undercover investigation resulted in 11 defendants being charged with selling prescription drugs paid for by Medicaid.
  • A Tennessee woman was charged with "doctor shopping" to fraudulently obtain controlled substances paid for by Medicaid.
  • A Tennessee man was charged with selling prescription drugs that were paid for by Medicaid.
  • A man from Tennessee was charged with fraud; authorities allege that he "hid" a relative's assets to make it appear that the family member was eligible for Medicaid benefits that would pay for nursing home care.
  • An Arkansas man was arraigned on charges of defrauding investors and the Department of Health and Human Services.

From April

From March

  • A North Dakota ambulance provider is to pay more than $300,000 to settle OIG allegations of false claims.
  • The former owner of two home healthcare companies in Florida is to pay $1.75 million to settle allegations of kickbacks to doctors for referrals.
  • A Florida businessman was sent to prison for 14.5 years and must repay more than $2.5 million in a fraud and money laundering scheme that included false billing, kickbacks and falsified and forged documents.
  • In another Florida case, an audiologist was sent to prison for nearly eight years after taking part in a multimillion-dollar healthcare fraud scheme; restitution of more than $2.5 million was ordered.
  • A Florida physician who participated in a Medicare Advantage plan purposely misdiagnosed patients to illegally increase payouts from Medicare.
  • A Miami clinic owner was sent to prison for nearly seven years and must forfeit more than $3 million in a Medicare fraud scheme that included sham clinic owners, kickbacks for prescriptions for home health care, bogus services and false claims.
  • A Florida couple were charged in a Medicaid fraud case with operating a clinic without a license or medical oversight, false billing, providing defective mammography services and forgery.
  • Drugmaker Endo and the state of New York reached an agreement under which Endo is to stop making false claims about the narcotic painkiller Opana ER. Endo must also create a program that will prevent its sales staff from promoting this powerful drug to healthcare providers who may be involved in the abuse and illegal diversion of opioids.
  • Jail time and restitution were ordered for a New York nursing home worker who admitted stealing from a patient trust account.
  • A Connecticut podiatrist must pay $618,000 for submitting false claims to Medicare and other insurers.
  • A Connecticut psychiatrist is to pay more than $400,000 to settle a lawsuit alleging false claims involving "upcoding," the use of a higher-paying code on a claim form showing a more expensive service, procedure or device than was actually used or was medically necessary.
  • A New Jersey physician who altered patient records and billed for bogus office visits was sent to prison for more than three years and must forfeit $280,000.
  • Another New Jersey physician was charged with accepting bribes for referrals to Biodiagnostic Laboratory Services. Authorities said that 39 defendants, including 26 doctors, have pleaded guilty in the $100 million scheme.
  • In another New Jersey case, a woman was put behind bars for 10 years for her role in a scheme to steal millions of dollars from elderly clients of a senior-care business.
  • Two defendants were sentenced in Nevada in a false claims case involving mental health services for children. Restitution of more than $60,000 was ordered.
  • A chiropractor in Kentucky admitted billing private insurers and government healthcare programs more than $200,000 for services never rendered, obstructing a federal investigation and witness tampering.
  • A Missouri chiropractor was sent to jail for more than four years and must repay over $2.2 million in a Medicare orthotics scheme that included false billing.
  • A Missourian who provided patients with used prosthetic legs but billed for new ones was sent to jail for 15 months and must repay $150,000.
  • Two from Kansas City, Mo., were charged with billing Medicaid for personal care services never provided.
  • Paige Industrial Services is to pay $450,000 to $675,000 to resolve allegations that it submitted false claims to the Department of Health and Human Services. Separately, the owner of a Paige Industrial Services subcontractor admitted unlawfully hiring illegal aliens.
  • Authorities have filed charges, alleging that a Maryland man, the manager of a care facility, stole elderly residents' identities to get credit cards and used the fraudulently obtained cards to buy goods worth more than $75,000.
  • A Maryland woman admitted conspiring in a prescription and healthcare fraud scheme to get controlled substances. She submitted 91 forged prescriptions in the name of a cardiologist who was not her doctor.
  • A Detroit-area doctor was jailed for nearly four years and must repay $2.7 million in a healthcare fraud scheme. The physician prescribed medically unneeded controlled substances and billed for bogus office visits and tests.
  • One North Carolina provider was jailed for more than three years for healthcare fraud and money laundering; he also must repay more than $2 million. Authorities said the man stole Medicaid recipients' information and used it to file fraudulent claims for services never rendered.
  • Five people were charged with Medicaid fraud in Tennessee; four of the cases involve prescription drugs, authorities said.
  • A pair of defendants in Tennessee were charged with "doctor shopping" to obtain prescription drugs.
  • In Idaho, two Californians admitted conspiring to distribute oxycodone and hydromorphone.
  • Eight people were charged in Puerto Rico with bribery, conspiracy, healthcare and mail fraud and aggravated identity theft. Authorities allege, among other things, that bribes were taken in exchange for certifications of Medicaid eligibility.

From February

  • OIG has updated its listing of provider self-disclosures. Visit our website for more information.
  • CVS is to pay $450,000 in a settlement with the Pennsylvania attorney general involving the alleged sale of expired drugs and other products.
  • A Philadelphia nurse was convicted of participating in a multimillion-dollar hospice scheme involving ineligible patients.
  • The Archdiocese of Philadelphia, Catholic Health Care Services is to pay $80,000 to resolve allegations tied to patient care and make improvements in the care of rehabilitation center patients.
  • The operator of an unlicensed assisted living facility in Maryland was charged with bank fraud, identity theft and elder abuse, authorities said.
  • A chiropractor was jailed for obstructing an investigation involving the District of Columbia Medicaid program.
  • A Florida woman was charged with financial exploitation of a senior citizen -- her mother. Investigators allege that the daughter received more than $5,000 to pay for her mother's care. But a review of bank records showed that the transferred money was not used for the benefit of the mother.
  • A Florida fugitive charged in a $170,000 Medicare fraud scheme was arrested in Texas.
  • A Florida woman was arrested for the third time in six months on charges linked to alleged Medicaid fraud.
  • A Georgia woman, a behavioral health provider, admitted submitting fraudulent claims to Medicaid. She was sentenced to two years in jail and must repay more than $659,000.
  • A husband and wife were sentenced in a $1.5 million medical equipment scam in California; one of the two was sent to prison for more than four years; restitution of more than $600,000 was ordered. The false billing scheme included kickbacks for referrals and for fraudulent prescriptions for power wheelchairs.
  • Members of a family were convicted in Las Vegas in a case of benefits fraud, which included cheating Medicaid.
  • An Idaho dental hygienist was charged with fraud and identity theft; she allegedly billed as if services were performed by a dentist.
  • A Boston dentist is to pay $650,000 to resolve allegations that she improperly used examination codes to overbill Medicaid.
  • A Massachusetts man admitted healthcare fraud: He wrongfully received Medicaid benefits.
  • A New Hampshire woman was sentenced to home confinement for Medicaid, Social Security and food stamp fraud; she must repay more than $60,000.
  • A woman in Louisiana was charged with identity theft, computer fraud and conspiracy to commit Medicaid fraud. Authorities asserted that she illegally downloaded the information of 13,000 Medicaid recipients from a managed care organization.
  • A Texas doctor pleaded guilty to illegally prescribing pain medications. In a related civil action, he is to forfeit nearly $4 million.
  • The owner of a Texas ambulance company was sent to prison for 4 1/2 years for identity theft and healthcare billing fraud; he is to repay nearly $459,000.
  • The owners of two Houston-area ambulance companies are to pay $245,000 to settle allegations of kickback arrangements tied to referrals.
  • A dentist in Missouri admitted taking part in $167,000 fraud conspiracy involving devices prescribed for pediatric patients.
  • Three Missourians admitted billing Medicaid for personal care services that were never rendered; together, they are to repay more than $15,000.
  • A mother and daughter in Missouri, who submitted false timesheets for care they never rendered, pleaded guilty to Medicaid fraud.
  • A Chicago-area physician with Mobile Doctors, which contracted with physicians to arrange in-home visits for patients in a number of states, was convicted of fraud. He cheated Medicare by falsely certifying patients as confined to their homes. His false certifications cost Medicare more than $45,000 for one patient alone.
  • An Illinois woman admitted defrauding Medicaid. She was placed on five years' probation and must repay nearly $17,000 for billing for personal assistant services she did not render.
  • In separate cases, personal assistants in Illinois admitted falsely billing Medicaid for care that was not provided. Case 1; Case 2.
  • Another Illinois personal assistant is to repay Medicaid more than $34,000; she, too, billed for services she didn't provide.
  • A Kentucky couple admitted defrauding the United States of hundreds of thousands of dollars by submitting false claims tied to grants from the National Institutes of Health.
  • Three people from Tennessee were charged with passing forged prescriptions for Percocet, paid for by Medicaid. Authorities said they used a prescription pad stolen from a doctor's office.
  • A Tennessee woman was charged with using Medicaid to obtain the painkiller hydrocodone and later selling some of it.
  • Two people were charged in separate Tennessee cases with "doctor shopping" for prescription drugs.
  • A Mississippi woman was charged with falsely reporting her residence to get Medicaid benefits in Tennessee.
  • A Medicaid recipient in New York was given a six-month term for collaborating with his personal care aide in a kickback scheme that was orchestrated from a jail cell.
  • A New York social worker was charged with endangering the welfare of an incompetent or physically disabled person and with willful violation of health laws. She is alleged to have pushed a nursing home resident to the ground.
  • A New York nurse's aide was charged with abusing a nursing home resident and lying to cover up the incident.
  • A New York home health care agency owner was charged with failing to pay 52 employees more than $110,000 in back wages.
  • A cardiologist was charged with double-billing insurance companies more than $600,000 for medical services he provided through healthcare businesses he owned in Paramus, New Jersey.
  • A neurologist in New Jersey was charged with billing insurance carriers for procedures he did not perform.
  • A New Jersey physician was charged with taking thousands in cash for referrals to two lab companies.

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