Info & Intel


Special Alert for Nursing Home Patients – Deadly New Infection

Special Alert for Nursing Home Patients – Deadly New Infection

Deadly New Infection Called Candida Auris Killing Nursing Home Patients Normally we publish stories about efforts to curb Medicaid fraud in our nation’s hospitals, clinics and nursing homes. Recently we learned of a deadly new infection sweeping through some nursing homes in New York, Illinois and New Jersey. The infection is caused by a newly discovered fungus known as Candida Auris.
A decade ago the fungus wasn’t known to even exist. It was first discovered in Japan in...

Houston Hospital Administrator Sentenced to 10 Years in Prison for His Role in $16-million Medicare Fraud

Houston Hospital Administrator Sentenced to 10 Years in Prison for His Role in $16-million Medicare Fraud

The former CFO and COO of Atrium Medical Center and Pristine Healthcare, Starsky Bomer, has been sentenced to 10 years in prison for his role in a scheme that defrauded Medicare out of $16 million. Between 2011 and 2013, Bomer allegedly aided in a fraudulent scheme involving inappropriate billings to government programs for hospital care services.
After a five-day trial that took place last year, the 46-year-old Houston-area administrator was found guilty of conspiring to commit...

DOJ Charges Amity Home Health Care, Advent Care, Amity’s CEO, Medical Professionals, and Marketers in Connection With $115 Million Bay Area Kickback Scheme

DOJ Charges Amity Home Health Care, Advent Care, Amity’s CEO, Medical Professionals, and Marketers in Connection With $115 Million Bay Area Kickback Scheme

Bay Area-based Amity Home Health Care, its CEO Ridhima Singh, Advent Care, and dozens of healthcare industry workers have been charged in connection with a patients-for-cash kickback scheme allegedly created by Singh. Federal prosecutors said in a statement that Amity’s CEO orchestrated a “wine and dine” scheme by which medical professionals received at least $115 million in bribes in exchange for Medicare beneficiary referrals.
According to Singh’s Linkedin...

Unqualified Physical Therapists Equals Medicaid Fraud

Unqualified Physical Therapists Equals Medicaid Fraud

Many of us have had to seek physical therapy before. Maybe it was after an operation or an accident at work. When we go for our appointment, we automatically assume the therapist is properly licensed and qualified. A recent case from Alabama suggests that isn’t always the case.
A former physiologist who worked at the Baldwin Bone & Joint clinic in Baldwin, Alabama blew the whistle on his former employer. He said the clinic was using physiologists, athletic trainers, assistants,...

Connecticut Woman Who Stole Identity of More Than 150 Medicaid Patients Receives Prison Sentence

Connecticut Woman Who Stole Identity of More Than 150 Medicaid Patients Receives Prison Sentence

A former healthcare provider received a seven-month prison term and was ordered to pay $1.3 million in restitution for Medicaid fraud. Nikkita Chesney, 46, Bridgeport, also requires three years of supervised release once she has served her time in prison.
Medicaid Identity Theft  In 2012, Chesney was working at a Bridgeport facility offering substance abuse treatment and a detoxification program. Toshirea Jackson, who owned the psychotherapy and social services businesses...

Upstate New York Owner of Medical Transport Company Pleads Guilty to Medicaid Fraud

Upstate New York Owner of Medical Transport Company Pleads Guilty to Medicaid Fraud

When it comes to Medicaid fraud, sometimes it’s all in the family. On July 11, Qaiser Gondal, 47, pleaded guilty in U.S. District Court to conspiring to defraud Medicaid. The Watervliet, New York man was the owner of Ti Taxi, Inc., a Ticonderoga-based medical transportation company. He faces up to 10 years in prison and a $250,000 fine, and has agreed to pay $325,000 in restitution. Sentencing is scheduled for November 14. 
A day earlier, his brother, Khurram Gondal, 38,...

Anonymous Tip Leads to Indictments of Seven Alabama Residents on Medicaid Fraud Charges

Anonymous Tip Leads to Indictments of Seven Alabama Residents on Medicaid Fraud Charges

Seven people living in the same Bridgeport, Alabama apartment complex are now charged with Medicaid fraud in neighboring Tennessee. The state line is just six miles from Bridgeport. Their whole scheme unraveled because of an anonymous tip. 
All seven claimed they were Tennessee residents so they could receive TennCare, the state’s Medicaid program. In Tennessee, Medicaid fraud is a class D felony, punishable by prison sentences running from two to 12 years. 
If the...

Hart to Heart Transportation Will Pay $1.25 Million to Resolve Medicare Fraud Allegations

Hart to Heart Transportation Will Pay $1.25 Million to Resolve Medicare Fraud Allegations

Hart to Heart, an ambulance service provider operating in Salisbury, has agreed to pay $1.25 million to resolve allegations for submitting false claims for payment to Medicare between 2010 and 2017.
In 2015, a whistleblower filed a False Claims Act lawsuit alleging that Hart to Heart was billing Medicare for ambulance transports that were medically unnecessary. Though it agreed to a sizable settlement, the Maryland-headquartered company has made no admission of guilt.
"Hart to Heart...

North Carolina Man Faces Up to 15 Years for Medicaid Fraud

North Carolina Man Faces Up to 15 Years for Medicaid Fraud

A Monroe, North Carolina man pleaded guilty to Medicaid fraud on June 20, and now faces up to 15 years in prison. Jerry Taylor pleaded guilty to healthcare fraud and tax evasion. He admitted conspiring with healthcare providers over a two-year period and submitting Medicaid claims for children who were not treated by these providers. 
Taylor conspired with Devon Rambert-Hairston,  a Monroe nurse practitioner, who pleaded guilty in April to money laundering, as well as collecting...

Chicago Nursing Homes Will Pay $9.7 Million to Settle Medicare Overbilling Allegations

Quality Therapy and Consultation Inc., its owner, Frances Parise, and four Chicago nursing homes have agreed to pay a combined $9.7 million settlement to resolve allegations that they were involved in a scheme to defraud Medicare. According to a whistleblower’s claims, the defendants routinely billed federal programs for services they never provided.   
The Chicago-based nursing homes allegedly involved in the fraudulent scheme are Lakeshore Healthcare, Balmoral Home,...

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