Healthcare / Medical

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Feds: Florida Ophthalmology Practice Paid Kickbacks, Defrauded $1.3 Million

An ophthalmology practice called Brandon Eye, which has offices in Brandon, Sun City and Plant City, Fla., has agreed to pay $1.3 million to resolve violations of the federal False Claims Act and a similar state statute, according to a Nov. 12 Justice Department press release.

Report Strahinja Nikolić | Dec 16, 2024

An_Eye_Doctor_Puts_Drops_in_the_Eyes_of_a_Worried-Looking_Patient

Bribery

Feds: QOL Medical Paid “Kickbacks” in the Form of Free Breath Testing Kits

Frederick E. Cooper and his pharmaceutical company QOL Medical agreed to pay $47 million to resolve allegations that they caused the submission of false claims to federal health care programs by offering kickbacks in the form of free Carbon-13 breath testing services, to induce claims for QOL’s drug Sucraid, according to a Justice Department press […]

Report Strahinja Nikolić | Dec 11, 2024

A Man In a Lab Coat With His Hands Behind His Back and Holding 1000 in 100 Bills.

Medical Fraud

Preying on the Vulnerable: Tennessee Clinic Owner Coerced Patients to Have Unnecessary Back Injections, Overbilled $35 Million

Michael Kestner, a 72-year-old owner of Pain MD and MedManagement, Inc. clinics in Franklin, Tenn., has been convicted of orchestrating a healthcare fraud scheme that involved pressuring vulnerable patients into receiving unnecessary back injections, primarily targeting individuals undergoing opioid addiction treatment.

Report Strahinja Nikolić | Nov 18, 2024

Six Injectors Stab a Moldy Apple Representing the Medically Unnecessary Pain Management Injections Given by Michael Kestners Medical Clinics For The Purpose of Overbilling the Government - The Daily Muck

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Medical Fraud

Pharmacy Owner/Aspiring Screenwriter Overbills Healthcare Insurers for $41 Million in OTCs never received

Ivor Jallah, a 37-year-old pharmacy owner from Dallas, Texas, has been sentenced to federal prison for his involvement in a massive healthcare fraud scheme.

Report Strahinja Nikolić | Nov 15, 2024

Hollywood Actor Nicolas Cage Poses With Ivor Jallah Convicted of Running A Healthcare Scam. - The Daily Muck

Medical Fraud

Man Pleads Guilty to Falsifying and Not Performing Covid-19 Tests

Zishan Alvi, a 45-year-old man from Inverness, Illinois, pleaded guilty on Sept. 30 to his role in a COVID-19 testing fraud scheme, according to a press release by the Justice Department.

Report Strahinja Nikolić | Nov 5, 2024

Zishan Alvi Owner of Lab Elite and Shown in a Promotional Photo Has Pleaded Guilty to a COVID-19 Fraud Scheme - The Daily Muck

Medical Fraud

Brooklyn Adult Day Care and Home Care Business Charged in $68 Million Medicaid scheme

Eight defendants were charged on Oct. 8 with a total of 14 counts of crimes related to a $68 million Medicaid fraud scheme.

Report Jessika Saunders | Nov 1, 2024

Zakia Khan Founded Happy Familiy Social Adult Daycare According to the Facilities Website - The Daily Muck

Medical Fraud

Healthcare Agency that Billed for Unnecessary Inpatient Psychiatric Services Settles With Feds for $20 Million

Acadia Healthcare, one of the biggest for-profit chains of psychiatric hospitals, has agreed to settle fraud claims alleged by the federal government, according to a Sept. 26 Justice Department statement.

Report Strahinja Nikolić | Oct 28, 2024

Park Royal Hospital in Fort Myers Fla. Is an Inpatient Psychiatric Hospital Owned by Arcadia Healthcare - The Daily Muck

Medical Fraud

Feds: Free Urine Collection Cups Represented ‘Kickbacks’ to Doctors Illegally Billing Federal Health Programs for Unneeded Tests

As of Oct. 2, 2024, Precision Toxicology, doing business as Precision Diagnostics, has settled accusations of False Claims Act violations by agreeing to repay $27 million to the federal government.

Report Jessika Saunders | Oct 24, 2024

A Pharmacy Stands Behind Three Different Surin Samples Representing a Settlement Acknowledging Violations of the Anti-Kickback Statute Signed by Precision Diangnostics - The Daily Muck

Medical Fraud

Walgreens to Pay More than $100 Million to Settle Claims of Billing Government for Undispensed Prescriptions

Billing government programs for prescriptions your customers never received can get you in hot water.

Report Jessika Saunders | Oct 15, 2024

Walgreens has Settled Lawsuits that It Charged Insurers for Undispensed Prescriptions Pictured is. Los Angles Location - The Daily Muck

Medical Fraud

CVS-Owned Subsidiary to Pay $60 Million for Medicare Advantage Kickback Scheme

Oak Street Health, a CVS subsidiary, agreed on Sept. 18 to pay $60 million to resolve allegations that it paid kickbacks to third-party insurance agents, according to a DOJ press release.

Report Jessika Saunders | Oct 4, 2024

A_Promotional_Photo_of_an_Oak_Street_Health_Clinic_in_Chicago_Ill._a_Compant_that_Paid_12_Million_with_The_Feds_to_Settle_Allegations_It_Paid_Kickbacks_for_Medical_Referrals_The_Daily_Muck

Medical Fraud

Ignorance, Empathy and Prosecutorial Overreach: Why Good Doctors Do Bad Things in the Eyes of Medicare

“Ignorance and Empathy” may sound like the title of a Jane Austen novel, but they are two causes of what can be called “innocent” Medicare fraud. However, health care providers must remember two maxims: ignorance of the law is no excuse, and the road to Hell is paved with good intentions.

Feature Raymond L. Daye | Oct 1, 2024

Misrepresentation

Medicaid: New Mexico Did a Terrible Job Vetting Medical Employees

The federal Department of Health and Human Services (HHS) has audited New Mexico’s Medicaid personal care services (PCS) program, finding that the State of New Mexico did not correctly vet attendants to ensure they were qualified, according to an HHS Inspector General audit posted on Sept. 5 and announced in a press release.

Report Jessika Saunders | Sep 27, 2024

Gloved_Hands_Gripping_Each_Other_Show_the_Importance_of_Medical_Assistants_Many_odf_Which_Were_Found_to_Be_Lacking_Qualidications_in_New_Mexico_The_Daily_Muck

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Healthcare / Medical

Feds: Florida Ophthalmology Practice Paid Kickbacks, Defrauded $1.3 Million

Feds: QOL Medical Paid “Kickbacks” in the Form of Free Breath Testing Kits

Preying on the Vulnerable: Tennessee Clinic Owner Coerced Patients to Have Unnecessary Back Injections, Overbilled $35 Million

Pharmacy Owner/Aspiring Screenwriter Overbills Healthcare Insurers for $41 Million in OTCs never received

Man Pleads Guilty to Falsifying and Not Performing Covid-19 Tests

Brooklyn Adult Day Care and Home Care Business Charged in $68 Million Medicaid scheme

Healthcare Agency that Billed for Unnecessary Inpatient Psychiatric Services Settles With Feds for $20 Million

Feds: Free Urine Collection Cups Represented ‘Kickbacks’ to Doctors Illegally Billing Federal Health Programs for Unneeded Tests

Walgreens to Pay More than $100 Million to Settle Claims of Billing Government for Undispensed Prescriptions

CVS-Owned Subsidiary to Pay $60 Million for Medicare Advantage Kickback Scheme

Ignorance, Empathy and Prosecutorial Overreach: Why Good Doctors Do Bad Things in the Eyes of Medicare

Medicaid: New Mexico Did a Terrible Job Vetting Medical Employees

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