Info & Intel


ImmediaDent Will Pay $5.1 Million to Settle Medicaid Fraud Allegations

ImmediaDent Will Pay $5.1 Million to Settle Medicaid Fraud Allegations

ImmediaDent and Samson Dental Partners, two licensed Medicaid and Medicare providers, are due to pay $5.1 million to settle claims of fraudulent Medicaid billings. ImmediaDent is the largest dental provider to Medicaid patients in Indiana, Kentucky, and Ohio. Over 40 percent of ImmediaDent’s patients are Medicaid beneficiaries. Samson Dental Partners is a corporation founded in 2003 which operates some ImmediaDent clinics.  
The case was initiated by a whistleblower suit filed...

Durable Medical Equipment-Related Medicare Fraud Costs Florida $58 Million Annually

Durable Medical Equipment-Related Medicare Fraud Costs Florida $58 Million Annually

Recent reports have shed light on the prevalence of Medicaid scams related to Durable Medical Equipment (“DME”).
On the one hand, the enduring nature of DME, which withstands wear and tear, makes it an easy target for illegal profiteering. According to sources from the Tampa Medicare Fraud Strike Force, the state of Florida has become a center for DME fraud. Since 2012, the federal law-enforcement has discovered over DME fraud amounting to $600 million across the nation, with...

From Brain Surgeon to Inmate in Just 6 Months

From Brain Surgeon to Inmate in Just 6 Months

A Michigan surgeon is today serving 19 years and six months in prison after being convicted of criminal Medicaid fraud. In a separate whistleblower action settled last month, Aria Sabit MD also agreed to pay $899,000 to settled civil charges claiming he defrauded Medicare and Medicaid.
Metropolitan Detroit is a Medicaid fraud hotspot. Dr. Sabit’s conviction adds one more to the area’s already grim statistics.
That Sabit was convicted of defrauding Medicaid comes as no...

Health Management Associates Reaches $260 Whistleblower Settlement on Medicare Fraud Charges

Health Management Associates Reaches $260 Whistleblower Settlement on Medicare Fraud Charges

A former national health care company, which was the subject of a scathing 60 Minutes investigation in 2012, is finally facing repercussions for allegedly violating anti-kickback laws; threatening and coercing physicians; and defrauding Medicare, Medicaid and TRICARE.
Health Management Associates (HMA), a hospital chain based in Naples, FL., has reached a $260 million settlement to bring an end to numerous civil and criminal fraud charges. The matter originates from eight separate...

Personal Care Attendant Sentenced for Stealing Money from Elderly Veteran, Medicaid Program

Personal Care Attendant Sentenced for Stealing Money from Elderly Veteran, Medicaid Program

Between one and two million seniors have been abused by caretakers in the U.S. That doesn’t just include neglect or physical abuse; financial abuse is, in fact, the second most common form of elder mistreatment. And, of course, elder abuse is closely tied to Medicaid fraud. A caregiver who is failing to provide a patient with necessary care is likely to lie about it in billing records, too.
Unfortunately, this is exactly what happened in a recent fraud and abuse case in Missouri....

Illinois Pharmacist to Serve up to a Decade in Prison for Medicaid Fraud

Illinois Pharmacist to Serve up to a Decade in Prison for Medicaid Fraud

A Red Bud, IL pharmacist has pleaded guilty to health care fraud charges, admitting that he defrauded Medicare, Medicaid, and private insurers out of more than $630,000. Steven P. Gibson, owner of Gibson’s Discount Drugs at 1506 S. Main Street, will spend up to 10 years in prison for the crime.
Gibson’s scam was simple: he wrote false prescriptions for expensive drugs and submitted them to public and private insurers for reimbursement. The prescriptions were submitted under...

MedBoston Home Health Owner Convicted for Stealing $2.7M from MassHealth

MedBoston Home Health Owner Convicted for Stealing $2.7M from MassHealth

The owner of Boston-based Harmony Home Health Care has been sentenced to two to three years in state prison for stealing $2.7 million from MassHealth, Massachusetts’ Medicaid program. Elena Kurbatzky, a 45-year-old registered nurse and the sole owner of Harmony Home Health, was convicted on three counts of Medicaid false claims, three counts of larceny and one count of Medicaid eligibility fraud.
Kurbatzky forged signatures, submitted fraudulent reports, and straight-up lied to...

Bonuses - Kickbacks for Slacker Dr. Referrals at Montana Hospital, Says KRH Whistleblower Lawsuit

Bonuses - Kickbacks for Slacker Dr. Referrals at Montana Hospital, Says KRH Whistleblower Lawsuit

Medical patients have a reasonable expectation that when a doctor makes a referral to a specialist, the doctor has their wellbeing in mind. But according to a complaint filed in U.S. District Court, patients at a Montana hospital weren’t always given that respect. Instead, doctors made referrals in consideration of their own financial gain.
Per the complaint, Kalispell Regional Healthcare (KRH), a healthcare system based in Kalispell, Montana, was engaging in illegal behavior and...

Upcoding and CAPITAL LETTERS – a New Way to Commit Billing Fraud

Upcoding and CAPITAL LETTERS – a New Way to Commit Billing Fraud

Healthcare fraud has reached epidemic levels in the United States. At times, the situation has become so bad that the Centers for Medicare and Medicaid Services (CMS) had to resort to drastic measures such as a moratorium on licensing new providers! That means the agency didn’t have the time to license new providers because all its resources were concentrated on rooting out bad providers.
In recent years we have seen these measures in Detroit, Houston and Philadelphia. When that...

Signature Settles $244M Fraud Whistleblower Lawsuit for Just $30M

Signature Settles $244M Fraud Whistleblower Lawsuit for Just $30M

Signature HealthCARE, one of the country’s largest healthcare facility operators, has agreed to pay $30 million to settle a False Claims Act lawsuit filed three years ago.
That seems like a hefty sum, until you realize the extent of the Medicaid fraud its staff allegedly committed—which amounts to $244 million, according to the U.S. Justice Department. 
Regardless, it’s a good thing that Signature is being held accountable for its supposed fraud, which...

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