Healthcare billing fraud: 10 recent cases

From a medical equipment company owner receiving a 15-year sentence for a $24 million scheme to the conviction of a New York physician in a scheme that subjected Medicaid patients to unnecessary radiological tests, here are 10 healthcare billing fraud cases Becker's has reported since Nov. 27:

1. The owner of a pair of medical equipment companies was sentenced to 15 years in prison after being found guilty of leading a scheme that billed Medicare for more than $24 million in medically unnecessary durable medical equipment and repairs. 

2. A Washington physician was charged in a $14 million medical supply scheme that targeted Medicare and Tricare members in five states.

3. A former executive of Little River Healthcare — a critical access hospital in Rockdale, Texas, — and three physicians agreed to pay $880,199 between them to resolve False Claims Act allegations, including alleged violations of the Anti-Kickback Statute. 

4. A Tulsa, Okla., man was sentenced to 54 months in prison for a scheme that involved submitting more than $30 million in claims to major payers for COVID-19 testing services that were never performed. 

5. The co-owner and CEO of a Louisiana diagnostic laboratory was indicted for his alleged role in a scheme to defraud Medicare and Medicaid of more than $148 million in unnecessary testing. 

6. A Connecticut behavioral health clinician was charged with submitting false claims to the state's Medicaid program.

7. A physician and his wife pleaded guilty to their roles in a genetic testing kickback and bribery scheme. 

8. A Virginia-based nurse practitioner pleaded guilty to her role in a $7.8 million telemedicine scheme involving medically unnecessary durable medical equipment.

9. A Nebraska pharmacist pleaded guilty to healthcare fraud, and a federal court ordered her to pay more than $573,000 in restitution. 

10. A New York physician was convicted of multiple charges in a kickback scheme that subjected Medicaid patients to unnecessary radiological tests.

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