Healthcare billing fraud: 10 recent cases

From the acquittal of a Maryland physician in an alleged $15 million scheme, to two Florida residents sentenced to prison for their roles in a $93 million scheme, here are 10 healthcare billing fraud cases Becker's has reported since Dec. 29: 

1. Kenilworth, N.J.-based clinical laboratory RDx Bioscience and its owner agreed to pay more than $13 million to resolve allegations of kickbacks and unnecessary testing.

2. Four owners and operators of Fairfax, Va.-based 1st Adult Pediatric Healthcare Services were among nine indicted for their roles in an alleged scheme to submit false claims to Medicaid for services that were not provided. 

3. Atlantic Home Health Care agreed to pay $10 million to settle allegations that it violated the False Claims Act by submitting false claims to the Energy Employees Occupational Illness Compensation Program, which is administered by the Labor Department.

4. Two Florida residents were sentenced to prison after being convicted for their roles in a scheme that billed Medicare $93 million for home health therapy services that were never performed. 

5. Memphis, Tenn.-based Methodist Le Bonheur Healthcare and its Methodist Healthcare-Memphis Hospitals paid $7.25 million to resolve False Claims Act allegations along with kickback allegations.

6. Tampa, Fla.-based Moffitt Cancer Center agreed to pay more than $19.5 million to resolve civil liability after self-disclosing that it improperly billed federal healthcare programs for clinical trial costs. 

7. A medical biller is accused of stealing more than $1 million that was intended to be paid directly to physicians who provided medical care to injured workers under the New York State Workers' Compensation Law.

8. The owner of a durable medical equipment company was indicted for his alleged role in a $60 million fraud scheme. 

9. A Maryland physician was acquitted of a more than $15 million fraud scheme conviction after the court determined prosecution did not provide enough evidence that "ambiguous" CPT codes were being abused. 

10. Twin siblings who ran a Medicare billing company have been charged for their alleged role in a $25 million scheme involving fraudulent durable medical equipment claims. 

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