From a Florida man being charged with allegedly using a Pennsylvania hospital in a $25 million Medicare scam, to the indictment of a New York physician in an alleged kickback scheme, here are 10 healthcare billing fraud cases that have made headlines since July 26.
1. American Senior Communities to pay $5.6M in Medicare fraud settlement
Indianapolis-based American Senior Communities, which operates several nursing homes in Indiana, has agreed to pay $5.6 million to settle allegations of false Medicare claims, the U.S. Justice Department said Aug. 10.
2. Georgia nurse practitioner sentenced to prison for role in telemedicine fraud scheme
Georgia nurse practitioner Sherley Beaufils was sentenced Aug. 9 to 87 months in federal prison and ordered to pay more than $1.6 million in restitution for her role in an orthopedic telemedicine fraud scheme.
3. North Carolina woman guilty in $34M healthcare fraud case
Former North Carolina physical therapy office administrator Jaroslava Ruiz was found guilty Aug. 4 by a federal jury of paying kickbacks and bribes to patient recruiters and patients with private insurance in exchange for allowing four Miami physical therapy clinics to bill for medical services that were never performed on those patients.
4. Medical equipment company owner pleads guilty in $2M billing fraud scheme
Ariel Paez, the owner of a Stuart, Fla.-based Always Medical Supply, pleaded guilty Aug. 4 to billing Medicare for durable medical equipment that was never provided to beneficiaries.
5. Lab testing company CEO, 7 others indicted in billing fraud scheme
Fadel Alshalabi, the owner and CEO of Spring Hill, Tenn.-based Crestar Labs, and seven others were indicted Aug. 1 for their alleged roles in a $150 million Medicare and Medicaid fraud scheme related to genetic testing.
6. New York physician indicted in alleged Medicaid fraud scheme
New York physician Payam Toobian, MD, was indicted Aug. 1 for an alleged kickback scheme that subjected Medicaid patients to unnecessary radiological tests. Dr. Toobian is accused of bribing other physicians for patient referrals, then subjecting some of those patients to unnecessary tests and submitting false claims to Medicaid.
7. Georgia man sentenced to prison for $17M Medicaid fraud
A Georgia man was sentenced to 70 months in prison and ordered to pay more than $5 million for his role in Medicaid fraud schemes that spanned three states. The schemes involved two companies owned by Glenn Pair, of Stonecrest, Ga., and Markuetric Stringfellow, according to a July 27 U.S. Justice Department news release. Mr. Stringfellow was previously sentenced to 78 months in prison and ordered to pay more than $5.2 million in restitution.
8. Man allegedly used Pennsylvania hospital for $25M Medicare scam
Daniel Hurt, of Fort Lauderdale, Fla., was charged July 27 with conspiracy involving $25 million in fraudulent Medicare claims submitted by Ellwood City (Pa.) Medical Center.
9. Pharmacy settles prior authorization fraud allegations
New York-based DJ Drugs & Surgicals agreed July 26 to settle allegations it committed prior authorization fraud. The Justice Department accused the specialty pharmacy of submitting altered patient medical records to Medicaid in order to obtain insurance coverage for an expensive class of cholesterol-lowering medications.
10. Virginia infusion center, owner ink false claims settlement
Danville, Va.-based Piedmont Infusion Services and its owner, Jacob Patterson, agreed to pay $310,000 to resolve allegations that they violated the False Claims Act and the Virginia Fraud Against Taxpayers Act by submitting false bills to Medicare and Medicaid, according to a July 26 statement from the U.S. attorney's office from the Western District of Virginia.