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135 Articles
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Pharma Insiders Expose Medicare Fraud Involving Illegal Kickbacks

Patient Services, Inc. (PSI) will pay $3 million to resolve allegations that it illegally funneled Medicare copay reimbursements to benefit Insys, Aegerion, and Alexion. The three pharmaceutical companies allegedly used PSI to cover copays that enabled Medicare beneficiaries to cover out-of-pocket costs for their drugs.
The alleged misconduct came to light in a series of whistleblower lawsuits, which have already led to settlements amounting to hundreds of millions of dollars. Over the...
Hospital Fined for Assembly Line Care - Medicare Fraud Post

Hospital Fined for Assembly Line Care - Medicare Fraud Post

Assembly lines have their place in commerce. But healthcare? Federal prosecutors fined Lenox Hill Hospital in New York for submitting Medicare claims for procedures only partially performed or supervised by the attending surgeons. At least one urologist was frequently absent from the operating room while surgeries were being performed. In the words of Manhattan’s U.S. Attorney, “Hospitals cannot pay surgeons for their referrals, and they cannot run their operating rooms like...
California-based Sutter Health Will Pay $45.6 Million To Resolve Allegations of Medicare Fraud and Stark Law Violations

California-based Sutter Health Will Pay $45.6 Million To Resolve Allegations of Medicare Fraud and Stark Law Violations

The DOJ has announced that Sutter Health will pay $30.5 million to settle a lawsuit filed by a former Sutter compliance officer, Laurie Hanvey. The California health system has also agreed to pay $15.1 million to resolve allegations of self-disclosed Medicare fraud.
According to Hanvey’s complaint, Sutter Memorial Center Sacramento had an illegal arrangement with Sacramento-based group practice Sacramento Cardiovascular Surgeons (“Sac Cardio”). The whistleblower...
Medicaid Whistleblowers - Report hospital schemes like false documentation, ambulance scams, neglect, or even illegal kickbacks

Medicaid Whistleblowers - Report hospital schemes like false documentation, ambulance scams, neglect, or even illegal kickbacks

Have you witnessed conditions at a facility that provides Medicaid or Medicare services? Maybe it’s your employer or a loved one’s care center? If you’ve noticed a hospital taking part in schemes like false documentation, ambulance scams, neglect, or even illegal kickbacks -- we urge you to report it through our hotline.
Every year, Medicaid fraud costs taxpayers billions of dollars (yes, that’s billion with a B). Whistleblowers -- the brave men and women who see...
Osteo Relief Institute Clinics in Six States Have Agreed to Pay $7.1 Million to Settle Medicare Fraud Claims Involving Medically Unnecessary Arthritis Treatments

Osteo Relief Institute Clinics in Six States Have Agreed to Pay $7.1 Million to Settle Medicare Fraud Claims Involving Medically Unnecessary Arthritis Treatments

The Osteo Relief Institute (“ORI”) was a network of clinics focused mainly on osteoarthritis treatments. The now-defunct clinics, located in Texas, Colorado, California, Kentucky, Arizona, and New Jersey, have agreed to pay a total of $7.1 million to settle allegations of Medicare fraud involving medically unnecessary knee braces and osteoarthritis treatments.
The settlement concludes an investigation prompted by a whistleblower lawsuit filed by a Kentucky resident. After...
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,...
Seniors Targeted by Medicare Fraud Involving Lucrative DNA Tests

Seniors Targeted by Medicare Fraud Involving Lucrative DNA Tests

A new elaborate Medicare scam is targeting seniors nationwide. One of its most recent victims was an 86-year-old woman from Utah, who spoke to reporters on condition of anonymity.
The woman, who lives in a rural area, was persuaded by two young people who knocked on her door to hand over her Medicare number, her SSN, and even a sample of her DNA. The object of the fraudsters was to bill Medicare for DNA tests covered by the government program.
Older Medicare beneficiaries all...
More Info & Intel • 135 Articles
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