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Criminal and Civil Enforcement

Criminal and Civil Enforcement Archive

September 2016

September 22, 2016; U.S. Attorney; District of Massachusetts: Winchester Therapist Agrees to Pay $110,000 to Resolve False Medicare Billing Allegations
BOSTON - The U.S. Attorney's Office reached a $110,000 settlement today with David Margolis, a clinical social worker with an office in Winchester, to resolve allegations that he submitted false claims to Medicare.
September 22, 2016; U.S. Attorney; District of Maryland: Five Defendants Face Federal Charges in Pain Management Clinic Kickback Scheme
Baltimore, Maryland - A federal grand jury indicted five defendants on charges arising from a scheme whereby physicians and administrative personnel associated with a Maryland pain management practice agreed to refer urine specimens to a testing lab for evaluation in return for $1.37 million in kickbacks.
September 21, 2016; U.S. Attorney; Eastern District of Michigan: United States Settles Health Care Fraud Action Involving Doctor Who Prescribed Unnecessary Opioid Prescriptions
A doctor who practiced in Warren, Michigan, agreed to pay $200,000 to resolve allegations that he violated the False Claims Act by writing prescriptions for oxycodone and other controlled medications without medical justification, and for billing for medical services without medical justification, announced U.S. Attorney Barbara L. McQuade.
September 20, 2016; U.S. Attorney; Central District of California: Final Defendants in Multi-Million Dollar Health Care Fraud and Money Laundering Case Sentenced to Federal Prison Terms
LOS ANGELES - With the final defendant receiving a prison term yesterday, six defendants who participated in a multi-million dollar health care fraud scheme or helped launder the illicit proceeds have now been sentenced to federal prison.
September 19, 2016; U.S. Department of Justice: North American Health Care Inc. to Pay $28.5 Million to Settle Claims for Medically Unnecessary Rehabilitation Therapy Services
North American Health Care Inc. (NAHC), its chairman of the board, John Sorenson, and its senior vice president of Reimbursement Analysis, Margaret Gelvezon, have agreed to pay a total of $30 million to resolve allegations that they violated the False Claims Act by causing the submission of false claims to government health care programs for medically unnecessary rehabilitation therapy services provided to residents at NAHC's skilled nursing facilities (SNFs), the Department of Justice announced today. Under the settlement agreement, NAHC has agreed to pay $28.5 million. Mr. Sorensen has agreed to pay $1 million and Ms. Gelvezon has agreed to pay $500,000.
September 15, 2016; U.S. Attorney; Eastern District of Texas: Texas Doctor Resentenced to Prison Following Appeal
TYLER, Texas - A 65-year-old Dallas County, Texas, physician, has been resentenced to federal prison for health care fraud and identity theft violations in the Eastern District of Texas, announced U.S. Attorney John M. Bales.
September 15, 2016; U.S. Attorney; District of Connecticut: UConn Health Center Pays $184,984 to the Federal Government to Settle Overbilling Allegations
Deirdre M. Daly, United States Attorney for the District of Connecticut, today announced that the UNIVERSITY OF CONNECTICUT HEALTH CENTER ("UConn Health") has entered into a civil settlement agreement with the federal government in which it will pay $184,984 to resolve allegations that it overbilled the Medicare Program.
September 14, 2016; U.S. Attorney; Northern District of Illinois: Owner of Illinois Home Health Company Admits Paying Illegal Kickbacks to 20 Medical Directors for Referrals of Medicare Patients
CHICAGO - The owner of a home health care company headquartered in Lemont admitted in federal court today that he paid illegal kickbacks to procure referrals of elderly patients on Medicare.
September 9, 2016; U.S. Attorney; Central District of California: L.A. Nursing Home, Two Physicians Pay over $3.5 Million to Resolve Allegations They Participated in Illegal Patient-Transfer Scheme
LOS ANGELES - A Los Angeles nursing home and two physicians who worked at the facility have paid $3,563,140 to resolve civil allegations that they participated in a scheme to improperly transfer patients recruited from the "Skid Row" district to a hospital for medically unnecessary services, and then transfer the patients from the hospital to the nursing home for medically unnecessary stays.
September 9, 2016; U.S. Attorney; Eastern District of New York: New York Pharmacist Sentenced To 43 Months For Medicare And Tax Fraud
Earlier today, Andrew Barrett, a New York pharmacist who operated pharmacies in Bronx, Queens, and Rockland counties, was sentenced to 43 months' imprisonment to be followed by three years of supervised release. As part of the sentence, he was ordered to forfeit $2.7 million in criminal proceeds, pay $2.7 million in restitution to Medicare and Medicaid, and pay $736,000 in restitution to the Internal Revenue Service.
September 8, 2016; U.S. Department of Justice: Florida Doctor Indicted for Role in $13.8 Million Medicare Fraud Scheme
The medical director of a clinic in Orlando, Florida, was charged in a superseding indictment filed today for his alleged participation in a $13.8 million health care fraud scheme involving claims for expensive prescription drugs and physical therapy.
September 8, 2016; U.S. Attorney; District of Idaho: Boise Doctor Convicted of Controlled Substance Delivery
BOISE - Michael Minas, 50, of Boise, Idaho, was sentenced today to eight years in federal prison on 80 counts of unlawfully distributing controlled substances outside the usual course of professional practice and not for a legitimate medical purpose, U.S. Attorney Wendy J. Olson announced. Senior U.S. District Judge Edward J. Lodge also ordered Minas to pay an $80,000 fine and to forfeit proceeds of $8,000. During the sentencing hearing, Judge Lodge stated that "doctors must be part of the solution, not the source of the problem." Minas was convicted in May at the end of a 14-day federal jury trial in Boise.
September 8, 2016; U.S. Attorney; Middle District of Florida: Florida Doctor Indicted For Role In $13.8 Million Medicare Fraud Scheme
Tampa, FL - The medical director of a clinic in Orlando, Florida, was charged in a superseding indictment filed today for his alleged participation in a $13.8 million health care fraud scheme involving claims for expensive prescription drugs and physical therapy.
September 8, 2016; U.S. Attorney; Southern District of Texas: Medical Equipment Company Owner and Biller Plead Guilty in Health Care Fraud Scheme
McALLEN, Texas - The owner of a Rio Grande Valley area durable medical equipment (DME) company has been convicted of conspiracy to commit health care fraud, announced U.S. Attorney Kenneth Magidson. Veronica Vela, 42, of Mission, entered her plea today before U.S. District Judge Micaela Alvarez.
September 7, 2016; U.S. Department of Justice: Two Psychologists Plead Guilty in $25 Million Nursing Home-Testing Scheme
Two clinical psychologists pleaded guilty today for their involvement in a fraudulent psychological testing scheme that preyed upon Medicare recipients living in nursing homes throughout the Southeastern United States.
September 7, 2016; U.S. Department of Justice: Diabetic Medical Equipment Companies to Pay More Than $12 Million to Resolve False Claims Act Allegations
U.S. Healthcare Supply LLC and Oxford Diabetic Supply Inc. and the two owners and presidents of those companies have agreed to pay the United States more than $12.2 million to resolve allegations that they violated the federal False Claims Act by using a fictitious entity to make unsolicited telephone calls to Medicare beneficiaries in order to sell them durable medical equipment, the U.S. Department of Justice announced. U.S. Healthcare Supply LLC, based in Milford, New Jersey, has agreed to pay more than $5 million, and Jon P. Letko, its owner and president, has agreed to pay more than $1 million. His brother, Edward J. Letko, the owner and president of Oxford Diabetic Supply Inc., a medical equipment supplier that allegedly also participated in the scheme, has agreed to pay $6 million plus interest.
September 7, 2016; U.S. Department of Justice: The United States Files False Claims Act Complaint Against Six Vanguard Nursing Facilities and Related Entities, as Well as Vanguard's Director of Operations
The United States has filed a False Claims Act case against Vanguard Healthcare LLC, Vanguard Healthcare Services LLC, Boulevard Terrace LLC, Vanguard of Crestview LLC, Glen Oaks LLC, Imperial Gardens Healthcare and Rehabilitation LLC, Vanguard of Memphis LLC, Vanguard of Manchester LLC and Vanguard's Director of Operations, Mark Miller, the Department of Justice announced today. The lawsuit alleges that the defendants were responsible for the submission of false claims to Medicare and Medicaid for skilled nursing home services that were either non-existent or grossly substandard. The lawsuit also alleges that the defendants submitted required nursing facility Pre-Admission forms with forged physician and nurse signatures. Vanguard Healthcare LLC is headquartered in Brentwood, Tennessee, and has 14 long-term care nursing home providers operating around the United States.
September 6, 2016; U.S. Attorney; Northern District of Ohio: Cleveland dentist sentenced to year in prison, ordered to pay $344,000 for healthcare fraud
A Cleveland dentist was sentenced to a year in prison and ordered to pay nearly $344,000 in restitution for fraudulently billing Medicaid for more work that not authorized or never done, said Carole S. Rendon, law enforcement officials said.
September 1, 2016; U.S. Attorney; Southern District of Texas: RGV Area Doctor Charged in Health Care Fraud and Illegal Kickback Scheme
McALLEN, Texas - A Rio Grande Valley area doctor has been charged in a federal indictment for his scheme to defraud Medicare and to solicit and obtain illegal kickbacks in exchange for patient referrals, announced U.S. Attorney Kenneth Magidson.
September 1, 2016; U.S. Attorney; Western District of Pennsylvania: Medical Doctor Pleads Guilty to Health Care Fraud, Illegally Distributing Drugs
PITTSBURGH - A resident of Hermitage, Pennsylvania pleaded guilty in federal court to charges of possession with intent to distribute and distribution of Tramadol, a Schedule IV controlled substance, and health care fraud, United States Attorney David J. Hickton announced today.
September 1, 2016; U.S. Attorney; Western District of New York: Salamanca Chiropractor Arrested And Charged With Health Care Fraud
BUFFALO, N.Y.-U.S. Attorney William J. Hochul Jr. announced today that Leo A. Kronert, Jr., aka Lee Kronert, of Frewsburg, NY, was arrested and charged by criminal complaint with health care fraud and false statements relating to health care matters. The charges carry a maximum penalty of 10 years in prison and a $250,000 fine.

August 2016

August 31, 2016; Middle District of Florida: United States Settles False Claims Act Allegations Against Coastal Spine And Pain For $7.4 Million
Jacksonville, FL - United States Attorney A. Lee Bentley, III announces today that Physicians Group Services, P.A., doing business as Coastal Spine and Pain ("Coastal"), has agreed to pay $7.4 million to the government to resolve allegations that Coastal violated the False Claims Act by performing medically unnecessary drug screening procedures.
August 31, 2016; Northern District of Illinois: Owner of Homewood Telemarketing Company Convicted of Taking Illegal Kickbacks for Referring Patients to Home Health Agencies
CHICAGO - A federal jury has convicted the head of a Homewood telemarketing company of pocketing illegal kickbacks in exchange for referring patients to home health care agencies.
August 31, 2016; Southern District of Florida: Clear Vue Eye Center and its Owner Agree to Pay One Million Dollars to Resolve False Claims Act Allegations
Clear Vue Eye Center, Inc. (Clear Vue) and its owner, Dr. Monique Barbour have agreed to pay $1 million to resolve allegations that they violated the False Claims Act by overbilling Medicare for patient visits at nursing homes and assisted living facilities, and for billing for procedures purportedly performed while Dr. Barbour was out of the country.
August 30, 2016; U.S. Department of Justice: Former Owner and Manager of Miami-Area Home Health Agencies Sentenced to 20 Years in Prison for Role in $57 Million Medicare Fraud Scheme
The owner and manager of three now-defunct Miami-area home health agencies was sentenced today to 240 months in prison for his role in a $57 million Medicare fraud scheme.
August 30, 2016; U.S. Department of Justice: Mother and Son Plead Guilty to Orchestrating $16 Million Medicare Fraud Scheme at Two Miami Pharmacies
A mother and son based in Miami each pleaded guilty today to fraud charges for their roles in a $16 million Medicare fraud scheme.
August 30, 2016; U.S. Attorney; District of Connecticut: Pediatric Dentist Pays $1.3 Million to Settle False Claims Act Allegations
Deirdre M. Daly, United States Attorney for the District of Connecticut, Connecticut Attorney General George Jepsen, and Phillip M. Coyne, Special Agent in Charge of the U.S. Department of Health and Human Services, Office of Inspector General, today announced that JESUS VILLEGAS, DDS, and his two pediatric dental clinics located in Milford and West Haven have entered into a civil settlement agreement with the federal and state governments in which they will pay $1,367,466 to resolve allegations that they violated the federal and state False Claims Acts.
August 30, 2016; U.S. Attorney; Western District of Pennsylvania: Mercer County Doctor, Practice Settle False Claims Act Allegations
PITTSBURGH - Dr. John P. Balko and John Balko & Associates, Inc., doing business as Senior Healthcare Associates (SHA), have agreed to pay the United States $930,000.00 to settle False Claims Act allegations, United States Attorney David J. Hickton announced today.
August 29, 2016; U.S. Attorney; District of South Carolina: Greenville Medical Practice Receives Probationary Sentence and Agrees to Pay $300,000 to the United States
Columbia, South Carolina ---- Acting United States Attorney Beth Drake stated today that Neurology Associates of Greenville, P.A., pled guilty and was sentenced today in federal court in Greenville, for receiving misbranded drugs in interstate commerce, a violation of Title 21, United States Code, Section 331(c). United States Magistrate Judge Jacquelyn D. Austin of Greenville placed the practice on 3 years of federal probation. No fine was imposed because the practice, in settlement of a parallel civil case brought by the U.S. Attorney's Office, agreed to pay $300,000 to the United States due to the submission of Medicare claims for non-approved botulinum toxin (Botox).
August 24, 2016; U.S. Attorney; District of Columbia: Maryland Woman Sentenced to 12 Months in Prison For Conspiring to Taking Part In Scheme Involving Prescription and Health Care Fraud
WASHINGTON - Novella White, 53, of Accokeek, Md., was sentenced today to 12 months in prison on federal charges of conspiracy to obtain controlled substances by prescription fraud and participating in a health care fraud scheme, announced U.S. Attorney Channing D. Phillips, Paul M. Abbate, Assistant Director in Charge of the FBI's Washington Field Office, and Nicholas DiGiulio, Special Agent in Charge of the U.S. Department of Health and Human Services, Office of Inspector General (HHS-OIG), for the region that includes Washington, D.C.
August 23, 2016; U.S. Attorney; Eastern District of Pennsylvania: Delaware County Podiatrist Pleads Guilty To $5 Million Health Care Fraud
PHILADELPHIA - Stephen A. Monaco, D.P.M., 59, of Broomall PA pleaded guilty to health care fraud today for perpetrating a $5 million scheme to defraud Medicare, Medicaid and four private victim insurance companies, announced United States Attorney Zane David Memeger.
August 24, 2016; U.S. Attorney; Southern District of New York: Manhattan U.S. Attorney Announces $2.95 Million Settlement With Hospital Group For Improperly Delaying Repayment Of Medicaid Funds
Preet Bharara, the United States Attorney for the Southern District of New York, Scott J. Lampert, Special Agent in Charge of the New York Field Office of the U.S. Department of Health and Human Services, Office of Inspector General ("HHS-OIG"), Eric Schneiderman, New York State Attorney General, and Thomas P. DiNapoli, the New York State Comptroller, today announced a $2,950,000 settlement of a civil fraud lawsuit against Beth Israel Medical Center d/b/a Mount Sinai Beth Israel ("Beth Israel"), St. Luke's-Roosevelt Hospital Center d/b/a Mount Sinai St. Luke's and Mount Sinai Roosevelt ("St. Luke's Roosevelt," and together with Beth Israel, the "Hospitals"), and Continuum Health Partners, Inc. ("Continuum," and together with the Hospitals, "Defendants") for willfully delaying repayment of over $ 800,000 in Medicaid overpayments. The settlement resolves claims under the federal False Claims Act and the New York State False Claims Act.
August 19, 2016; U.S. Attorney; Central District of California: Pasadena Doctor Sentenced to 4 Years in Prison for Falsely Certifying Patients Were Terminally Ill as Part of Healthcare Fraud Scheme
LOS ANGELES - A doctor from Pasadena who falsely certified that at least 79 Medicare and Medi-Cal patients were qualified for hospice care because they were terminally ill - when, in fact, the vast majority of them were not dying - has been sentenced to four years in federal prison.
August 18,2016; U.S. Attorney; Northern District of Alabama: Northwest Alabama Pharmacies Owner Pleads Guilty to Obstructing Medicare Audit
BIRMINGHAM - The owner of two northwest Alabama pharmacies pleaded guilty today to obstructing a Medicare audit and agreed to pay a $2.5 million penalty to the government.
August 17, 2016; U.S. Attorney; Middle District of Florida: Fort Myers Urologist Agrees To Pay $250,000 For Ordering Unnecessary Medical Tests
Fort Myers, FL - United States Attorney A. Lee Bentley, III announces that Robert A. Scappa, D.O. has agreed to pay $250,000 to the government to resolve allegations that he violated the False Claims Act by causing claims to be submitted to federal health care programs for laboratory tests that were not medically necessary.
August 17, 2016; U.S. Attorney; Eastern District of Pennsylvania: Fourth Suboxone Doctor And Office Manager Indicted For Illegally Selling Prescriptions Of Suboxone And Klonopin
PHILADELPHIA - An indictment was filed today charging a doctor and his office manager in a scheme to sell commonly abused prescription drugs in exchange for cash payments. Charged in the conspiracy are: Dr. Clarence Verdell, 66, of Voorhees, NJ and Rochelle Williams-Morrow, 37, of Philadelphia, PA. The indictment includes charges of conspiracy to distribute controlled substances, distribution of controlled substances, health care fraud, and money laundering and was announced by United States Attorney Zane David Memeger, Drug Enforcement Administration Special Agent-in-Charge Gary Tuggle, and Special Agent-in-Charge Nick DiGuilio with Health and Human Services Office of Inspector General.
August 16, 2016; U.S. Attorney; District of New Jersey: Morris County, New Jersey, Husband And Wife Sentenced To Prison For Falsifying Thousands Of Medical Diagnostic Reports As Part Of $4.8 Million Health Care Fraud Scheme
NEWARK, N.J. - Two Rockaway, New Jersey, residents who owned a mobile diagnostic testing company were each sentenced today to over six years in prison for receiving more than $4.8 million from Medicare and private insurance companies for diagnostic testing and reports that were never interpreted by a licensed physician, U.S. Attorney Paul J. Fishman announced.
August 16, 2016; U.S. Attorney; Western District of Virginia: Pair Sentenced on Health Care Fraud, Conspiracy Charges
ABINGDON, VIRGINIA - A pair of former lab professionals, who were convicted of billing Medicaid, Medicare, TennCare and a variety of other insurance companies following a bench trial earlier this year, were sentenced yesterday in the United States District Court for the Western District of Virginia in Abingdon, United States Attorney John P. Fishwick Jr., Virginia Attorney General Mark R. Herring and HHS Office of Inspector General Special Agent in Charge Nick DiGiulio announced today.
August 15, 2016; U.S. Department of Justice: Miami Man Pleads Guilty to Fraud Charges for Role in $4.2 Million Home Health Care Scheme
A Miami man pleaded guilty today to charges related to his role in a $4.2 million home health care fraud scheme.
August 15, 2016; U.S. Attorney; Northern District of Illinois: Oak Brook Doctor Sentenced to Two Years in Prison in Connection with Kickback Scheme at Sacred Heart Hospital
CHICAGO - A federal judge sentenced an Oak Brook doctor to two years in prison for illegally receiving benefits in exchange for referring elderly patients to Sacred Heart Hospital on Chicago's West Side.
August 11, 2016; U.S. Attorney; Eastern District of Louisiana: New Orleans Business Owner Sentenced to 80 Months in Prison for Role in $3.3 Million Fraud Scheme
WASHINGTON - The owner of a New Orleans company that defrauded Medicare of more than $3.3 million was sentenced today to 80 months in prison for directing the scheme.
August 10, 2016; U.S. Attorney; Northern District of Alabama: Former Community Health Clinic CFO Involved in Complicated Scheme to Defraud the Government Sentenced to 17 Years in Prison
BIRMINGHAM - A federal judge today sentenced the former chief financial officer of an Alabama non-profit health clinic for the poor and homeless to 17 years in prison for a complicated scheme to defraud millions of dollars from two non-profit health clinics and the federal government health agencies that provided most of their funding, and for a separate scheme to defraud a life insurance company that involved identity theft against a physician.
August 8, 2016; U.S. Attorney; Eastern District of Pennsylvania: Healthcare Settlement Announced With Easton Hospital
PHILADELPHIA - Northampton Hospital Company, LLC d/b/a Easton Hospital ("Easton Hospital") has agreed to resolve allegations relating to improper billing for inpatient procedures performed at Easton Hospital. Easton Hospital provides inpatient and outpatient healthcare services in Easton, Pennsylvania. The hospital's services include cardiovascular, orthopedic, oncology, maternal, child health, pediatric, physical therapy rehabilitation, and mental health services. In addition, it offers surgical care, emergency care, occupational and speech therapy, wound healing management, imaging, radiology, home health, hospice, and laboratory services.
August 5, 2016; U.S. Attorney; Middle District of Georgia: Sweet Dreams Nurse Anesthesia Group Pays More Than $1 Million to Resolve Kickback Allegations
G.F. "Pete" Peterman, III, United States Attorney for the Middle District of Georgia, and Georgia Attorney General Sam Olens announced today a civil settlement with a series of anesthesia businesses, collectively known as Sweet Dreams Nurse Anesthesia (Sweet Dreams). Sweet Dreams agreed to pay to the United States $1,034,416 and the State of Georgia $12,078.79 to resolve allegations that it violated the False Claims Act and the Georgia False Medicaid Claims Act by paying unlawful kickbacks to health care providers with the intent to induce referrals of Medicare and Medicaid patients.
August 5, 2016; U.S. Attorney; Western District of Wisconsin: Janesville Pharmacist Charged with Health Care Fraud & Identity Theft
Madison, Wis. - John W. Vaudreuil, United States Attorney for the Western District of Wisconsin, announced that Mark Johnson, 55, Janesville, Wis., was arrested without incident this morning in Janesville, by agents from the U.S. Department of Health and Human Services and the U.S. Postal Inspection Service, with assistance from the Janesville Police Department. Johnson will make his initial appearance in federal court later today.
August 3, 2016; U.S. Attorney; Middle District of Florida: Former Tampa-Area Hospital Employee Sentenced For Stealing Patient Information And Filing Fraudulent Tax Returns
Tampa, Florida - U.S. District Judge Susan C. Bucklew today sentenced Shanakia Benton to three years in federal prison for wrongful disclosure of individual identifiable health information and wire fraud. As part of her sentence, the Court also entered a money judgment in the amount of $77,239, the proceeds of the wire fraud. Benton pleaded guilty on May 2, 2016.
August 2, 2016; U.S. Attorney; District of New Jersey: Passaic County Man Convicted Of Health Care Fraud And Other Charges For Operating Ambulance Company Despite Ban
NEWARK, N.J. - A Passaic County, New Jersey, man was convicted in federal court today of illegally operating a Clifton, New Jersey, ambulance company despite having been banned from participating in federal health care programs due to a prior conviction, U.S. Attorney Paul J. Fishman announced.
August 1, 2016; U.S. Attorney; Northern District of New York: St. Joseph's Hospital To Pay $3.2 Million For Billing Medicaid For Mental Health Services Rendered By Unqualified Staff
SYRACUSE, NEW YORK - United States Attorney Richard S. Hartunian and New York State Attorney General Eric T. Schneiderman announced today that St. Joseph's Hospital Health Center (St. Joseph's) will pay $3.2 million to resolve allegations that it violated the federal and New York False Claims Acts by presenting false claims for payment to the state Medicaid program for mental health services rendered by unqualified staff.

July 2016

July 29, 2016; U.S. Department of Justice: New York Doctor Convicted of Multimillion-Dollar Health Care Fraud
A New York surgeon who practiced at hospitals in Brooklyn and Long Island, New York, was convicted last night for submitting millions of dollars in false and fraudulent claims to Medicare.
July 29, 2016; U.S. Attorney; Southern District of Florida: Three Miami Residents Sentenced in Largest Medicare Fraud Scheme Loss in 2015
Three Miami residents were sentenced for their role in the largest Medicare fraud scheme loss prosecuted in the Southern District of Florida in 2015.
July 29, 2016; U.S. Attorney; Eastern District of Kentucky: Lexington Man and His Medical Device Company Sued for Grant Fraud
LEXINGTON, Ky. - The United States Government has sued a Lexington man, and the Lexington-based medical device company he owns, for violations of the False Claims Act, a federal law that prohibits people from submitting false or fraudulent claims for payment to the federal government.
July 29, 2016; U.S. Attorney; Western District of Oklahoma: United States and State Of Oklahoma Obtain $4.7 Million Judgment Against Behavioral Health Counseling Company and Its Owner for Submitting False Claims
Oklahoma City, Oklahoma - Mark A. Yancey, Acting United States Attorney for the Western District of Oklahoma, and E. Scott Pruitt, Attorney General for the State of Oklahoma, jointly announce that a judgment for $4,752,101.50 has been entered against LXE Counseling, LLC ("LXE") and Lexie Darlene George a/k/a Lexie Darlene Batchelor ("Batchelor") in a civil qui tam "whistleblower" lawsuit for submitting false claims related to behavioral health counseling to Medicaid patients in Oklahoma.
July 27, 2016; U.S. Attorney; Central District of Illinois: Judge Finds Co-Owner of Chicago Medical Transport Company Guilty of Multi-Million Dollar Fraudulent Billing Scheme
Springfield, Ill. - U.S. District Judge Sue E. Myerscough has rendered verdicts of guilty on all counts against a Chicago man for fraudulent overbilling of an estimated $4.7 million to Illinois' Medicaid program for non-emergency medical transport. Sentencing for Gregory D. Toran, 67, of Hazel Crest, Ill., is scheduled on Nov. 14, 2016.
July 28, 2016; U.S. Department of Justice: South Carolina Hospital to Pay $17 Million to Resolve False Claims Act and Stark Law Allegations
The Lexington County Health Services District Inc. d/b/a Lexington Medical Center located in West Columbia, South Carolina, has agreed to pay $17 million to resolve allegations that it violated the Physician Self-Referral Law (the Stark Law) and the False Claims Act by maintaining improper financial arrangements with 28 physicians, the Department of Justice announced today.
July 27, 2016; U.S. Attorney; Central District of Illinois: Judge Finds Co-Owner of Chicago Medical Transport Company Guilty of Multi-Million Dollar Fraudulent Billing Scheme
Springfield, Ill. - U.S. District Judge Sue E. Myerscough has rendered verdicts of guilty on all counts against a Chicago man for fraudulent overbilling of an estimated $4.7 million to Illinois' Medicaid program for non-emergency medical transport. Sentencing for Gregory D. Toran, 67, of Hazel Crest, Ill., is scheduled on Nov. 14, 2016.
July 27, 2016; U.S. Attorney; District of Connecticut: Danbury Physician and Mental Health Practice Pay $36,000 to Settle False Claims Act Allegations
Deirdre M. Daly, United States Attorney for the District of Connecticut, announced that ANTON FRY, M.D. and CPC ASSOCIATES, INC. have entered into a civil settlement agreement with the federal government in which they will pay $36,704 to resolve allegations that they violated the False Claims Act.
July 27, 2016; U.S. Attorney; Eastern District of New York: Long Island Dermatologist Settles Claims That He Defrauded Medicare And Medicaid
United States Attorney Robert L. Capers and Scott J. Lampert, Special Agent-in-Charge, Health and Human Services, Office of Inspector General (HHS-OIG), New York Region, today announced that the United States has entered into a civil settlement agreement with Deremedx Dermatology, P.C. d/b/a Dermatique and Dr. Barry A. Solomon to resolve a case brought under the federal False Claims Act. Solomon is the owner of, and sole practitioner at, Dermatique. The agreement resolves an investigation involving allegations that, in contravention of Medicare and Medicaid regulations, Solomon engaged in a host of fraudulent billing practices and submitted false claims to government healthcare programs.
July 27, 2016; U.S. Attorney; Western District of Pennsylvania: False Claims Act Violation by UPMC Resolved for $2.5 Million
PITTSBURGH - The University of Pittsburgh Medical Center, together with the University of Pittsburgh Physicians, UPMC Community Medicine, Inc., and Tri-State Neurosurgical Associates-UPMC, Inc. ("UPMC") have agreed to pay the United States $2,520,429 to settle False Claims Act allegations, United States Attorney David J. Hickton announced today.
July 27, 2016; U.S. Attorney; District of Oregon: Ophthalmology Biller Pleads Guilty to Healthcare Fraud and Conspiring to Defraud the Internal Revenue Service
PORTLAND, Ore. - The former practice manager for Eye Care Services, Inc. appeared in federal court yesterday and admitted to his role in defrauding Medicare and other public and private health care plans and conspiring to defraud the Internal Revenue Service (IRS). Anthony Curtis Neal, 40, pled guilty to health care fraud and conspiracy to defraud the IRS before U.S. District Judge Robert E. Jones and admitted that he, along with his deceased father, Dr. Dean Neal, committed health care fraud and tax related crimes between 2007 and 2014. According to the plea agreement, the government will be seeking a sentence of imprisonment and restitution to Medicare, private insurers and the IRS. The actual sentence will be determined by Judge Jones at Anthony Neal's sentencing hearing which is scheduled for January 4, 2017.
July 26, 2016; U.S. Attorney; Southern District of Texas: Houston Doctor Convicted for Distributing Prescription Narcotics
HOUSTON - A federal jury has returned guilty verdicts on all 19 counts as charged against a Houston doctor for distributing oxycodone and hydrocodone, announced U.S. Attorney Kenneth Magidson.
July 26, 2016; U.S. Attorney; Northern District of Illinois: Head of Schaumburg Home Health Company Sentenced to Six Years for Scheming to Fraudulently Bill Medicare for Unnecessary Care
CHICAGO - A federal judge today sentenced the head of a Schaumburg home health company to six years in prison for scheming to bill Medicare for millions of dollars in unnecessary services.
July 25, 2016; U.S. Attorney; Eastern District of Louisiana: Local Doctor Arrested for Illegally Dispensing Controlled Substances and Threatening to Kill Law Enforcement
U.S. Attorney Kenneth A. Polite announced the unsealing of a criminal complaint against SHANNON CHRISTOPHER CEASAR, age 43, a physician who practices in Metairie and resides in New Orleans. On Friday, July 22, 2016, CEASAR was arrested on charges of drug distribution and threatening to murder law enforcement agents. According to court records, CEASAR illegally dispensed and conspired with others to illegally dispense controlled substances, including Oxycodone, a Schedule II controlled substance. In addition, based on recorded telephone calls secured by law enforcement, CEASAR was charged with threatening to assault and/or murder federal law enforcement officers with the intent to impede, intimidate, or interfere with such law enforcement officers while engaged in the performance of official duties, or with the intent to retaliate against such law enforcement on account of the performance of official duties.
July 22, 2016; U.S. Department of Justice: Johnson & Johnson Subsidiary Acclarent Inc. Pays Government $18 Million to Settle False Claims Act Allegations
California-based medical device manufacturer Acclarent Inc., a subsidiary of Johnson & Johnson, has agreed to pay $18 million to resolve allegations that the company caused health care providers to submit false claims to Medicare and other federal health care programs by marketing and distributing its sinus spacer product for use as a drug delivery device without U.S. Food and Drug Administration (FDA) approval of that use, the Justice Department announced today.
July 22, 2016; U.S. Attorney; Northern District of Texas: Prefered Imaging, LLC to Pay $3,510,000 to Resolve False Claims Act Allegations
DALLAS - Preferred Imaging, LLC, (Preferred Imaging), a provider of diagnostic imaging services, has agreed to pay $3,510,000 to resolve allegations that it improperly billed Medicare and Medicaid for services performed without proper medical supervision in violation of the False Claims Act and the Texas Medicaid Fraud Prevention Act. Preferred Imaging cooperated with the investigation and, by settling, did not admit any wrongdoing or liability. The announcement was made today by U.S. Attorney John Parker of the Northern District of Texas.
July 22, 2016; U.S. Attorney; Southern District of Florida: Three Individuals Charged in $1 Billion Medicare Fraud and Money Laundering Scheme
The owner of more than 30 Miami-area skilled nursing and assisted living facilities, a hospital administrator and a physician's assistant were charged with conspiracy, obstruction, money laundering and health care fraud in connection with a $1 billion scheme involving numerous Miami-based health care providers.
July 21, 2016; U.S. Attorney; District of Alaska: Anchorage Resident Indicted for Health Care Fraud Scheme
Anchorage, Alaska - U.S. Attorney Karen L. Loeffler announced today that an Anchorage woman was indicted in federal court on one count of committing a health care fraud scheme against the State of Alaska Medicaid program.
July 21, 2016; U.S. Attorney; District of Massachusetts: Former Acclarent, Inc. Executives Convicted of Crimes Related to the Sale of Medical Devices
BOSTON - The former Chief Executive Officer and Vice President of Sales of Acclarent, Inc., a medical device company, were convicted by a federal jury in connection with distributing adulterated and misbranded medical devices.
July 21, 2016; U.S. Attorney; Eastern District of Louisiana: Two Nurses Plead Guilty to Health Care Fraud
U.S. Attorney Kenneth A. Polite announced that ERICA EDWARDS, age 31, of New Orleans, and JEFF KOON, age 43, of Lockport, each pleaded guilty today to one count of health care fraud.
July 19, 2016; U.S. Department of Justice: Jury Convicts Houston Registered Nurse in $8 Million Medicare Fraud Scheme
A registered nurse was convicted today by a federal jury in the Southern District of Texas for participating in an $8 million Medicare fraud scheme involving fraudulent claims for home-health services.
July 19, 2016; U.S. Attorney; Southern District of Texas: Doctor Heads to Prison for Home Health Care Fraud
HOUSTON - A Houston doctor has been ordered to federal prison following his conviction on five counts related to health care fraud, announced U.S. Attorney Kenneth Magidson. A jury deliberated for approximately three hours following a three-day trial before convicting Dr. Warren Dailey, 68, on March 30, 2016, of conspiracy to commit health care fraud, two counts of false statements relating to health care matters, one count of conspiracy to pay and receive health care kickbacks and one count of payment and receipt of health care kickbacks.
July 18, 2016; U.S. Attorney; District of Connecticut: Torrington Woman Pleads Guilty to Health Care Fraud Charge
Deirdre M. Daly, United States Attorney for the District of Connecticut, today announced that on July 15, PATRICIA LAFAYETTE, 61, of Torrington, waived her right to indictment and pleaded guilty before U.S. District Judge Victor A. Bolden in Bridgeport to one count of health care fraud.
July 14, 2016; U.S. Attorney; Southern District of New York: Manhattan U.S. Attorney Announces $9.5 Million Settlement With Columbia University For Improperly Seeking Excessive Cost Recoveries In Connection With Federal Research Grants
Preet Bharara, the United States Attorney for the Southern District of New York, and Scott J. Lampert, Special Agent in Charge of the New York Region of the Office of Inspector General for the U.S. Department of Health and Human Services ("HHS-OIG"), announced today a settlement of a civil fraud lawsuit against THE TRUSTEES OF COLUMBIA UNIVERSITY IN THE CITY OF NEW YORK ("COLUMBIA") for improperly seeking and receiving excessive cost recoveries in connection with research grants funded by the National Institutes of Health ("NIH"). The United States' Complaint-In-Intervention (the "Complaint") alleges that from July 1, 2003, through June 30, 2015, COLUMBIA impermissibly applied its "on-campus" indirect cost rate - instead of the much lower "off-campus" indirect cost rate - when seeking federal reimbursement for 423 NIH grants where the research was primarily performed at off-campus facilities owned and operated by the State of New York and New York City. The Complaint further alleges that COLUMBIA failed to disclose to NIH that it did not own or operate these facilities and that COLUMBIA did not pay for use of the space for most of the relevant period.
July 13, 2016; U.S. Department of Justice: Minnesota-Based Hospice Provider to Pay $18 Million for Alleged False Claims to Medicare for Patients Who Were Not Terminally Ill
Evercare Hospice and Palliative Care will pay $18 million to resolve False Claims Act allegations that it claimed Medicare reimbursement for hospice care for patients who were not eligible for such care because they were not terminally ill, the Justice Department announced today. Evercare, now known as Optum Palliative and Hospice Care, is a Minnesota-based provider of hospice care in Arizona, Colorado and other states across the United States.
July 13, 2016; U.S. Attorney; Eastern District of Kentucky: U.S. District Court Orders $4.5 Million Civil Judgment Against Lexington Woman And Her Medical Device Companies For Committing Grant Fraud
LEXINGTON - The U.S. District Court has entered a civil judgment of $4,506,267 in favor of the United States and against a Lexington woman, and the medical device companies she owns, holding them liable for making false statements that allowed them to receive millions of dollars in federal grants from the National Institutes of Health (NIH).
July 13, 2016; U.S. Attorney; District of New Jersey: Owner Of Union County, New Jersey, Home Health Care Agency Gets 54 Months In Prison For Bilking Medicaid Out Of $7 Million
NEWARK, N.J. - A Springfield, New Jersey, man was sentenced today to more than four years in prison for his role in a scheme that used bogus records and unqualified home health aides to defraud Medicare out of $7 million, U.S. Attorney Paul J. Fishman announced.
July 12, 2016; U.S. Attorney; District of New Jersey: New Jersey Couple And Two Diagnostic Companies Ordered To Pay $7.75 Million For Falsifying Diagnostic Test Reports And Failing To Properly Supervise Tests
NEWARK, N.J. - A Morris County, N.J., couple and their diagnostic imaging companies were ordered to pay more than $7.75 million for knowingly submitting false claims to Medicare for thousands of falsified diagnostic test reports and the underlying tests, U.S. Attorney for New Jersey Paul J. Fishman announced today.
July 7, 2016; U.S. Attorney; Northern District of Alabama: Northwest Alabama Pharmacies Owner Agrees to Plead Guilty to Obstructing Medicare Audit
BIRMINGHAM - The owner of two northwest Alabama pharmacies has agreed to plead guilty to obstructing a Medicare audit and to pay a $2.5 million penalty to the government.
July 7, 2016; U.S. Attorney; Western District of Kentucky: Louisville Based MD2U, A Regional Provider Of Home-Based Care, And Its Principal Owners Admit To Violating The Federal False Claims Act And Being Liable For Millions
LOUISVILLE, KY - MD2U Holding Company, including its related companies and individually named owners ("Defendants"), have agreed to pay millions to resolve a government lawsuit alleging that they violated the federal False Claims Act by knowingly submitting false medical claims to Medicare and other government health care programs, altering records to support false claims, and providing services that were medically unnecessary U.S. Attorney John E. Kuhn, Jr. today announced.
July 6, 2016; U.S. Attorney; Southern District of Florida: Doctor Who Falsely Diagnosed Hundreds of Patients As Part of a Medicare Fraud Scheme Sentenced to Prison
Dr. Isaac Kojo Anakwah Thompson, M.D. 57, of Delray Beach, was sentenced today by United States District Judge William J. Zloch to 46 months' imprisonment, to be followed by two years of supervised release, after having previously pled guilty to health care fraud. Dr. Thompson was further ordered to pay restitution in the amount of $2,114,332.33.
July 5, 2016; U.S. Attorney; District of South Carolina: Drayer Physical Therapy Institute, LLC Settle False Claims Act Case for $7,000,000
Columbia, South Carolina ---- Acting United States Attorney Beth Drake announced today that the U.S. Attorney's Office for the District of South Carolina has settled claims of health care fraud with Drayer Physical Therapy Institute, LLC ("Drayer"). Drayer has locations in South Carolina and 14 other states from Pennsylvania to Oklahoma. The United States contended that Drayer submitted claims to Medicare, TRICARE, and Federal Employee Health Benefit Programs for services being provided to multiple patients simultaneously as though the services were being provided by a physical therapist or physical therapist assistant to one patient at a time.
July 5, 2016; U.S. Attorney; District of Massachusetts: North Shore Ophthalmologist Agrees to Pay $55,000 to Resolve False Medicare Billing Allegations
BOSTON - United States Attorney Carmen M. Ortiz announced today that Martin E. Cutler, M.D., an ophthalmologist with offices in Woburn and Gloucester, and his company, Martin E. Cutler, M.D., P.C., have agreed to pay $55,000 to resolve allegations that they submitted false claims to Medicare. Specifically, the government alleged that, between January 2010 and December 2014, Dr. Cutler and his practice falsely billed Medicare for ophthalmic diagnostic imaging when there was no underlying diagnosis to justify the imaging. They also allegedly falsely billed Medicare for office visits where a prior claim for the same visit had been denied and the new claim was not supported by Dr. Cutler's documentation.
July 1, 2016; U.S. Attorney; Southern District of Indiana: Indianapolis woman posing as a registered nurse sentenced
Indianapolis - United States Attorney Josh Minkler today announced the sentence of an Indianapolis woman for making false statements regarding health care matters and aggravated identity theft. Holly M. Whyde, 45, was sentenced to two years and six months imprisonment by U.S. District Judge Jane Magnus-Stinson.

June 2016

June 30, 2016; U.S. Department of Justice: Florida Cardiologist and His Practice Pay Millions and Agree to Three Years of Exclusion to Resolve Alleged False Billings for Unnecessary Procedures and Illegal Kickbacks
An Ocala, Florida, cardiologist, Dr. Asad Qamar, and his practice, the Institute of Cardiovascular Excellence (ICE), will pay $2 million, plus release any claim to $5.3 million in suspended Medicare funds, to resolve a lawsuit alleging that they improperly billed Medicare, Medicaid and TRICARE for medically unnecessary procedures, and paid kickbacks to patients by waiving Medicare copayments irrespective of financial hardship, the Justice Department announced today. Dr. Qamar also agreed to a three-year period of exclusion from participating in any federal health care program followed by a three-year Integrity Agreement with the Department of Health and Human Services Office of the Inspector General (HHS-OIG). The settlement relates to two consolidated lawsuits in which the United States intervened on Dec. 22, 2014.
June 30, 2016; U.S. Attorney; Eastern District of California: El Dorado County Health Care Provider Agrees to Pay $5.5m to Resolve False Claims Act Allegations
SACRAMENTO, Calif. - Acting U.S. Attorney Phillip A. Talbert announced today that El Dorado County based Marshall Medical Center (MMC) will pay the United States and the State of California $5.5 million to settle allegations that MMC; Marshall Foundation for Community Health; El Dorado Hematology & Medical Oncology II, Inc.; Lin H. Soe, M.D.; and Tsuong Tsai, M.D., violated the federal False Claims Act and the State of California's version of the False Claims Act. The federal lawsuit, filed by whistleblower Colleen Herren, contends that MMC and the other defendants defrauded Medicare, Tricare and Medicaid by a variety of billing improprieties.
June 30, 2016; U.S. Attorney; District of New Jersey: New Jersey Doctor Pleads Guilty In Connection With Test Referral Scheme With New Jersey Clinical Lab
NEWARK, N.J. - A doctor with a practice in Clifton, New Jersey, today admitted taking bribes in connection with a long-running and elaborate test referral scheme operated by Biodiagnostic Laboratory Services LLC (BLS), of Parsippany, New Jersey, its president and numerous associates, U.S. Attorney Paul J. Fishman announced.
June 30, 2016; U.S. Attorney; Western District of Kentucky: McCracken County, Kentucky, Physician Guilty Of Fraudulent Possession Of A Controlled Substance, Wire Fraud And Making False Statements Related To Health Care Matters
PADUCAH, Ky. - A McCracken County, Kentucky, physician plead guilty today, in United States District Court, before Senior District Judge Thomas B. Russell, to fraudulent possession of a controlled substance, wire fraud and making false statements related to health care matters, announced United States Attorney John E. Kuhn, Jr.
June 29, 2016; U.S. Attorney; Eastern District of Pennsylvania: VIP Ambulance Owner Pleads Guilty To False Statements
PHILADELPHIA - Bassem Kuran, 23, of Philadelphia, PA, pleaded guilty on June 28, 2016 to criminal Information charging him with false statements in a health care matter, announced United States Attorney Zane David Memeger. The defendant faces a maximum possible sentence of 5 years in prison, three years of supervised release, a $250,000 fine, and a $100 special assessment. U.S. District Court Judge Gerald J. Pappert scheduled a sentencing hearing for September 30, 2016.
June 29, 2016; U.S. Attorney; Eastern District of Pennsylvania: Jury Finds Philadelphia Doctor Guilty of Running Pill Mill And Causing A Death Through Illegal Distribution
PHILADELPHIA - A federal jury, late yesterday, found William J. O'Brien III, a doctor of osteopathic medicine, guilty of causing a death through the illegal distribution of a controlled substance and a number of other charges related to the operation of a "pill mill," announced United States Attorney Zane David Memeger.
June 29, 2016; U.S. Attorney; Western District of North Carolina: Medical Device Company Agrees To Pay $8 Million To Resolve Claims It Paid Illegal Kickbacks To Physicians
CHARLOTTE, N.C. - Minneapolis-based Cardiovascular Systems, Inc. (CSI), has agreed to pay $8 million to resolve allegations that it paid illegal kickbacks to induce physicians to use the company's medical devices, announced Jill Westmoreland Rose, U.S. Attorney for the Western District of North Carolina.
June 29, 2016; U.S. Attorney; Southern District of Texas: Four Convicted in Health Care Fraud Scheme
HOUSTON - A Houston federal jury has returned guilty verdicts against four defendants on all counts as charged in a $6 million fraudulent Medicare billing scheme, announced U.S. Attorney Kenneth Magidson. Giam Nguyen, D.O., 46, of Houston, Benjamin Martinez, M.D., 35, of Dallas, Donovan Simmons, M.D., 43 of Austin, and Anna Bagoumian, 43 of Glendale, California, were convicted late yesterday following an eight-day trial and approximately 13 hours of deliberation.
June 28, 2016; U.S. Attorney; District of New Jersey: New Jersey Clinical Lab At Center Of Largest Physician Bribery Case Ever Prosecuted Pleads Guilty
NEWARK, N.J. - Biodiagnostic Laboratory Services LLC (BLS), the Parsippany, New Jersey clinical lab at the center of a long-running and elaborate test referral scheme operated by its president and numerous associates, pleaded guilty and was sentenced today in federal court, U.S. Attorney Paul J. Fishman announced.
June 27, 2016; U.S. Attorney; Eastern District of Texas: North Texas Companies and Individuals Pay $1.125 Million to Settle Medicaid Allegations
PLANO, Texas - PLANO, Texas - Ten North Texas companies and individuals agreed to pay the United States a total of $1.125 million to resolve alleged False Claims Act violations for causing false claims to be submitted to the U.S. Department of Health and Human Services (HHS) and its component agency the Centers for Medicare and Medicaid Services (CMS), announced U.S. Attorney John M. Bales.
June 23, 2016; U.S. Attorney; Middle District of Florida: Pinellas County Doctor Arrested And Charged With Multiple Offenses Related To Writing Prescriptions For Compounded Medications
Tampa, FL - United States Attorney A. Lee Bentley, III announces the unsealing of an indictment charging Dr. Anthony Baldizzi (52, Tierra Verde) with one count of conspiracy to defraud the United States, twenty-one counts of health care fraud, one count of money laundering, one count of making a false statement, and one count of receiving illegal kickbacks. The health care fraud and money laundering counts each carry a maximum penalty of 10 years in federal prison. The remaining counts each carry a maximum penalty of five years. The indictment also notifies Baldizzi that the United States is seeking a money judgment in the amount of at least $5.3 million as proceeds of the conspiracy and health care fraud offenses and forfeiture of a 2015 BMW M3, which is alleged as property traceable to proceeds of the charged conduct.
June 23, 2016; U.S. Attorney; District of New Jersey: Doctor Admits Accepting Thousands Of Dollars In Cash Bribes For Referrals To Lab Companies
CAMDEN, N.J. - A doctor with offices in Toms River, New Jersey, today admitted accepting thousands of dollars in exchange for patient referrals to two lab companies that performed blood and DNA testing, U.S. Attorney Paul J. Fishman announced.
June 22, 2016; U.S. Attorney; Western District of Kentucky: McCracken County, Kentucky, Physician Charged With Fraudulent Possession Of A Controlled Substance, Wire Fraud And Making False Statements Related To Health Care Matters
PADUCAH, Ky. - A McCracken County, Kentucky, physician was charged by federal Information today with the fraudulent possession of a controlled substance, wire fraud and making false statements related to health care matters, announced United States Attorney John E. Kuhn, Jr.
June 22, 2016; U.S. Attorney; Western District of Kentucky: Med 1st Of Evansville, P.C., Charged With Conspiracy To Commit Health Care Fraud, Conspiracy To Violate The Controlled Substance Act And Money Laundering
LOUISVILLE, Ky. - MED 1st of Evansville, P.C., located in Evansville, Indiana, was charged by Grand Jury Indictment today with conspiracy to commit health care fraud, health care fraud, and conspiracy to violate the Controlled Substance Act announced United States Attorney John E. Kuhn, Jr.
June 22, 2016; U.S. Attorney; Eastern District of Pennsylvania: Delaware County Podiatrist Charged With $5 Million Health Care Fraud Scheme
PHILADELPHIA - Stephen A. Monaco, D.P.M., 59, of Broomall PA was charged by criminal information, unsealed today, in connection with a $5 million scheme to defraud Medicare, Medicaid and four private victim insurance companies, announced United States Attorney Zane David Memeger. The information alleges that Dr. Monaco committed the fraud through his practice, A Foot Above Podiatry, Inc. ("A Foot Above"), located in Havertown PA.
June 22, 2016; U.S. Attorney; Middle District of Alabama: Two Charged in Dothan, Alabama as Part of Largest National Medicare Fraud Takedown in History
Montgomery, Alabama - U.S. Attorney George L. Beck Jr., Alabama Attorney General Luther Strange, United States Attorney General Loretta E. Lynch, and Department of Health and Human Services (HHS) Secretary Sylvia Mathews Burwell, announced today an unprecedented nationwide sweep led by the Medicare Fraud Strike Force in 36 federal districts, resulting in criminal and civil charges against 301 individuals, including 61 doctors, nurses and other licensed medical professionals, for their alleged participation in health care fraud schemes involving approximately $900 million in false billings. Twenty-three state Medicaid Fraud Control Units also participated in today's arrests. In addition, the HHS Centers for Medicare & Medicaid Services (CMS) is suspending payment to a number of providers using its suspension authority provided in the Affordable Care Act. This coordinated takedown is the largest in history, both in terms of the number of defendants charged and loss amount.
June 22, 2016; U.S. Attorney; District of Connecticut: Stamford Woman Charged with Operating Health Care Fraud Scheme
Deirdre M. Daly, United States Attorney for the District of Connecticut, today announced that ELENA ILIZAROV, 43, of Stamford, was arrested yesterday on a federal criminal complaint alleging that she used stolen identity information to operate a health care fraud scheme. ILIZAROV owned and operated Advanced Dentistry, a dental practice located in Stamford.
June 22, 2016; U.S. Attorney; Northern District of Illinois: Two North Suburban Doctors Charged as Part of Largest National Medicare Fraud Takedown in History
CHICAGO - Two north suburban doctors have been charged as part of the largest national Medicare fraud takedown in history, federal authorities announced today.
June 22, 2016; U.S. Attorney; Middle District of Florida: Fifteen Charged In Middle District As Part Of Largest National Health Care Fraud Takedown In History
Tampa, FL - United States Attorney A. Lee Bentley, III, Attorney General Loretta E. Lynch, and Department of Health and Human Services (HHS) Secretary Sylvia Mathews Burwell announced today an unprecedented nationwide sweep led by the Medicare Fraud Strike Force in 36 federal districts, resulting in criminal and civil charges against 301 individuals, including 61 doctors, nurses and other licensed medical professionals, for their alleged participation in health care fraud schemes involving approximately $900 million in false billings. Twenty-three state Medicaid Fraud Control Units also participated in today's arrests. In addition, the HHS Centers for Medicare & Medicaid Services (CMS) is suspending payment to a number of providers using its suspension authority provided in the Affordable Care Act. This coordinated takedown is the largest in history, both in terms of the number of defendants charged and loss amount.
June 22, 2016; U.S. Attorney; Northern District of Georgia: Georgia Dentist Indicted for Medicaid Fraud and Money Laundering
ATLANTA - A federal grand jury has indicted Oluwatoyin Solarin for filing false Medicaid claims, money laundering, and seeking to evade banking reporting requirements.
June 22, 2016; U.S. Attorney; Southern District of Texas: 22 Charged in SDTX as Part of Largest National Medicare Fraud Takedown in History
HOUSTON - Attorney General Loretta E. Lynch and Department of Health and Human Services (DHHS) Secretary Sylvia Mathews Burwell announced today an unprecedented nationwide sweep led by the Medicare Fraud Strike Force in 36 federal districts, resulting in criminal and civil charges against 301 individuals, including 61 doctors, nurses and other licensed medical professionals, for their alleged participation in health care fraud schemes involving approximately $900 million in false billings. Twenty-three state Medicaid Fraud Control Units also participated in today's arrests. In addition, the HHS Centers for Medicare & Medicaid Services (CMS) is suspending payment to a number of providers using its suspension authority provided in the Affordable Care Act. This coordinated takedown is the largest in history, both in terms of the number of defendants charged and loss amount.
June 22, 2016; U.S. Attorney; Northern District of Texas: Twelve Charged in Dallas as Part of Largest National Medicare Fraud Takedown in History
DALLAS - Attorney General Loretta E. Lynch and Department of Health and Human Services (HHS) Secretary Sylvia Mathews Burwell announced today an unprecedented nationwide sweep led by the Medicare Fraud Strike Force in 36 federal districts, resulting in criminal and civil charges against 301 individuals, including 61 doctors, nurses and other licensed medical professionals, for their alleged participation in health care fraud schemes involving approximately $900 million in false billings. Twenty-three state Medicaid Fraud Control Units also participated in today's arrests. In addition, the HHS Centers for Medicare & Medicaid Services (CMS) also suspended a number of providers using its suspension authority provided in the Affordable Care Act. This coordinated takedown is the largest in the history of the Medicare Fraud Strike Force, both in terms of the number of defendants charged and loss amount.
June 22, 2016; U.S. Attorney; Southern District of New York: New York City Pharmacy Owner Arrested For $8.5 Million Fraud As Part Of Largest National Medicare Fraud Takedown In History
Preet Bharara, the United States Attorney for the Southern District of New York, Diego Rodriguez, the Assistant Director-in-Charge of the New York Office of the Federal Bureau of Investigation ("FBI"), and Scott J. Lampert, the Special Agent-in-Charge of the New York Office of the Department of Health and Human Services, announced today that SAJID JAVED was charged with participating in a health care fraud scheme that used nine pharmacies in Brooklyn and Queens, New York, through which JAVED submitted more than $8.5 million in fraudulent claims to Medicaid and Medicare. JAVED's arrest is part of an unprecedented nationwide sweep led by the Medicare Fraud Strike Force, resulting in criminal and civil charges against 301 individuals, including 61 doctors, nurses, or other licensed medical professionals, for their alleged participation in health care fraud schemes involving approximately $900 million in false billings. Twenty-three state Medicaid Fraud Control Units also participated in today's arrests. In addition, the HHS Centers for Medicare & Medicaid Services ("CMS") also suspended a number of providers using its suspension authority provided in the Affordable Care Act. This coordinated takedown is the largest in the history of the Medicare Fraud Strike Force, both in terms of the number of defendants charged and loss amount.
June 22, 2016; U.S. Attorney; District of Vermont: Brandon Woman Arrested For Medicaid Fraud During National Takedown
The Office of the United States Attorney for the District of Vermont announced that Misti Baker, 36, of Brandon, Vermont, was arrested today as part of a national healthcare fraud takedown. U.S. Magistrate Judge John M. Conroy ordered Baker detained pending a detention hearing on June 24, 2016.
June 22, 2016; U.S. Department of Justice: National Health Care Fraud Takedown Results in Charges against 301 Individuals for Approximately $900 Million in False Billing
Attorney General Loretta E. Lynch and Department of Health and Human Services (HHS) Secretary Sylvia Mathews Burwell announced today an unprecedented nationwide sweep led by the Medicare Fraud Strike Force in 36 federal districts, resulting in criminal and civil charges against 301 individuals, including 61 doctors, nurses and other licensed medical professionals, for their alleged participation in health care fraud schemes involving approximately $900 million in false billings. Twenty-three state Medicaid Fraud Control Units also participated in today's arrests. In addition, the HHS Centers for Medicare & Medicaid Services (CMS) is suspending payment to a number of providers using its suspension authority provided in the Affordable Care Act. This coordinated takedown is the largest in history, both in terms of the number of defendants charged and loss amount.
June 20, 2016; U.S. Attorney; Central District of California: Organizer of $9 Million Scam Sentenced to 8 Years in Federal Prison in Scheme to Provide Hospice to Patients who were not Terminally Ill
LOS ANGELES - A Placentia woman was sentenced today to 96 months in federal prison related to her operation of a hospice that submitted more than $9 million in fraudulent bills to Medicare and Medi-Cal for purportedly providing end-of-life care to patients who were not actually dying.
June 17, 2016; U.S. Attorney; Northern District of Alabama: Federal Jury Convicts Former Non-Profit Health Clinics CEO for Funneling Millions in Grant Money to Private Companies
BIRMINGHAM - A federal jury today convicted the former chief executive of two non-profit health clinics for the poor and homeless for funneling millions in federal grant money to private companies he formed to contract with the clinics. U.S. Attorney Joyce White Vance, FBI Special Agent in Charge Roger C. Stanton, Internal Revenue Service-Criminal Investigation Special Agent in Charge Veronica Hyman-Pillot, and U.S. Department of Health and Human Services, Office of Inspector General, Special Agent in Charge Derrick L. Jackson announced the verdict.
June 17, 2016; U.S. Attorney; District of Maryland: Vice President of X-Ray Company Sentenced to Four Years in Federal Prison for Health Care Fraud
Baltimore, Maryland - U.S. District Judge James K. Bredar sentenced Timothy Emeigh, age 52, of York Springs, Pennsylvania today to four years in prison, followed by one year of supervised release, for health care fraud arising from a scheme in which insurance providers and Medicare were fraudulently billed for tests interpreted by unlicensed personnel, and for tests and services which in fact had not been provided.
June 16, 2016; U.S. Attorney; Northern District of Texas: North Richland Hills Physician Admits Role in Health Care Fraud Conspiracy
DALLAS, Texas - A licensed physician from North Richland Hills, Texas, Byron Felton Conner, 48, pleaded guilty today to one count of conspiracy to commit health care fraud stemming from a scheme to defraud Medicare through the submission of false claims for physician home visits and home health care services. The announcement was made today by U.S. Attorney John Parker of the Northern District of Texas.
June 15, 2016; U.S. Attorney; District of Maryland: Maryland Health Care Provider Sentenced to 10 Years in Federal Prison for Health Care Fraud Resulting in Patient Deaths
Baltimore, Maryland - U. S. District Judge James K. Bredar sentenced the owner of Alpha Diagnostics, Rafael Chikvashvili, age 69, of Baltimore, Maryland, today to 10 years in prison, followed by two years of supervised release, for charges related to a health care fraud and wire fraud conspiracy resulting in the deaths of patients, as well as false statements and aggravated identity theft, related to a scheme to defraud Medicare and Medicaid of more than $6 million. Judge Bredar also ordered that Chikvashvili pay restitution and forfeit proceeds of the fraud, with the exact amount to be determined at a later date. Chikvashvili has been detained since his conviction by a federal jury on February 17, 2016.
June 14, 2016; U.S. Attorney; Southern District of New York: Former Owner And Operator Of Purported HIV/AIDS Health Clinics Sentenced To 63 Months In Prison For $12 Million Medicare Fraud Scheme
Preet Bharara, the United States Attorney for the Southern District of New York, announced that JORGE JUVIER, a former owner and operator of multiple HIV/AIDS clinics in New York City, was sentenced today to 63 months in prison for engaging in a scheme to defraud Medicare out of more than $12 million through the use of fraudulent HIV/AIDS clinics in New York City. As part of the Medicare fraud scheme, JUVIER and his co-conspirators paid patients cash kickbacks for coming to the clinics, coached patients on lies to tell clinic doctors to enable fraudulent billing, and billed Medicare for medications that were never administered, that were administered at incorrect dosages, or that were medically unnecessary. JUVIER previously pled guilty to conspiring to commit health care fraud before U.S. Magistrate Judge Frank Maas. U.S. District Judge Kimba M. Wood imposed today's sentence.
June 13, 2016; U.S. Department of Justice: Former Fugitive Sentenced to Prison for Florida Multimillion-Dollar Health Care Fraud Scheme
A Cuban national was sentenced to 37 months in prison today for his role in a multimillion-dollar health care fraud scheme in the greater Tampa, Florida, area.
June 10, 2016; U.S. Attorney; Southern District of Texas: Houston Physician Sentenced in Health Care Fraud Conspiracy
HOUSTON - Two defendants in a nearly $3 million fraudulent vestibular diagnostic testing scheme have been ordered to federal prison, announced U.S. Attorney Kenneth Magidson. Dr. Augustine Egbunike, 61, pleaded guilty Jan. 16, 2015, while Loretta Mbadugha, 58, also of Houston, entered a plea for her role in the scheme Dec. 12, 2014.
June 9, 2016; U.S. Attorney; Southern District of New York: Manhattan U.S. Attorney Announces $54 Million Settlement Against Salix Pharmaceuticals For Using "Speaker Programs" As Mechanism To Pay Illegal Kickbacks To Doctors To Induce Them To Prescribe Salix Products
Preet Bharara, the United States Attorney for the Southern District of New York, Scott J. Lampert, Special Agent in Charge of the U.S. Department of Health and Human Services, Office of Inspector General's New York Region ("HHS-OIG"), and Diego Rodriguez, Assistant Director-in-Charge of the New York Field Office of the Federal Bureau of Investigation ("FBI"), announced today a $54 million settlement in a civil fraud lawsuit against SALIX PHARMACEUTICALS, INC. ("SALIX"), a specialty pharmaceutical company based in Raleigh, North Carolina, that sells products used to treat various gastroenterology conditions.
June 9, 2016; U.S. Attorney; Southern District of New York: Former Pharmaceutical Company Employees Arrested For Participating In Fentanyl Kickback Scheme
Preet Bharara, the United States Attorney for the Southern District of New York, Diego Rodriguez, Assistant Director-in-Charge of the New York Field Office of the Federal Bureau of Investigation ("FBI"), and Scott Lampert, Special Agent in Charge of the U.S. Department of Health and Human Services, Office of Inspector General's ("HHS-OIG") New York Region, announced that JONATHAN ROPER, a former District Manager at a pharmaceutical company ("Pharma Company-1"), and FERNANDO SERRANO, a former sales representative at Pharma Company-1, were charged today with violating the Anti-Kickback Statute in connection with their participation in a scheme to pay doctors thousands of dollars to participate in sham educational programs in order to induce the doctors to prescribe millions of dollars' worth of a fentanyl-based sublingual spray manufactured by Pharma Company-1 (the "Fentanyl Spray"). ROPER was arrested this morning by FBI agents on Long Island, and SERRANO was arrested this morning by FBI agents in New Jersey.
June 8, 2016; U.S. Attorney; District of Columbia: Nurse-Practitioner Indicted on Federal Charges, Accused of Illegally Distributing Oxycodone
WASHINGTON - Ivan Lamont Robinson, a licensed nurse practitioner who was based in Southeast Washington, has been indicted on federal charges that he distributed oxycodone outside the legitimate scope of professional practice and without a legitimate medical purpose.
June 8, 2016; U.S. Attorney; District of New Jersey: Physician Sentenced To One Year In Prison For Accepting More Than $174,000 In Bribes For Referrals To Mobile Diagnostic Company
TRENTON, N.J. - An internal medicine physician practicing in Jamesburg, New Jersey, was sentenced today to 12 months in prison for accepting bribes in exchange for patient referrals to a mobile diagnostic company, U.S. Attorney Paul J. Fishman announced.
June 8, 2016; U.S. Attorney; District of New Jersey: New York Doctor Sentenced To 37 Months In Prison For Taking Bribes In Test-Referral Scheme With New Jersey Clinical Lab
NEWARK, N.J. - A doctor who admitted taking bribes in connection with a long-running and elaborate test referral scheme operated by Biodiagnostic Laboratory Services LLC (BLS), of Parsippany, New Jersey, its president and numerous associates was sentenced today to 37 months in prison, U.S. Attorney Paul J. Fishman announced.
June 8, 2016; U.S. Attorney; District of Maryland: Frederick Pediatrician Whose License Was Revoked Admits to Prescribing Oxycodone Without a Medical Need
Baltimore, Maryland - Nicola Tauraso, age 81, of Frederick, Maryland pleaded guilty today to health care fraud.
June 8, 2016; U.S. Attorney; District of Vermont: Paul Hebert Sentenced to Four Year Term of Probation and $5,000 Fine for Social Security and Medicaid Fraud
The Office of the United States Attorney for the District of Vermont announced that Paul Hebert, 51, of Gloucester, Massachusetts, formerly of Barre, Vermont, was sentenced today for Social Security fraud and Medicaid fraud. Chief District Judge Christina Reiss sentenced Hebert to a four year term of probation, a $5,000 fine, and ordered to pay restitution totaling $53,660.57.
June 8, 2016; U.S. Attorney; Middle District of Tennessee: Hendersonville Physician Indicted on Federal Kickback Charges
Dr. Hailu T. Kabtimer, 56, of Hendersonville, Tennessee, was indicted by a federal grand jury today, charging him with five counts of violating the federal anti-kickback act, announced David Rivera, United States Attorney for the Middle District of Tennessee.
June 6, 2016; U.S. Department of Justice: Pharmaceutical Companies to Pay $67 Million To Resolve False Claims Act Allegations Relating to Tarceva
Pharmaceutical companies Genentech Inc. and OSI Pharmaceuticals LLC will pay $67 million to resolve False Claims Act allegations that they made misleading statements about the effectiveness of the drug Tarceva to treat non-small cell lung cancer, the Department of Justice announced today. Genentech, located in South San Francisco, California, and OSI Pharmaceuticals, located in Farmingdale, New York, co-promote Tarceva, which is approved to treat certain patients with non-small cell lung cancer or pancreatic cancer. OSI Pharmaceuticals LLC is the successor to OSI Pharmaceuticals Inc., which was acquired by Astellas Holding US Inc. in 2010 and converted to a limited liability company in 2011.
June 5, 2016; U.S. Attorney; District of South Dakota: Rapid City Woman Indicted for Health Care Fraud and Identity Theft
United States Attorney Randolph J. Seiler announced that a Rapid City, South Dakota, woman has been indicted by a federal grand jury for False Statements Relating to Health Care Matters, Aggravated Identity Theft, Health Care Fraud, and Obtaining or Attempting to Obtain Controlled Substances by Fraud.
June 2, 2016; U.S. Attorney; Middle District of Louisiana: Owner And Chief Financial Officer Of Healthcare Company Sentenced To Prison For Their Roles In Fraud Scheme
BATON ROUGE, LA - BARBARA A. SADLER, age 63, of Zachary, Louisiana, and SEDRIC C. BLAKES, age 42, of Zachary, Louisiana, have been sentenced to federal prison arising out of their convictions in a multi-million dollar scheme to defraud the Louisiana Medicaid program through Extraordinary Care Network, Inc. ("Extraordinary"), an attendant care services company that SADLER and BLAKES owned and operated.
June 2, 2016; U.S. Attorney; Western District of Pennsylvania: Former Horizons Hospice Chief Operating Officer Pleads Guilty to Health Care Fraud
PITTSBURGH - A Cambria County resident pleaded guilty in federal court to a charge of health care fraud, United States Attorney David J. Hickton announced today.
June 1, 2016; U.S. Attorney; District of Columbia: Owners of Home Health Care Agency Sentenced to Prison For Taking Part in $80 Million Medicaid Fraud
WASHINGTON -Florence Bikundi and her husband, Michael D. Bikundi, Sr., the owners of Global Healthcare, Inc., a home care agency, were sentenced today to prison terms for health care fraud, money laundering, and other charges stemming from a scheme in which they and others defrauded the District of Columbia Medicaid program of over $80 million.
June 1, 2016; U.S. Attorney; Middle District of Tennessee: Former CEO-Physician and Drug Testing Laboratory Pay $9.35 Million to Settle False Claims Act Allegations
Dr. Jonathan Oppenheimer, former owner and CEO of Nashville drug testing laboratory Prost-Data, Inc., d/b/a OURLab ("OURLab"), OPKO Health, Inc. ("OPKO"), and OPKO Lab, LLC, have agreed to pay $9.35 million to resolve False Claims Act ("FCA") allegations, announced David Rivera, United States Attorney for the Middle District of Tennessee. Pursuant to the civil settlement, Oppenheimer, and OPKO will be jointly and severally liable for the settlement amount. OPKO is a successor to OPKO Lab, LLC, which purchased OURLab from Oppenheimer in December 2012, after OURLab and Oppenheimer instituted the alleged conduct. OPKO Lab, LLC ceased commercial operations in early 2016 and is no longer billing federal payors. Oppenheimer has agreed to an exclusion from participation in all federal health care programs for 5 years as part of the agreement.

May 2016

May 31, 2016; District of Connecticut: Former Connecticut Group Home Operator Pays $1.5 Million to Settle Overbilling Allegations
U.S. Attorney Deirdre M. Daly and Connecticut Attorney General George Jepsen today announced that REM CONNECTICUT COMMUNITY SERVICES, INC. ("REM") has entered into a civil settlement agreement with the federal and state governments in which it will pay $1.5 million to resolve allegations that it received overpayments from the Connecticut Medicaid Program.
May 31, 2016; District of New Jersey: Newark Hospital To Pay $450,000 For Allegedly Billing Health Care Programs For Unnecessary Procedures
NEWARK, N.J. - Saint Michael's Medical Center Inc., located in Newark, New Jersey, has agreed to pay $450,000 to resolve allegations that it falsely billed Medicare and Medicaid for medically unnecessary cardiac procedures, U.S. Attorney Paul J. Fishman announced today.
May 27, 2016; U.S. Department of Justice: Patient Recruiter Sentenced to 60 Months in Prison for Role in $2.3 Million Miami Medicare Fraud Scheme
The owner and president of a Miami-area consulting and staffing company was sentenced today to 60 months in prison for his role in a $2.3 million Medicare fraud scheme.
May 27, 2016; U.S. Attorney; District of Maryland: Paradigm Spine Agrees to Resolve False Claims Act Allegations
Baltimore, Maryland - Medical device manufacturer Paradigm Spine has agreed to pay the United States $585,000 to resolve allegations under the False Claims Act that the company caused health care providers to submit false claims to Medicare and other federal health care programs for spine surgeries by marketing the company's coflex-F® device for surgical uses that were not approved by the U.S. Food and Drug Administration (FDA). The settlement further resolves allegations that Paradigm caused false claims by giving false recommendations on how to code health claims for procedures involving the company's coflex® device.
May 26, 2016; U.S. Attorney; Central District of California: Medical Doctor Arrested on Federal 'Structuring' Charges for Making Cash Deposits to Avoid Federal Reporting Requirements
LOS ANGELES - A Los Angeles-area doctor was arrested this morning after being indicted on federal "structuring" charges that allege he made hundreds of thousands of dollars in cash deposits designed to circumvent federal reporting requirement.
May 26, 2016; U.S. Attorney; Middle District of Pennsylvania: Tioga County Physician And Drug Dealer Sentenced For Health Care Fraud
WILLIAMSPORT - The United States Attorney's Office for the Middle District of Pennsylvania announced today that Dr. John Terry, age 65, and Thomas Ray, age 53, both of Wellsboro, were sentenced yesterday by Chief United States District Court Judge Christopher C. Conner in Williamsport. Terry was sentenced to 20 months' in federal prison and ordered to pay $4,762 in restitution to the state Department of Human Services for fraudulent prescriptions he wrote for Oxycodone, a Schedule II controlled substance.
May 25, 2016; U.S. Department of Justice: United States Intervenes in False Claims Act Lawsuit Against Prime Healthcare Services Inc. and its CEO Alleging Unnecessary Inpatient Admissions from Emergency Rooms
The United States has intervened in a lawsuit against Prime Healthcare Services Inc. (Prime); the company's founder and chief executive officer, Dr. Prem Reddy; and 14 Prime hospitals in California that alleges Emergency Departments at Prime facilities improperly admitted patients to the hospitals and submitted false claims to Medicare, the Justice Department announced today.
May 25, 2016; U.S. Attorney; Eastern District of New York: New York Pharmacist Pleads Guilty To Medicare And Medicaid Fraud And Tax Fraud
Earlier today, Andrew Barrett, a New York pharmacist and pharmacy owner, pleaded guilty to health care fraud and filing false tax returns. From January 2011 to December 2012, Barrett operated pharmacies in Bronx, Rockland, and Queens counties in New York State. From his Queens pharmacy, Barrett fraudulently billed Medicare and Medicaid approximately $2.7 million for prescription medications that he never dispensed to patients. Barrett also siphoned off over $2.6 million for personal expenses from the Bronx and Rockland pharmacy accounts while falsely claiming those funds as business expenses on his tax returns. When sentenced, Barrett faces up to ten years in prison, as well as restitution, criminal forfeiture, and a fine.
May 24, 2016; U.S. Attorney; District of Connecticut: Bristol Woman, 2 Others Charged with Health Care Fraud
Deirdre M. Daly, United States Attorney for the District of Connecticut, Phillip Coyne, Special Agent in Charge for the U.S. Department of Health and Human Services, Office of Inspector General, and Chief State's Attorney Kevin T. Kane today announced that a federal grand jury in New Haven has returned an indictment charging RONNETTE BROWN, 43, of Bristol, with 23 counts of health care fraud and one count of conspiracy to commit health care fraud.
May 20, 2016; U.S. Attorney; Northern District of Illinois: Local Physician Pleads Guilty to Health Care Fraud
ROCKFORD - A suspended physician pleaded guilty today in federal court to charges of health care fraud. CHARLES S. DEHANN, 61, of Belvidere, Ill., pleaded guilty before Judge Frederick J. Kapala to two counts of health care fraud in a scheme to defraud Medicare that included overbilling and billing Medicare for treatment of patients that were already deceased.
May 20, 2016; U.S. Attorney; District of Puerto Rico: Government Reaches $2.5 Million Settlement in Healthcare Fraud Matter
SAN JUAN, Puerto Rico - On May 18, 2016, the U.S. Government entered into an out of court settlement agreement with Hospicio La Paz, Inc., in connection with a False Claims Act investigation carried out by the U.S. Department of Health and Human Services, Office of Inspector General (HHS-OIG) and the U.S. Attorney's Office, District of Puerto Rico. The investigation uncovered approximately $1,504,509.00 in questionable billings submitted for payment by Hospicio La Paz, Inc. to Medicare Program, Part A, from October 2011, through September 2012.
May 18, 2016; U.S. Attorney; Western District of Missouri: Jefferson City Physician Pleads Guilty to Making False Statements
KANSAS CITY, Mo. - Tammy Dickinson, United States Attorney for the Western District of Missouri, announced today that a Jefferson City, Mo., physician has pleaded guilty in federal court to making false statements in order to receive payments on health care claims.
May 17, 2016; U.S. Attorney; Western District of Arkansas: Fort Smith Man Arraigned on Charges of Defrauding Investors and the Department of Health and Human Services
Fort Smith, Arkansas - Kenneth Elser, United States Attorney for the Western District of Arkansas, announced that William Jackson Moates, Jr., age 49, of Fort Smith, Arkansas, appeared before United States Magistrate Judge Mark Ford for arraignment on a 25 count Indictment charging him with Money Laundering, Wire Fraud, Theft Concerning a Program Receiving Federal Funds, Mail Fraud, Bank Fraud, and Theft or Embezzlement from Employee Benefit Plan.
May 16, 2016; U.S. Attorney; Eastern District of Pennsylvania: Ambulance Company Owner Charged With Making False Statements In A Health Care Matter
PHILADELPHIA - Bassem Kuran, 23, of Philadelphia, formerly the owner of VIP Ambulance, Inc., ("VIP") now defunct, was charged by information with making false statements in a health care matter, announced United States Attorney Zane David Memeger.
May 12, 2016; U.S. Department of Justice: Kentucky Anesthesiologist Sentenced to 100 Months for Unlawful Distribution of Controlled Substances, Health Care Fraud, Conspiracy and Money Laundering
Anesthesiologist Jaime Guerrero, 48, of Kentuckiana, Kentucky, was sentenced in federal court in Louisville, Kentucky, to 100 months in prison for his role in the unlawful distribution of controlled substances, including the prescription opioid hydrocodone without a legitimate medical purpose and related crimes, announced U.S. Attorney John E. Kuhn Jr for the Western District of Kentucky.
May 12, 2016; U.S. Attorney; District of Massachusetts: Healthcare Sale Representative Pleads Guilty to Obstructing Federal Investigation
BOSTON - A sales representative for multiple healthcare companies pleaded guilty today in U.S. District Court in Boston in connection with obstruction of an investigation into kickbacks paid to medical professionals.
May 12, 2016; U.S. Attorney; Western District of Virginia: Florida Woman Sentenced for Health Care Fraud
ROANOKE, VIRGINIA - A Florida woman, who billed Medicaid for services she did not provide while living and working in the New River Valley, was sentenced today in the United States District Court for the Western District of Virginia in Roanoke on healthcare fraud charges, United States Attorney John P. Fishwick Jr. and Virginia Attorney General Mark R. Herring announced today.
May 11, 2016; U.S. Attorney; Southern District of Illinois: Granite City Chiropractor Pleads Guilty To Healthcare Fraud And Money Laundering
James L. Porter, Acting United States Attorney for the Southern District of Illinois, announced today, that Bridget Brasfield, 45, of Edwardsville, Illinois, pled guilty to a two-count information charging Health Care Fraud and Money Laundering. Sentencing has been set for August 30, 2016, in U.S. District Court in Benton, Illinois. At that time Brasfield will face up to 20 years in prison, a fine of up to $500,000, and up to 3 years of supervised release.
May 11, 2016; Eastern District of Pennsylvania: Three Doctors Indicted For Illegally Selling Prescriptions Of Suboxone And Klonopin
PHILADELPHIA - An indictment was filed today charging three doctors in a scheme to sell commonly abused prescription drugs in exchange for cash payments. Charged in the conspiracy are: Dr. Alan Summers, 78, of Ambler, PA; Dr. Azad Khan, 63, of Villanova, PA; and Dr. Keyhosrow Parsia, 79, of Ridley Park, PA. The indictment includes charges of conspiracy to distribute controlled substances, distribution of controlled substances, health care fraud, and money laundering and was announced by United States Attorney Zane David Memeger, Drug Enforcement Administration Special Agent-in-Charge Gary Tuggle, and Special Agent-in-Charge Nick DiGuilio with Health and Human Services Office of Inspector General.
May 9, 2016; U.S. Attorney; Eastern District of California: Lodi Oncologist and Office Administrator Pay $300,000 to Settle False Claims Act Allegations
SACRAMENTO, Calif. - A Lodi oncologist and his wife, who served as the doctor's office administrator, have paid the United States $300,000 to settle allegations that they improperly billed Medicare for certain chemotherapy drugs purchased from an unlicensed foreign pharmaceutical distributor, Acting United States Attorney Phillip A. Talbert announced today.
May 6, 2016; U.S. Attorney; Eastern District of Pennsylvania: Settlement Reached Over University's Home Health Care Billing
PHILADELPHIA - The United States has reached a settlement agreement with the Trustees of the University of Pennsylvania, on behalf of its operating divisions, including the University of Pennsylvania Health System (UPHS), for the alleged submission of false home health care billings to the Medicare program. The settlement includes $75,787 to resolve allegations that Penn Care at Home violated the False Claims Act by submitting claims to Medicare for services not rendered and for services that were not reasonable or necessary. As part of the settlement agreement, UPHS has also agreed to implement new compliance oversight measures for its home health entities and will annually submit certified compliance reports pertaining to its home health entities to the United States Attorney's Office through 2019. The settlement releases UPHS from liability for conduct pertaining to a specific limited number of episodes of patient care.
May 5, 2016; U.S. Attorney; Southern District of New York: Manhattan U.S. Attorney Announces $4.3 Million Settlement Of False Claims Act Action Based On New York City Fire Department's Receipt Of Improper Reimbursements From Medicare
Preet Bharara, the United States Attorney for the Southern District of New York, and Scott J. Lampert, Special Agent in Charge of the U.S. Department of Health and Human Services, Office of Inspector General's New York Region ("HHS-OIG"), announced today that the United States has settled civil claims under the False Claims Act against the City of New York (the "City") related to the receipt by the New York City Fire Department ("FDNY") of reimbursements for claims for emergency ambulance services that did not meet Medicare's medical necessity requirement. This matter was brought to the attention of the U.S. Attorney's Office through a voluntary disclosure by the City.
May 5, 2016; U.S. Attorney; Central District of California: Two Doctors Convicted of Falsely Certifying 'Patients' as Terminally Ill as Part of $8.8 Million Healthcare Fraud Scheme
LOS ANGELES - Two doctors were found guilty today of federal health care fraud charges for falsely certifying that Medicare patients were terminally ill, and therefore qualified for hospice care, when the vast majority of them were not actually dying.
May 3, 2016; U.S. Attorney; Eastern District of Virginia: Alexandria Adult Day Healthcare Center Settles Civil Fraud Allegations
ALEXANDRIA, Va. - Agape Health Management, Inc., which operates under the name Agape Adult Day Healthcare Center, located in Alexandria, has agreed to pay $385,917 to settle federal and state civil fraud allegations that claimed Agape submitted false claims for reimbursement to the Virginia Medicaid Program.
May 2, 2016; U.S. Department of Justice: New Orleans Jury Convicts Company Owner for Directing $3 Million Fraud and Kickback Scheme
On Saturday, a jury in New Orleans convicted the owner of a health care company for her role in a $3.2 million Medicare fraud scheme operating in and around New Orleans.
May 2, 2016; U.S. Attorney; Western District of North Carolina: Hickory, N.C. Physician Sentenced To 18 Months In Prison For Health Care Fraud
CHARLOTTE, N.C. - A Hickory physician was sentenced to 18 months in prison today on health care fraud charges for submitting to Medicaid and Medicare over $467,376 in fraudulent reimbursement claims, announced Jill Westmoreland Rose, U.S. Attorney for the Western District of North Carolina. Wayne Vincent Wilson, 55, was also ordered to serve one year of supervised release and to pay $208,112.58 as restitution to Medicaid and $2,148.08 to Medicare.

April 2016

April 29, 2016; U.S. Attorney; District of Massachusetts: Byram Healthcare and Hollister, Inc. to Pay $20 Million to Resolve Kickback Allegations
BOSTON - United States Attorney Carmen M. Ortiz announced today that Hollister, Inc., a manufacturer of disposable health care products, and Byram Healthcare Centers, Inc., a supplier of medical products, have agreed to pay $11.44 million and $9.3 million, respectively, to resolve allegations that they engaged in a kickback scheme designed to increase sales and profits.
April 28, 2016; U.S. Department of Justice: California Doctor Pleads Guilty to $2.4 Million Medicare Fraud Scheme
A Valencia, California, doctor pleaded guilty today to submitting more than $2.4 million in fraudulent claims to Medicare.
April 28, 2016; U.S. Department of Justice: Twenty-Five Miami-Area Defendants Charged with Submitting $26 Million in False Claims to the Medicare Part D Program
Charges were filed today against 25 Miami-area defendants in three separate cases for their alleged participation in various schemes to defraud Medicare of approximately $26 million in false claims through the Medicare Part D program.
April 28, 2016; U.S. Attorney; Eastern District of Pennsylvania: Philadelphia Man Charged In Disability Fraud
PHILADELPHIA - Sheikh Mohammed Khurshan, 55, of Philadelphia, PA, was charged by indictment, unsealed today, in a disability benefits fraud, announced United States Attorney Zane David Memeger. Khurshan is charged with 11 counts of wire fraud, 16 counts of health care fraud, one count of Social Security fraud, one count of false statements, and one count of false statements in connection with an application for a passport. According to the indictment, the defendant applied for and received disability benefits from the Social Security Administration while lying and concealing his work activity.
April 27, 2016; U.S. Department of Justice: Wyeth and Pfizer Agree to Pay $784.6 Million to Resolve Lawsuit Alleging That Wyeth Underpaid Drug Rebates to Medicaid
The Department of Justice announced today that pharmaceutical companies Wyeth and Pfizer Inc. have agreed to pay $784.6 million to resolve allegations that Wyeth knowingly reported to the government false and fraudulent prices on two of its proton pump inhibitor (PPI) drugs, Protonix Oral and Protonix IV. Pfizer, which is headquartered in New York City, acquired New Jersey-based Wyeth in 2009, approximately three years after Wyeth had ended the conduct that gave rise to the settlement.
April 26, 2016; U.S. Attorney; Western District of New York: Local Pain Doctor Named In A 114 Count Indictment; Accused Of Illegally Issuing Hundreds Of Thousands Of Prescriptions For Controlled Substances
BUFFALO, N.Y.-U.S. Attorney William J. Hochul Jr. announced today that a federal grand jury has returned a 114 count indictment charging Dr. Eugene Gosy, 55, of Clarence, NY, with conspiracy to distribute controlled substances, unlawful distribution of narcotics, conspiracy to commit health care fraud, and health care fraud. The charges carry a maximum penalty of 20 years, a $1,000,000 fine or both.
April 27, 2016; U.S. Attorney; Southern District of West Virginia: Beckley doctor sentenced to eight years in prison for Federal drug crime and health care fraud
BECKLEY, W.Va. - Acting United States Attorney Carol Casto announced today that Jose Jorge Abbud Gordinho, M.D., of Beckley, was sentenced to eight years in prison, a $15,000 fine, and ordered to pay over $48,000 in restitution to Medicare and Medicaid for a federal drug crime and health care fraud. Dr. Gordinho previously pleaded guilty in January 2016 to illegally prescribing the pain medication hydrocodone and defrauding Medicare and Medicaid by submitting materially false claims for services that were not medically necessary.
April 22, 2016; U.S. Attorney; District of Virginia: Pair Sentenced For Making False Statements in Regards to Healthcare Programs
HARRISONBURG, VIRGINIA - A pair of Winchester residents, who previously pled guilty to submitting false timesheets for payment to Virginia Medicaid, were sentenced yesterday in the United States District Court for the Western District of Virginia in Harrisonburg, United States Attorney John P. Fishwick Jr. and Virginia Attorney General Mark R. Herring announced today.
April 21, 2016; U.S. Attorney; District of Utah: Kilgore Sentenced to 60 Months in Prison after Pleading Guilty to Three Counts of Conspiracy to Commit Health Care Fraud
SALT LAKE CITY - Jacob J. Kilgore, a former owner of a Salt Lake City durable medical equipment company, will serve 60 months in federal prison after pleading guilty to three counts of conspiracy to commit health care fraud as a part of Medicare fraud scheme involving power wheelchairs. Three company sales representatives were sentenced Thursday, two receiving prison terms, for their role in the fraud
April 21, 2016; U.S. Attorney; Southern District of Texas: Two Former Houston Medical Clinic Owners Convicted of Defrauding Medicare of $5.4 Million
HOUSTON - Two former owners of medical clinics in Houston have entered pleas of guilty to defrauding Medicare of $5.4 million, announced U.S. Attorney Kenneth Magidson.
April 20, 2016; U.S. Attorney; District of New Jersey: Doctor Sentenced To Two Years In Prison For Taking Bribes In Test-Referrals Scheme With New Jersey Clinical Lab
NEWARK, N.J. - A doctor with a medical practice in Randolph, New Jersey was sentenced today to 24 months in prison for accepting bribes in exchange for test referrals as part of a long-running scheme operated by Biodiagnostic Laboratory Services LLC (BLS), of Parsippany, New Jersey, its president and numerous associates, U.S. Attorney Paul J. Fishman announced.
April 20, 2016; U.S. Attorney; Eastern District of Michigan: Detroit Area Doctor Charged with Illegal Distribution of Prescription Drugs and Fraud
An indictment was unsealed today charging a doctor and three other individuals with conspiracy to illegally distribute prescription drugs, U.S. Attorney Barbara L. McQuade announced today.
April 19, 2016; U.S. Department of Justice: Physician Pleads Guilty for Role in Detroit-Area Medicare Fraud Scheme
A licensed physician who worked for a Detroit-area medical practice pleaded guilty today for his role in a $2.4 million health care fraud scheme.
April 18, 2016; U.S. Department of Justice: Miami Physician Sentenced to 108 Months in Prison for His Role in $30 Million Health Care Fraud Scheme
A Miami physician was sentenced today to 108 months in prison for his role in a Medicare fraud scheme that caused approximately $30 million in losses.
April 18, 2016; U.S. Attorney; Northern District of Illinois: Federal Jury Convicts Head of Schaumburg Home Health Company in Scheme to Fraudulently Bill Medicare for Unnecessary Care
CHICAGO - A federal jury has convicted the head of a Schaumburg home health company on fraud charges for scheming to bill Medicare for millions of dollars in unnecessary services.
April 18, 2016; U.S. Attorney; Northern District of Georgia: Dermatology Physicians and Practice to Pay $1.9 Million to Settle False Claims Act Investigation into Overbilling Medicare for Evaluation and Management Services
ATLANTA-The U.S. Attorney's Office for the Northern District of Georgia announced that it has reached a settlement with dermatologists Margaret Kopchick, M.D., and Russell Burken, M.D., and their practice group, Toccoa Clinic Medical Associates, who agreed collectively to pay $1.9 million to settle claims that they violated the False Claims Act by billing Medicare for evaluation and management (E&M) services that were not permitted by Medicare rules.
April 18, 2016; U.S. Attorney; District of New Jersey: Blood Lab Owner Sentenced To Nine Months In Prison For Paying Thousands In Cash Bribes For Referrals
NEWARK, N.J. - An owner of a blood diagnostic company located in Essex County, New Jersey, was sentenced today to nine months in prison for paying a doctor cash bribes for patient lab work referrals, U.S. Attorney Paul J. Fishman announced.
April 18, 2016; U.S. Attorney; Eastern District of Virginia: Bon Secours Health System and Doctor Settle False Claims Act Allegations
RICHMOND, Va. -Bon Secours Health System, Inc., located in Marriottsville, Maryland, and one of its surgical oncologists, Dr. Eugene Y. Chang, M.D., of Suffolk, have agreed to pay $400,000 to settle civil fraud allegations that while at Bon Secours Maryview Medical Center in Portsmouth, Dr. Chang billed Medicare and other federal healthcare payors for non-covered breast examinations and ultrasounds.
April 15, 2016; U.S. Attorney; Eastern District of California: Roseville Podiatrist Sentenced to 3 Years in Federal Prison for Health Care Fraud Scheme
SACRAMENTO, Calif. - Neil Van Dyck, 64, of Roseville, was sentenced today by United States District Judge Garland E. Burrell Jr. to three years in prison and a $10,000 fine for committing healthcare fraud, United States Attorney Benjamin B. Wagner announced.
April 15, 2016; U.S. Attorney; District of Massachusetts: Warner Chilcott Sentenced to Pay $125 Million for Health Care Fraud Scheme
BOSTON - Pharmaceutical company Warner Chilcott was sentenced today in U.S. District Court in Boston to pay $125 million to resolve criminal and civil liability arising from the illegal promotion of various drugs.
April 14, 2016; U.S. Attorney; Middle District of Georgia: Valdosta Dentist Indicted For Healthcare Fraud
On Wednesday, April 13, 2016, Dr. Stanley Marable, DDS aged 55, from Valdosta, Georgia was indicted on 12 counts of Healthcare Fraud in the Middle District of Georgia, announced Acting United States Attorney G.F. Peterman, III. The federal charges stem from dental claims submitted to Georgia's Medicaid program with Dr. Marable receiving an alleged overpayment totaling nearly $800,000 as the result of his conduct.
April 14, 2016; District of Massachusetts: Boston Medical Center Agrees to Pay $1.1 Million to Resolve Allegations that it Improperly Billed Medicare and Medicaid
BOSTON - United States Attorney Carmen M. Ortiz announced today that Boston Medical Center (BMC) and two of its physician practice organizations have agreed to pay $1.1 million to resolve allegations that BMC improperly billed Medicare and Medicaid.
April 13, 2016; U.S. Department of Justice: Former Health Care Clinic Consultant and Biller Sentenced to 135 Months in Miami for Role in $63 Million Medicare Fraud Scheme
A former health care clinic consultant and Medicare biller was sentenced to 135 months in prison and ordered to pay a $100,000 fine for her role in laundering money in connection with a $63 million health care fraud scheme involving a now-defunct Miami health provider.
April 13, 2016; U.S. Attorney; Southern District of Florida: Florida Pain Medicine and its Owners Agree to Pay Over One Million Dollars to Resolve False Claims Act Allegations
Florida Pain Medicine Associates, Inc. (Florida Pain Medicine) and its owners, Drs. Bart Gatz, Alexis Renta, and Albert Rodriguez have agreed to pay $1.1 million to resolve allegations that they violated the False Claims Act by billing Medicare for medically unnecessary nerve conduction studies (NCS).
April 13, 2016; U.S. Attorney; Northern District of Texas: Dallas Doctor and Three Dallas-Area Home Health Agency Owners Convicted for Running Large-Scale, Sophisticated Health Care Fraud Scheme
DALLAS - Following a six-week-long trial before U.S. District Judge Sam A. Lindsay and less than two days of deliberation, this afternoon a federal jury convicted a Dallas physician and three owners of home health agencies on various felony offenses, including conspiracy to commit health care fraud, stemming from their participation in a nearly $375 million health care fraud scheme involving fraudulent claims for home health services, announced U.S. Attorney John Parker of the Northern District of Texas.
April 11, 2016; U.S. Attorney; Middle District of Tennessee: Premiertox Pays U.S. and Tennessee $2.5 Million to Resolve False Claims Act Lawsuit
PremierTox 2.0, Inc. has paid $2.5 million to resolve alleged violations of the False Claims Act, announced David Rivera, United States Attorney for the Middle District of Tennessee. PremierTox previously did business in Tennessee under the name Nexus and is a company that provides drug urine screening services to citizens of Tennessee and Kentucky. The government alleged that PremierTox submitted false claims when billing Medicare, TennCare and Kentucky Medicaid for drug urine screening services.
April 12, 2016; U.S. Department of Justice: Unlicensed Physician Pleads Guilty to Role in Detroit-Based $6.2 Million Medicare Fraud Scheme
An Ohio man pleaded guilty to fraud charges for his role in a scheme to defraud Medicare out of approximately $6.2 million while he acted as an unlicensed physician at a Detroit in-home physician services company.
April 11, 2016; U.S. Department of Justice: Husband and Wife Owners of Chicago Physical Therapy Company Indicted in Schemes to Defraud Medicare and Force Labor
A Chicago couple was charged in an indictment with a scheme to use their health care business to defraud Medicare out of millions of dollars, while also conspiring to employ a woman against her will.
April 11, 2016; U.S. Department of Justice: Home Health Care Agency Owner Pleads Guilty in $4 Million Detroit-Area Medicare Fraud Scheme
The owner and operator of a Detroit-area home health care agency pleaded guilty today for his participation in a $4 million health care fraud scheme.
April 11, 2016; U.S. Attorney; District of Maryland: Doctor Sentenced to Over Nine Years in Prison for $3.1 Million Health Care Fraud Scheme
Greenbelt, Maryland - U.S. District Judge Deborah K. Chasanow sentenced physician Paramjit Singh Ajrawat, age 60, Potomac, Maryland, today to 111 months in prison, followed by three years of supervised release for health care fraud, two counts of making a false statement related to a health care program, one count of obstruction of justice, four counts of wire fraud, and one count of aggravated identity theft related to a health care fraud scheme in connection with the pain clinic he owned and operated with his wife. Judge Chasanow also entered an order requiring Ajrawat to forfeit and pay restitution of $3,103,874.58.
April 8, 2016; U.S. Attorney; Western District of Virginia: Pair Convicted on Health Care Fraud, Conspiracy Charges
ABINGDON, VIRGINIA - A pair of lab professionals who billed Medicaid, Medicare, TennCare, and a variety of other health care providers and insurance companies, were convicted yesterday of federal conspiracy and health care fraud charges following a bench trial, announced United States Attorney John P. Fishwick Jr. and Virginia Attorney General Mark R. Herring.
April 8, 2016; U.S. Attorney; Northern District of Texas: Ellis County Woman Sentenced to 105 Months in Federal Prison for Defrauding Medicaid
DALLAS - An Ellis County woman who pleaded guilty last year to one count of health care fraud arising from her submission of false and fraudulent claims for counseling and psychotherapy services to Medicaid, on behalf of Medicaid beneficiaries, was sentenced this afternoon, announced U.S. Attorney John Parker of the Northern District of Texas.
April 6, 2016; U.S. Attorney; District of Pennsylvania: Health Care Fraud Charge Filed in Fayette County Addiction Specialists Inc. Case
PITTSBURGH - Four southwestern Pennsylvania residents have been indicted by a federal grand jury in Pittsburgh on multiple charges of distribution and dispensing of Schedule III and Schedule IV controlled substances, conspiracy and health care fraud United States Attorney David J. Hickton announced today.
April 5, 2016; U.S. Department of Justice: Owner of Detroit Home Health Care Agency Sentenced to 57 Months in Prison for His Role in $3.4 Million Health Care Fraud Scheme
The owner and operator of a Detroit-area home health care agency was sentenced to 57 months in prison today for his participation in a $3.4 million health care fraud scheme.
April 5, 2016; U.S. Department of Justice: Retired Judge, Attorney and Psychologist Indicted in $600 Million Social Security Fraud Scheme
A retired administrative law judge, a lawyer and a psychologist were charged in a federal indictment unsealed today for their roles in a scheme to fraudulently obtain more than $600 million in federal disability payments for thousands of claimants.
April 5, 2016; U.S. Attorney; Southern District of Texas: Two Durable Medical Equipment Company Owners Charged in Similar Health Care Fraud Schemes
McALLEN, Texas - Federal charges have been filed against two individuals in separate cases for defrauding Texas Medicaid and/or Medicare in two separate schemes to defraud through false billings, announced U.S. Attorney Kenneth Magidson.
April 1, 2016; U.S. Department of Justice: Houston Psychiatrist Sentenced to 144 Months in Prison for Role in $158 Million Medicare Fraud Scheme
A Houston psychiatrist was sentenced today to 144 months in prison for her role in a $158 million Medicare fraud scheme involving false claims for mental health treatment.
April 1, 2016; U.S. Department of Justice: Patient Recruiter and Staffing Company Employee Convicted of $2 Million Home Health Care Fraud Scheme
A patient recruiter for several Miami-area home health agencies was convicted today for his role in a fraud and kickback scheme that resulted in the submission of millions of dollars in false and fraudulent claims to Medicare.

March 2016

March 31, 2016; U.S. Attorney; District of Maryland: "Pill Mill" Distributor Pleads Guilty to Conspiracy to Distribute Oxycodone
Baltimore, Maryland - Walter Moffett, age 51, of Chestertown, Maryland pleaded guilty today to his participation in a drug conspiracy in connection with the operation of purported pain management clinics that were actually "pill mills." Eight co-conspirators previously pleaded guilty to the same charge.
March 31, 2016; U.S. Attorney; Middle District of Pennsylvania: Middletown Woman Indicted For Health Care Fraud
HARRISBURG - The United States Attorney's Office for the Middle District of Pennsylvania announced today that China Scott, age 45, of Middletown, Pennsylvania was indicted yesterday by a federal grand jury in Harrisburg for Health Care Fraud.
March 25, 2016; U.S. Department of Justice: President of Miami-Based Transportation Company Sentenced to 60 Months in Prison for Role in $70 Million Health Care Fraud Scheme
The president of a transportation company based in Miami was sentenced today to 60 months in prison for his role in a health care fraud scheme involving three mental health centers that resulted in the submission of approximately $70 million in false and fraudulent claims to Medicare.
March 25, 2016; U.S. Attorney; Northern District of Georgia: Georgia Doctor Pleads Guilty to False Billing for Surgical Monitoring Performed by Medical Assistant
ATLANTA - Robert E. Windsor, an Atlanta-area physician, has pleaded guilty to health care fraud for filing claims for surgical monitoring services he did not perform.
March 25, 2016; U.S. Attorney; District of Maryland: Former NIH Employee Sentenced to Prison for Using Her Government Credit Card for Unauthorized Purchases
Greenbelt, Maryland - U.S. District Judge Theodore D. Chuang sentenced Francesca Maria Daniele, age 49, of LaPlata, Maryland, today to 21 months in prison followed by three years of supervised release for wire fraud in connection with the misuse of her government credit card. Judge Chuang also ordered Daniele to forfeit and pay restitution of $22,338.67, the amount of loss resulting from her conduct.
March 24, 2016; U.S. Attorney; Southern District of Texas: Houston Physician and Another Sent to Federal Prison in Health Care Fraud Conspiracy
HOUSTON - Dr. Enyibuaku Rita Uzoaga, 43, has been ordered to serve 42 months and pay restitution to Medicare and Medicaid as a result of her six convictions of health care fraud and one count of conspiracy, announced U.S. Attorney Kenneth Magidson. A federal jury sitting in Houston returned guilty verdicts Nov. 3, 2015, against Uzoaga following four hours of deliberation and a six-day trial.
March 24, 2016; U.S. Department of Justice: Last of Five Defendants Pleads Guilty in Multimillion-Dollar Medicare Fraud Scheme involving Detroit-Area Home Health Companies
The last of five defendants pleaded guilty for his role in a $33 million Medicare fraud scheme involving Detroit-area home health care and hospice companies. The other four defendants have all pleaded guilty since March 15, 2016.
March 24, 2016; U.S. Attorney; Middle District of Tennessee: United States and Tennessee File Suit Against Lenoir City Chiropractor and Manchester Physician
The United States and Tennessee filed suit in U.S. District Court in Nashville today, alleging that Matthew Anderson, a Chiropractor from Lenoir City, Tenn., and David Florence, a Doctor of Osteopathy from Manchester, Tenn., made fraudulent claims to Medicare and TennCare in violation of the False Claims Act and the Tennessee Medicaid False Claims Act, announced David Rivera, U.S. Attorney for the Middle District of Tennessee. The suit also names the Cookeville Center for Pain Management; Preferred Pain Center of Grundy County; McMinnville Pain Relief Center; and PMC Management; and claims that the defendants have been unjustly enriched and caused Medicare and TennCare to pay out money through mistake of fact.
March 24, 2016; U.S. Attorney; Western District of Virginia: Former CEO of Karlise In-Home Care Sentenced in Federal Court
CHARLOTTESVILLE, VIRGINIA - The former CEO of a home health care provider that operated in the Western District of Virginia, and who previously pled guilty to a pair of federal criminal charges, was sentenced today in the United States District Court for the Western District of Virginia in Charlottesville, announced United States Attorney John P. Fishwick Jr. and Virginia Attorney General Mark R. Herring.
March 23, 2016; U.S. Department of Justice: Respironics to Pay $34.8 Million for Allegedly Causing False Claims to Medicare, Medicaid and Tricare Related to the Sale of Masks Designed to Treat Sleep Apnea
Respironics Inc., based in Murrysville, Pennsylvania, has agreed to pay $34.8 million to resolve alleged False Claims Act violations for paying kickbacks in the form of free call center services to durable medical equipment (DME) suppliers that bought its masks for patients with sleep apnea, the Department of Justice announced today.
March 23, 2016; U.S. Department of Justice: Detroit-Area Physician Sentenced to 45 Months in Prison for Role in $5.7 Million Medicare Fraud Scheme
A Detroit-area doctor who prescribed medically unnecessary controlled substances and billed for office visits and diagnostic testing that never took place was sentenced to 45 months in prison today for his role in a $5.7 million Medicare fraud scheme.
March 22, 2016; U.S. Attorney; Northern District of Illinois: Chicago Marketer Convicted of Illegally Pocketing Bribes in Exchange for Referring Elderly Patients to Skokie-Based Home Health Company
CHICAGO - A federal judge today convicted a Chicago marketer of taking illegal payments in exchange for referring elderly patients to a Skokie-based home healthcare company.
March 22, 2016; U.S. Attorney; Eastern District of North Carolina: Pitt County Behavioral Health Businessman Sentenced To 20 Years In Federal Prison For Medicaid Fraud
WILMINGTON - The United States Attorney's Office for the Eastern District of North Carolina announced that yesterday in federal court, TERRY LAMONT SPELLER, 38, of Winterville, North Carolina, was sentenced to 240 months in federal prison and 3 years of supervised release following his prior guilty plea to Health Care Fraud, and Engaging in Monetary Transactions in Criminally Derived Property. SPELLER was also ordered to make restitution of $5,962,189.77 to the victims of the offense, which included the North Carolina Medicaid program and a physician, whose name and identification number SPELLER used to commit the fraud.
March 21, 2016; U.S. Department of Justice: Florida Audiologist Sentenced to 94 Months in Prison in Multimillion-Dollar Health Care Fraud and Money Laundering Scheme
A Florida audiologist was sentenced to 94 months in prison today for her role in a multimillion-dollar health care fraud and money laundering scheme.
March 18, 2016; U.S. Department of Justice: New Orleans Jury Convicts Company Owner and Doctor for Roles in $34 Million Fraud Scheme
A federal jury in New Orleans convicted the owner of a health care company and a doctor for their roles in a $34 million Medicare fraud scheme that operated over the course of seven years in New Orleans and surrounding communities.
March 17, 2016; U.S. Department of Justice: Owner of Two Miami Clinics Sentenced to 82 Months for Health Care Fraud Charges
An owner of two fraudulent medical clinics in the Miami area was sentenced to 82 months in prison today for his role in a Medicare fraud scheme that caused more than $3 million in losses.
March 16, 2016; U.S. Attorney; Eastern District of Missouri: Kirksville Owner of Prosthetics Company Sentenced
St. Louis, MO - Theodore Deininger was sentenced to 15 months imprisonment and ordered to pay $150,000 in restitution.
March 15, 2016; U.S. Attorney; Western District of North Carolina: Charlotte Man Sentenced To Three Years In Prison For $2 Million Health Care Fraud Scheme
CHARLOTTE, N.C. - U.S. Attorney Jill Westmoreland Rose announced today that Eric Bernard Mitchell, 44, of Charlotte, was sentenced to 37 months in prison for defrauding Medicaid of over $2 million. U.S. District Judge Max O. Cogburn, Jr. also ordered Mitchell to serve one year under court supervision and to pay $ 2,049,932.12 as restitution to Medicaid. Mitchell pleaded guilty October 2015 to health care fraud and money laundering charges.
March 14, 2016; U.S. Attorney; District of New Jersey: Bergen County, New Jersey, Doctor Who Billed For Bogus Office Visits, Altered Patient Medical Records Sentenced To More Than Three Years In Prison
NEWARK, N.J. - A family physician with offices in Cresskill and Little Falls, New Jersey, was sentenced today to 37 months in prison for defrauding Medicare, Medicaid and private insurance companies out $280,000 by billing them for non-existent office visits, U.S. Attorney Paul J. Fishman announced.
March 11, 2016; U.S. Attorney; Northern District of Illinois: Chicago Psychiatrist Who Took Kickbacks to Prescribe Mental Health Medication Sentenced to Nine Months in Federal Prison
CHICAGO - A Chicago psychiatrist was sentenced today to nine months in federal prison for accepting nearly $600,000 in fees and benefits from pharmaceutical companies in exchange for prescribing a medication to his patients.
March 9, 2016; U.S. Attorney; District of Idaho: Two California Men Plead Guilty to Conspiracy to Distribute Oxycodone and Hydromorphone
BOISE - Michael Kulikoff, 30, and Kenneth Miller, 57, both of California City, California, pleaded guilty yesterday to conspiracy to distribute oxycodone and hydromorphone, U.S. Attorney Wendy J. Olson announced. Co-defendants Diane Miller, 41, and Crystal Clark 43, also of California City, California, previously pleaded guilty to conspiracy to distribute oxycodone and hydromorphone. Diana Miller was sentenced on January 15, 2016, to 15 months in prison, to be followed by five years of supervised release. All four were indicted by a federal grand jury in Boise on May 12, 2015.
March 9, 2016; U.S. Attorney; Eastern District of Pennsylvania: Ambulance Company Employee Sentenced To 37 Months In Prison For Fraud
PHILADELPHIA - Fritzroy Brown, 39, of Philadelphia, PA, was sentenced today to 37 months in prison for a healthcare fraud scheme centering on Brotherly Love Ambulance, Inc. In addition to the prison term, U.S. District Court Judge Gerald J. Pappert ordered three years of supervised release, restitution in the amount of $2,015,712.52 to Medicare, restitution of $14,150 to the Commonwealth of Pennsylvania, and a $300 special assessment.
March 8, 2016; U.S. Attorney; Middle District of Florida: United States Settles False Claims Act Allegations Against 21st Century Oncology For Nearly $34.7 Million
United States Attorney A. Lee Bentley, III announces that the government has formally settled a lawsuit brought by a whistle-blower alleging that one of the nation's largest radiation oncology providers, 21st Century Oncology, has agreed to settle allegations that they performed and billed for procedures that were not medically necessary. Pursuant to the settlement agreement, 21st Century shall pay the United States $34,695,243 to resolve these allegations. Headquartered in Fort Myers, 21st Century has offices in 16 states.
March 8, 2016; U.S. Attorney; District of New Jersey: Bergen County, New Jersey, Doctor Charged With Taking Bribes
NEWARK, N.J. - A family doctor practicing in Bergen County, New Jersey, was charged today with accepting bribes in exchange for test referrals as part of a long-running and elaborate scheme operated by Biodiagnostic Laboratory Services LLC (BLS), of Parsippany, New Jersey, its president and numerous associates, U.S. Attorney Paul J. Fishman announced.
March 7, 2016; U.S. Department of Justice: Florida Man Sentenced to More than 14 Years in Prison for Multimillion-Dollar Health Care Fraud and Money Laundering Scheme
A Land O' Lakes, Florida, businessman was sentenced by a judge in federal court in Tampa today to 174 months in prison for his role in a multimillion-dollar health care fraud and money laundering scheme.
March 4, 2016; U.S. Attorney; Southern District of Florida: Doctor Who Falsely Diagnosed Hundreds Of Patients As Part of a Medicare Fraud Scheme Pleads Guilty
Dr. Isaac Kojo Anakwah Thompson, 57, of Delray Beach, pled guilty to one count of health care fraud.
March 4, 2016; U.S. Attorney; Northern District of Illinois: Oak Brook Doctor Convicted in Kickback Scheme at Sacred Heart Hospital
CHICAGO - A federal jury today convicted an Oak Brook doctor of illegally receiving benefits in exchange for referring elderly patients to Sacred Heart Hospital on Chicago's West Side.
March 4, 2016; U.S. Attorney; Southern District of Texas: Houstonians Plead Guilty in $13 Million Health Care Fraud Case
HOUSTON - The leader and four others charged in a $13 million Medicare and Medicaid health care fraud case have entered guilty pleas for their respective roles, announced U.S. Attorney Kenneth Magidson.
March 4, 2016; U.S. Attorney; Northern District of Texas: Federal Jury Convicts Dallas Anesthesiologist on Health Care Fraud Offenses Involving Approximately $10 Million in Fraudulent Billings
DALLAS - Following a four-day trial before U.S. District Judge Reed C. O'Connor and approximately three hours of deliberation, a federal jury has convicted Dr. Richard Ferdinand Toussaint, Jr., a licensed anesthesiologist, on all counts of a superseding indictment charging seven counts of health care fraud, announced U.S. Attorney John Parker of the Northern District of Texas.
March 2, 2016; U.S. Department of Justice: Former Owner of Florida Home Health Care Companies Agrees to Pay $1.75 Million to Resolve Kickback and False Claims Act Allegations
Mark T. Conklin, the former owner, operator and sole shareholder of Recovery Home Care Inc. and Recovery Home Care Services Inc. (collectively RHC) has agreed to pay $1.75 million to resolve a lawsuit alleging that he violated the False Claims Act by causing RHC to pay illegal kickbacks to doctors who agreed to refer Medicare patients to RHC for home health care services, the Department of Justice announced today. Conklin sold the RHC companies to National Home Care Holdings LLC, on Oct. 9, 2012.
March 2, 2016; U.S. Attorney; Eastern District of Missouri: Local Chiropractor and Billing Assistant Sentenced on Health Care Fraud Charges
St. Louis, MO - Dr. Donald Havey was sentenced to 51 months in prison and ordered to pay restitution of $2,276,221 on charges involving a scheme to bill Medicare for expensive custom ankle-foot orthotics that were never provided to the patients. His billing assistant, Susan Reno, was sentenced earlier to five years of probation and ordered to pay restitution of $10,571.
March 1, 2016; U.S. Department of Justice: Former Fugitive Pleads Guilty in Florida Multimillion-Dollar Health Care Fraud Scheme
A Cuban national who fled the United States and had been wanted since 2013 on federal criminal charges relating to a multimillion-dollar health care fraud scheme in the greater Tampa Bay, Florida, area pleaded guilty today for his role in the scheme.
March 1, 2016; U.S. Attorney; District of Connecticut: Stamford Podiatrist Who Submitted False Claims is Sentenced
Deirdre M. Daly, United States Attorney for the District of Connecticut, today announced that AMIRA MANTOURA, 53, of Greenwich, was sentenced yesterday by U.S. District Judge Michael P. Shea in Hartford to three years of probation, and a fine that will result in MANTOURA paying three times the amount of money she stole by submitting false claims to Medicare and other health insurance plans. MANTOURA also will be required to perform 200 hours of community service as part of her sentence.
March 1, 2016; U.S. Department of Justice: Medical Equipment Company Will Pay $646 Million for Making Illegal Payments to Doctors and Hospitals in United States and Latin America
The United States' largest distributor of endoscopes and related equipment will pay $623.2 million to resolve criminal charges and civil claims relating to a scheme to pay kickbacks to doctors and hospitals, U.S. Attorney Paul J. Fishman of the District of New Jersey and Principal Deputy Assistant Attorney General Benjamin C. Mizer of the Justice Department's Civil Division announced today. U.S. Attorney Fishman and Principal Deputy Assistant Attorney General David Bitkower of the Justice Department's Criminal Division also announced that a subsidiary of the distributor will pay $22.8 million to resolve criminal charges relating to the Foreign Corrupt Practices Act (FCPA) in Latin America.

February 2016

February 26, 2016; U.S. Department of Justice: Two Dallas-Area Doctors and Four Others Charged for Roles in $13.4 Million Medicare Fraud Scheme
Six individuals, including two Dallas-area doctors, were charged in a superseding indictment that was unsealed today for their alleged participation in a $13.4 million health care fraud scheme involving fraudulent claims for home health services.
February 25, 2016; U.S. Attorney; District of Columbia: Maryland Woman Pleads Guilty to Conspiring to Taking Part In Scheme Involving Prescription and Health Care Fraud
WASHINGTON - Claire Elizabeth Rice, 68, of Silver Spring, Md., pled guilty today to federal charges of conspiracy to obtain controlled substances by prescription fraud and participating in a health care fraud scheme, announced U.S. Attorney Channing D. Phillips, Paul M. Abbate, Assistant Director in Charge of the FBI's Washington Field Office, and Nicholas DiGiulio, Special Agent in Charge of the U.S. Department of Health and Human Services, Office of Inspector General (HHS-OIG), for the region that includes Washington, D.C.
February 25, 2016; U.S. Attorney; District of Puerto Rico: Eight Individuals Arrested For Bribery, Conspiracy, Health Care And Mail Fraud
SAN JUAN, P.R. - On February 24, 2016, a Federal grand jury returned a fourteen count indictment against eight individuals for bribery, conspiracy to commit health care fraud, conspiracy to commit an offense against the United States, mail fraud, and aggravated identity theft, announced Rosa Emilia Rodríguez-Vélez, United States Attorney for the District of Puerto Rico. The investigation was led by the U.S. Department of Health and Human Services-Office of Inspector General, with the collaboration of the Federal Bureau of Investigation, United States Secret Service, United States Postal Inspection Service, and the Puerto Rico Department of Health Medicaid Anti-Fraud Unit.
February 25, 2016; U.S. Attorney; District of Maryland: Assisted Living Facility Manager Indicted for Stealing Elderly Residents' Identities to Obtain Credit Cards
Baltimore, Maryland - A federal grand jury indicted Salah Eldean Sood, age 34, of Baltimore, today on charges arising from a scheme to open credit card accounts using the stolen identity information of elderly persons who were in Sood's care at Holland Manor Eldercare, an assisted living facility in Towson, Maryland.
February 24, 2016; U.S. Attorney; Eastern District of New York: Clinic Owner And Four Medical Professionals Sentenced In A $4 Million Medicare Fraud Scheme
Earlier today, Jeffrey Suh, Richelle Munoz, Sophia Lin, Kang Young Chung, and Emily Shim were sentenced in federal court in Brooklyn for conspiring to commit health care fraud in a scheme where they fraudulently billed Medicare for more than $4 million.
February 23, 2016; U.S. Attorney; Western District of Kentucky: Louisville Chiropractor Guilty Of Health Care Fraud
LOUISVILLE, Ky. - A Louisville chiropractor pleaded guilty to numerous charges today, including health care fraud, obstruction of a criminal investigation, and tampering with a witness for his role in billing private insurance companies and government health care agencies for services that were never performed, announced United States Attorney John E. Kuhn, Jr.
February 23, 2016; U.S. Attorney; Eastern District of Pennsylvania: Ambulance Company Employee Sentenced To 37 Months In Prison
PHILADELPHIA - Thael Kuran, 24, of Philadelphia, PA, was sentenced today to 37 months in prison for a health care fraud scheme involving Brotherly Love Ambulance, Inc. In addition to the prison term, U.S. District Court Judge Gerald J. Pappert ordered three years of supervised release, restitution in the amount of $2,015,712.52, and a $200 special assessment.
February 22, 2016; U.S. Attorney; District of Maryland: Paige Industrial Services Agrees to Resolve False Claims Act Allegations
Baltimore, Maryland - Government contractor Paige Industrial Services, Inc. has agreed to pay the United States between $450,000 and $675,000 to resolve allegations under the False Claims Act that the company submitted false claims to the Department of Health and Human Services. In a related parallel criminal proceeding involving a Paige subcontracting company, construction company owner Luis Alonso Valle, age 46, of Silver Spring, Maryland, pleaded guilty on February 11, 2016 to an illegal pattern and practice of hiring unauthorized aliens.
February 19, 2016; U.S. Attorney; District of Idaho: Fruitland Woman Indicted for False Billing at Payette Dental Clinic
BOISE - Cherie R. Dillon, 60, of Fruitland, Idaho, made an initial appearance yesterday on charges of health care fraud and aggravated identity theft, U.S. Attorney Wendy J. Olson announced. Dillon was indicted on February 9, 2016, by a federal grand jury in Boise.
February 19, 2016; U.S. Attorney; Middle District of Florida: Adventist To Pay More Than $2 Million To Resolve False Claims Allegations
Tampa, FL - United States Attorney A. Lee Bentley, III announces that Adventist Health System Sunbelt Healthcare Corporation (Adventist) has agreed to pay the government $2.09 million to resolve allegations that patients were administered portions of single-dose vials of chemotherapy drugs that were left over from administrations to prior patients.
February 17, 2016; U.S. Department of Justice: Fifty-One Hospitals Pay United States More Than $23 Million to Resolve False Claims Act Allegations Related to Implantation of Cardiac Devices
The Department of Justice has reached settlements with 51 hospitals in 15 states for more than $23 million related to cardiac devices that were implanted in Medicare patients in violation of Medicare coverage requirements, the Department of Justice announced today. These settlements represent the final stage of a nationwide investigation into the practices of hundreds of hospitals improperly billing Medicare for these devices. With these additional agreements, the Justice Department's investigation has now yielded settlements with more than 500 hospitals totaling more than $280 million.
February 17, 2016; U.S. Attorney; District of Montana: Billings Hospital One of 51 Hospitals Nationwide to Pay More Than $23 Million to Resolve False Claims Act Allegations Related to Implantation of Cardiac Devices
WASHINGTON - The Department of Justice announced today that it has reached settlements with 51 hospitals in 15 states for more than $23 million related to cardiac devices that were implanted in Medicare patients in violation of Medicare coverage requirements. Saint Vincent Healthcare in Billings is one of the hospitals included in the settlements. St. Vincent is part of the Sisters of Charity of Leavenworth Health System, based in Broomfield, CO, and is one of five Sisters of Charity hospitals that together paid 1.95 million under the settlements.
February 17, 2016; U.S. Attorney; District of Maryland: Maryland Health Care Provider Convicted for Patient Deaths
Baltimore, Maryland - A federal jury today convicted the owner of Alpha Diagnostics, Rafael Chikvashvili, age 67, of Baltimore, Maryland, of health care fraud and wire fraud conspiracy, healthcare fraud, including two counts of health care fraud resulting in death, as well as wire fraud, false statements and aggravated identity theft, related to a scheme to defraud Medicare and Medicaid of more than $7.5 million. Judge Bredar ordered that Mr. Chikvashvili be immediately taken into custody. A detention hearing will be held on Thursday, February 18, 2016 at 2:00 p.m. to determine whether he will remain in custody pending his sentencing.
February 17, 2016; U.S. Attorney; Eastern District of Texas: Physician Pleads Guilty To Illegally Prescribing Pain Medication
TYLER, Texas - U.S. Attorney John M. Bales announced that an East Texas pain management physician has pleaded guilty to illegally dispensing controlled substances.
February 16, 2016; U.S. Attorney; District of Columbia: Chiropractor Sentenced for Obstructing Investigation Of Health Care Fraud Involving D.C. Medicaid Program
WASHINGTON - Rehman Mirza, 43, a chiropractor who practiced in Suitland, Md., was sentenced today to seven months in prison and an additional six months in home confinement after earlier pleading guilty to obstructing a criminal health care fraud investigation, announced U.S. Attorney Channing D. Phillips and Paul M. Abbate, Assistant Director in Charge of the FBI's Washington Field Office.
February 12, 2016; U.S. Attorney; District of New Jersey: New Jersey Doctor, Two Companies Agree To Pay $5.25 Million For Allegedly Submitting Bogus Claims To Federal Health Care Programs
NEWARK, N.J. - Dr. Labib E. Riachi, 47, of Westfield, New Jersey, and two companies that he owns and operates, Riachi, Inc. and Center for Advanced Pelvic Surgery, LLC, both based in Westfield, have agreed to pay $5.25 million to resolve allegations that they falsely billed federal health care programs for tests that were never provided, among other claims, U.S. Attorney Paul J. Fishman announced today.
February 11, 2016; U.S. Attorney; Middle District of Florida: United States Announces Approximately $10 Million Settlement With Four Physicians And Two Compounding Pharmacies
Jacksonville, FL - United States Attorney A. Lee Bentley, III announces that two compounding pharmacies - WELLHealth and Topical Specialists, as well as four physicians - Manish Bansal, Mehul Parekh, Marisol Arcila, and Syed Asad, have agreed to pay the government a total of approximately $10 million to resolve allegations involving TRICARE, the military's healthcare program.
February 11, 2016; U.S. Attorney; District of New Jersey: Doctor Charged With Accepting Thousands Of Dollars In Cash Bribes For Referrals To Lab Companies
NEWARK, N.J. - A doctor with offices in Toms River, New Jersey, was indicted today for accepting thousands of dollars in cash bribes in exchange for referring his patients to two lab companies that performed blood and DNA testing, U.S. Attorney Paul J. Fishman announced.
February 11, 2016; U.S. Attorney; Western District of Missouri: Dentist Pleads Guilty to Medicaid Fraud Scheme
SPRINGFIELD, Mo. - Tammy Dickinson, United States Attorney for the Western District of Missouri, announced that an Independence, Mo., dentist who formerly practiced at clinics in Springfield, Mo., and Mountain Grove, Mo., pleaded guilty in federal court today to his role in a conspiracy to collect more than $167,000 in fraudulent Medicaid payments for child patients of the clinics.
February 11, 2016; U.S. Attorney; Southern District of Illinois: O'Fallon Woman Sentenced for Healthcare Fraud
James L. Porter, Acting United States Attorney for the Southern District of Illinois, announced today, that Ann Marie Sheppard, 55, of O'Fallon, Illinois, was sentenced on February 10, 2016, in the U.S. District Court in East Saint Louis, Illinois, on the charges that she engaged in a scheme to steal from a health care program and that she committed two related mail frauds. The district court sentenced Sheppard to five years of probation with the first six months to be served in home detention. She is also ordered to pay $34,168.33 in restitution to the Home Services Program and a $300.00 special assessment.
February 10, 2016; U.S. Attorney; Eastern District of Kentucky: Lexington Couple Pleads Guilty to Grant Fraud
LEXINGTON - A Lexington couple has admitted in federal court that they submitted false claims related to federal grants from the National Institutes of Health ("NIH") and defrauded the government out of hundreds of thousands of dollars.
February 10, 2016; District of Maryland: Lutherville Man Faces Federal Charges for Bank Fraud and Identity Theft and State Charges for Elder Abuse
Baltimore, Maryland - Salah Sood, age 34, of Lutherville, Maryland, faces federal charges of aggravated identity theft and bank fraud. Sood has also been indicted in Baltimore County with four counts of abuse of vulnerable adults and one count of operating an unlicensed assisted living home. The state and federal charges arise from an investigation of Holland Manor Eldercare where, on December 3, 2015, two elderly residents were found alone when Baltimore County police and the fire department personnel responded to a fire alarm at that location.
February 10, 2016; U.S. Attorney; District of New Jersey: U.S. Attorney’s Office Files Civil Lawsuit Against New Jersey Doctor, Two Companies For Submitting Bogus Claims To Federal Health Care Programs
NEWARK, N.J. - U.S. Attorney Paul J. Fishman announced today that the government has filed a complaint against a Union County, New Jersey, doctor and his medical practice companies for knowingly submitting millions of dollars in false claims to Medicare and Medicaid for thousands of diagnostic tests that were never performed and for physical therapy services performed by unqualified personnel.
February 9, 2016; U.S. Attorney; Southern District of Florida: Miami Physician Pleads Guilty For Role in $20 Million Health Care Fraud Scheme
A Miami physician pleaded guilty today for his role in a Medicare fraud scheme that caused more than $20 million in losses.
February 9, 2016; U.S. Attorney; Southern District of Illinois: Granite City Woman Sentenced For Healthcare Fraud
James L. Porter, Acting United States Attorney for the Southern District of Illinois, announced today, that on February 9, 2016, Jessica A. Teets, 28, of Granite City, Illinois, was sentenced in the U.S. District Court in East Saint Louis on the charge that she engaged in a scheme to defraud a health care program. The district court sentenced Teets to five years of probation. She was also ordered to pay $1,292.62 in restitution to the Home Services Program.
February 9, 2016; U.S. Attorney; Eastern District of Pennsylvania: Nurse Convicted For Role In Multi-Million Dollar Hospice Health Care Fraud
PHILADELPHIA - A federal jury, yesterday, returned guilty verdicts against Patricia McGill, 68, of Philadelphia, a registered nurse who took part in a multi-million dollar fraud on Medicare that involved hospice care. The jury found McGill guilty of four counts of health care fraud. The jury acquitted the defendant of a conspiracy charge and nine counts of health care fraud. U.S. District Court Judge Eduardo C. Robreno scheduled a sentencing hearing for May 24, 2016. McGill faces a potential advisory sentencing guideline range of 33 to 41 months in prison, a possible fine, and a $400 special assessment.
February 1, 2016; U.S. Attorney; Southern District of Illinois: Cottage Hills Woman Sentenced On Healthcare Fraud Charge
James L. Porter, Acting United States Attorney for the Southern District of Illinois, announced today, that on January 29, 2016, Lisa Jorden, 50, of Cottage Hills, Illinois, pled guilty and was sentenced in the U.S. District Court in East Saint Louis, Illinois, on the charge that she engaged in a scheme to steal from a health care program. The district court sentenced Jorden to five years of probation. She is also ordered to pay $16,828.00 in restitution to the Home Services Program and a $100.00 special assessment.

January 2016

January 29, 2016; U.S. Department of Justice

Former Owner and Operator of California Medical Equipment Supply Company Sentenced for Their Roles in $1.5 Million Medicare Fraud Scheme
The former owner and the former operator of a durable medical equipment supply company based in Long Beach, California, were sentenced today for their roles in a $1.5 million Medicare fraud scheme.

January 29, 2016; U.S. Attorney; Southern District of Illinois

Belleville Woman Pleads Guilty To Healthcare Fraud
James L. Porter, Acting United States Attorney for the Southern District of Illinois, announced today, that Kiara Hopkins, 24, of Belleville, Illinois, pled guilty in federal court to charges that she engaged in a scheme to steal from a health care program. Sentencing has been set for May 5, 2016. Hopkins will face up to 10 years in prison, a fine of up to $250,000, and up to 3 years of supervised release.

January 27, 2016; U.S. Attorney; Southern District of Texas

Area Ambulance Company Owner Sentenced in Health Care Fraud Scheme
McALLEN, Texas - The owner of Vic's Texas Transport, Inc. (dba Victory EMS) has been ordered to federal prison following his conviction of health care fraud and aggravated identity theft, announced U.S. Attorney Kenneth Magidson. Victor Lee Gonzalez, 28, of Mission, pleaded guilty Sept, 22, 2015.

January 27, 2016; U.S. Attorney; Southern District of Texas

Ambulance Company Owners Agree to Pay More Than $245,000 to Resolve Kickback Allegations
HOUSTON - The former owner and operator of Houston-area ambulance company National Care EMS has agreed to settle allegations that he and the company provided kickbacks to various nursing facilities and hospitals in exchange for rights to the institutions' more lucrative Medicare and Medicaid transport referrals, announced U.S. Attorney Kenneth Magidson along with Gregory Demske, Chief Counsel to the Inspector General of the U.S. Department of Health and Human Services - Office of Inspector General (HHS-OIG) and Special Agent in Charge CJ Porter, of HHS-OIG, Office of Investigations - Dallas Regional Office.

January 26, 2016; U.S. Attorney; Eastern District of Pennsylvania

Health Care Agreement Announced Regarding Care Enhancements At Rehab Center
PHILADELPHIA - The Archdiocese of Philadelphia, Catholic Health Care Services has agreed to resolve allegations relating to resident care at St. Monica Center for Rehabilitation and Health Care and St. Monica Manor, announced United States Attorney Zane David Memeger. The Archdiocese of Philadelphia has agreed to improve, or has already improved, care in the following areas: physician orders; wound care and pressure ulcers; medication administration; documentation of care; and transfer and toileting of residents. Pursuant to the agreement, the Archdiocese has also agreed to pay $80,000 in addition to implementing the care enhancements. Although St. Monica Manor has been sold to Center Management Group ("CMG"), CMG has agreed to assume all duties in connection with the settlement agreement.

January 25, 2016; U.S. Attorney; Northern District of Illinois

Federal Jury Convicts Tinley Park Physician in Medicare Fraud Scheme
CHICAGO - A physician at Chicago-based Mobile Doctors was convicted on federal fraud charges today for falsely certifying patients as confined to their homes as part of a scheme to defraud Medicare.

January 22, 2016; U.S. Department of Justice

Owner and Manager of Three Miami-Area Home Health Agencies Convicted in $57 Million Health Care Fraud Scheme
The owner and manager of three Miami-area home health agencies was convicted late yesterday for his role in a health care fraud scheme that resulted in the submission of false and fraudulent claims to Medicare.

January 22, 2016; U.S. Attorney; District of New Hampshire

Seabrook Woman Sentenced To Home Confinement For Social Security, Food Stamp, And Medicaid Fraud
CONCORD, N.H. - Beverly Eaton, 57, of Seabrook, who pleaded guilty to one count of Social Security Fraud and four counts of Making False Statements on September 28, 2015, was sentenced today to three years of probation, including six months of home confinement, and was ordered to pay $51,189.70 in restitution to the Social Security Administration and $11,235.36 to the New Hampshire Department of Health and Human Services, announced United States Attorney Emily Gray Rice.

January 20, 2015; U.S. Attorney; District of Nevada

Family Members Convicted In Benefits Fraud Case
LAS VEGAS, Nev. - A brother and sister have been convicted by a federal jury of multiple felony counts for using false identities to steal almost $300,000 in unemployment funds and other federal benefits, announced U.S. Attorney Daniel G. Bogden for the District of Nevada. Two other family members were also convicted of fraud for their part in the scheme to unlawfully obtain unemployment compensation funds.

January 20, 2016; U.S. Attorney; District of Vermont

Paul Hebert Pleads Guilty to Social Security and Medicaid Fraud
Paul Hebert, 50, of Gloucester, Massachusetts, formerly of Barre, Vermont, pleaded guilty today to charges of Social Security fraud and Medicaid fraud.

January 19, 2016; U.S. Attorney; District of New Jersey

Ocean County, New Jersey, Man Admits Bribing Doctor As Part Of Compounding Pharmacy Fraud Scheme
CAMDEN, N.J. - A Manchester, New Jersey, man today admitted paying tens of thousands of dollars in bribes to a sports medicine doctor on behalf of Prescriptions R Us, a compound pharmacy in Lakewood, New Jersey, U.S. Attorney Paul J. Fishman announced.

January 19, 2016; U.S. Attorney; Northern District of Texas

Registered Nurse Co-Owner of Ultimate Care Home Health Services, Inc. Sentenced to 10 Years in Federal Prison for Role in Healthcare Fraud Conspiracy
DALLAS - A 52-year-old registered nurse and home health company owner from Cedar Hill, Texas, was sentenced this morning in federal court in Dallas on a health care fraud conspiracy conviction, announced U.S. Attorney John Parker of the Northern District of Texas.

January 15, 2016; U.S. Department of Justice

California Hospital to Pay More Than $3.2 Million to Settle Allegations That It Violated the Physician Self-Referral Law
Tri-City Medical Center, a hospital located in Oceanside, California, has agreed to pay $3,278,464 to resolve allegations that it violated the Stark Law and the False Claims Act by maintaining financial arrangements with community-based physicians and physician groups that violated the Medicare program's prohibition on financial relationships between hospitals and referring physicians, the Justice Department announced today.

January 15, 2016; U.S. Attorney; Middle District of Pennsylvania

Tioga County Physician And One Other Plead Guilty To Health Care Fraud Charges
WILLIAMSPORT - The United States Attorney's Office for the Middle District of Pennsylvania announced today that Dr. John Terry, age 65, of Wellsboro and Stephen Heffner, Jr., age 46, of Elkland, pleaded guilty today before Chief United States District Court Judge Christopher C. Conner in Williamsport.

January 14, 2016; U.S. Department of Justice

Health Care Clinic Consultant and Medicare Biller Pleads Guilty in Miami for Role in $63 Million Health Care Fraud Scheme
A former health care clinic consultant and Medicare biller pleaded guilty today in connection with a $63 million health care fraud and money laundering scheme involving a defunct Miami-area health care provider.

January 12, 2016; U.S. Department of Justice

Nation's Largest Nursing Home Therapy Provider, Kindred/Rehabcare, to Pay $125 Million to Resolve False Claims Act Allegations
Contract therapy providers RehabCare Group Inc., RehabCare Group East Inc. and their parent, Kindred Healthcare Inc., have agreed to pay $125 million to resolve a government lawsuit alleging that they violated the False Claims Act by knowingly causing skilled nursing facilities (SNFs) to submit false claims to Medicare for rehabilitation therapy services that were not reasonable, necessary and skilled, or that never occurred, the Department of Justice announced today.

Corporate Integrity Agreement: RehabCare Group, Inc.; Kindred Healthcare, Inc.

January 12, 2016; U.S. Attorney; District of Connecticut

Connecticut Medical Equipment Company Pays $600,000 to Settle False Claims Act Allegations
United States Attorney Deirdre M. Daly and Connecticut Attorney General George Jepsen today announced that J&L MEDICAL SERVICES, LLC ("J&L MEDICAL") has entered into a civil settlement agreement with the federal and state governments in which it will pay $600,000 to resolve allegations that it violated the federal and state False Claims Acts.

January 12, 2016; U.S. Attorney; Western District of Michigan

Physician Assistant, Kyle D. Gandy, Sentenced To Fourteen Months In Prison For Accepting Illegal Kickbacks
GRAND RAPIDS, MICHIGAN - U.S. Attorney Patrick Miles announced today that Kyle D. Gandy, age 37, a physician assistant who formerly resided in Mt. Pleasant, Michigan, was sentenced to 14 months in prison and two years of supervised release for accepting $1,000.00 in illegal kickbacks for referring patients to medical clinics, physical therapy clinics, and a home health care agency. Gandy is the tenth person, and the fourth physician assistant, convicted of felony charges in connection with a joint federal-state investigation into a kickback scheme initiated by Babubhai Rathod. As part of this felony conviction, Gandy was ordered to pay $18,030.17 in restitution, representing the amount of the referred services paid by Medicare and Medicaid. Gandy will be excluded from participating with the Medicare and Medicaid programs for at least five years.

January 12, 2016; U.S. Attorney; Western District of Tennessee

Local Dermatologist, Cordova-based Medical Practice to Pay $450,000 for Overbilling Medicare
Memphis, TN - A doctor and his Cordova-based medical practice will pay $450,000 to the government to resolve allegations that it billed Medicare for unnecessary dermatological surgical procedures and office visits. Edward L. Stanton III, U.S. Attorney for the Western District of Tennessee, announced the settlement today.

January 12, 2016; U.S. Attorney; Southern District of Ohio

Ambulance Company Owner Pleads Guilty to Health Care Fraud
CINCINNATI - Terry Johnson, 42, of Hamilton Ohio, pleaded guilty in U.S. District Court to one count of health care fraud and one count of money laundering.

January 11, 2016; U.S. Attorney; Southern District of New York

Doctor And Owner Of Bronx Clinics Involved In Illegal Distribution Of More Than Five Million Oxycodone Pills Is Sentenced To 12 Years In Prison
Preet Bharara, the United States Attorney for the Southern District of New York, announced the conviction of KEVIN LOWE, the owner of "Astramed," a purported medical clinic with multiple locations in the Bronx, New York, and from which more than five million tablets of the prescription painkiller oxycodone were unlawfully distributed over a three-year period. On May 4, 2015, LOWE was convicted of a conspiracy to distribute narcotics following a two-week jury trial presided over by U.S. District Judge Lorna G. Schofield. Today, Judge Schofield sentenced LOWE to a term of 144 months in prison.

January 8, 2016; U.S. Department of Justice

Former Owner of Bostwick Laboratories Agrees to Pay Up to $3.75 Million to Resolve Allegations of Unnecessary Testing and Illegal Remuneration to Physicians
Dr. David G. Bostwick has agreed to pay the United States up to $3.75 million to resolve alleged violations of the False Claims Act for billing Medicare and Medicaid for medically unnecessary cancer detection tests and offering incentives to physicians to obtain Medicare and Medicaid business, the Department of Justice announced today. Dr. Bostwick was the founder, owner and chief executive officer of Bostwick Laboratories Inc. from 1999 to 2011. Bostwick Laboratories is a pathology laboratory headquartered in Glen Allen, Virginia.

January 8, 2016; U.S. Department of Justice

President of Miami-Based Transportation Company Convicted in $70 Million Health Care Fraud Scheme
The president of a Miami-based transportation company was convicted today for his role in a health care fraud scheme involving three mental health centers based in Miami that resulted in the submission of approximately $70 million in false and fraudulent claims to Medicare.

January 8, 2016; U.S. Attorney; Southern District of Florida

Four Miami-Dade Residents Indicted for Participation in Fraud Schemes
Four Miami-Dade residents have been indicted for their participation in various schemes to defraud the United States government.

January 7, 2016; U.S. Attorney; Northern District of Illinois

West Suburban Doctor Sentenced to Two Years in Federal Prison for Falsely Approving Unnecessary Treatment
CHICAGO - A west suburban physician was sentenced today to two years in prison for fraudulently certifying patients as confined to the home, allowing healthcare agencies to bill Medicare for millions of dollars in unnecessary in-home treatment.

January 7, 2016; U.S. Attorney; Southern District of West Virginia

Beckley physician pleads guilty to Federal drug crime and health care fraud
BECKLEY, W.Va. - Acting United States Attorney Carol Casto announced today that Jose Jorge Abbud Gordinho, M.D., of Beckley, pleaded guilty in federal court to illegally prescribing the pain medication hydrocodone. Dr. Gordinho also pleaded guilty to defrauding Medicare and Medicaid by submitting materially false claims for medical services that were not medically necessary.

January 6, 2016; U.S. Attorney; Central District of California

Doctor Who Pre-Signed Thousands of Prescriptions in $20 Million Health Care Fraud Scheme Sentenced to Nine Years in Prison
LOS ANGELES - The medical doctor at the center of a conspiracy linked to a sham medical clinic in Glendale was sentenced today to nine years in federal prison for his role in a $20 million scheme to defraud the Medicare and Medi-Cal programs.

January 6, 2016; U.S. Attorney; Middle District of Pennsylvania

United States Reaches Agreement With Former York County Chiropractor In Civil False Claims Act Suit
HARRISBURG - The United States Attorney’s Office for the Middle District of Pennsylvania announced today that it has entered into a Consent Decree with former chiropractor Kurt Bauer, age 62, of York, PA, to resolve a suit the United States filed alleging that Bauer remained involved in the management of a Medicare provider’s business despite his exclusion by the U.S. Department of Health and Human Services, in violation of the False Claims Act.

January 5, 2016; U.S. Attorney; District of Maryland

Two Defendants Sentenced to Prison in Conspiracy to Distribute Over $6.6 Million In Contraband Cigarettes
Baltimore, Maryland - U.S. District Judge William D. Quarles, Jr. sentenced Nikolay Zakharyan, age 24, of Owings Mills, Maryland, and Zarakh Yelizarov, age 53, of Pikesville, Maryland, today to a year and a day in prison, and 18 months in prison, respectively, each followed by three years of supervised release, for conspiracy to receive, possess, sell and distribute over $6.6 million in contraband cigarettes, that is, cigarettes on which the applicable state taxes have not been paid. Judge Quarles entered an order requiring Yelizarov to pay restitution of $2.5 million to New York City and the state of New York and to forfeit $56,000, proceeds of the offense. Judge Quarles also entered an order requiring Nikolay Zakharyan to pay restitution of $9,659,880.

January 5, 2016; U.S. Attorney; District of Idaho

Leader of Boise Oxycodone and Heroin Organization Sentenced to Ten Years in Federal Prison
BOISE - Austin Serb, 22, of Boise, Idaho, was sentenced today to 120 months in federal prison for distributing tens of thousands of oxycodone pills and heroin in a large scale drug trafficking conspiracy. Senior U.S. District Judge Edward J. Lodge also ordered Serb to serve three years of supervised release, 200 hours of community service, and to forfeit $1,000,000 in drug proceeds. At his sentencing hearing, Judge Lodge determined that Serb was a manager and supervisor of an extensive criminal organization. Serb pleaded guilty on February 13, 2015, and admitted that he conspired to distribute oxycodone and heroin from September 1, 2012, to March 10, 2014.

January 5, 2016; U.S. Attorney; Middle District of Tennessee

Nashville Pharmacy Services Settles False Claims Act Lawsuit
Nashville Pharmacy Services, LLC, and its majority owner Kevin Hartman have agreed to pay up to $7.8 million to settle allegations that they overbilled Medicare and TennCare for pharmacy services, announced David Rivera, U.S. Attorney for the Middle District of Tennessee. Nashville Pharmacy Services' primary location is at 100 Oaks in Nashville, Tenn. and it specializes in dispensing HIV and AIDS-related medications.

January 5, 2016; U.S. Attorney; Middle District of Pennsylvania

Health Care Fraud Charges And Plea Agreements Filed Against Tioga County Physician And Two Others
SCRANTON - The United States Attorney's Office for the Middle District of Pennsylvania announced today that a criminal information has been filed in U.S. District Court in Scranton against Dr. John Terry, age 65, of Wellsboro, in connection with fraudulent prescriptions he wrote for Oxycodone, a Schedule II controlled substance.

January 4, 2016; U.S. Department of Justice

Owner of Three Los Angeles Clinics Sentenced to 78 Months in Prison for Medicare Fraud
The former owner and operator of three medical clinics located in Los Angeles was sentenced today to 78 months in prison for his role in a scheme that submitted more than $4.5 million in fraudulent claims to Medicare.

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