Healthcare billing fraud: 11 recent cases

From the Justice Department charging 78 people in a $2.5 billion scheme to a woman being sentenced to prison for leading a $24 million scheme, here are 11 healthcare billing fraud cases Becker's has reported since June 20: 

1. A group of California healthcare providers, including two health systems and a health plan, agreed to pay $68 million to settle allegations that they submitted false claims to Medi-Cal related to Medicaid Adult Expansion under the Patient Protection and Affordable Care Act. 

2. The Justice Department charged 78 individuals, including 24 physicians, for their alleged participation in a sweeping $2.5 billion telehealth, pharmaceutical and opioid distribution fraud scheme. 

3. An Andover, Mass.-based pharmacy that has bought some of the nation's largest quantities of opioids agreed to pay $10 million to settle a lawsuit accusing the company of improperly dispensing drugs and submitting false claims. 

4. A federal jury found a California woman guilty of leading a scheme that billed Medicare more than $24 million in fraudulent claims for medically unnecessary durable medical equipment and repairs. 

5. A father and son pleaded guilty in a $21.7 million scheme to defraud Medicare through fraudulent medical device prescriptions. 

6. The owner of two Connecticut mental health clinics was sentenced to 30 months in prison for submitting over $1 million in false claims to Medicaid. 

7. A Wisconsin prenatal care coordinator was indicted for an alleged $2.3 million Medicaid fraud scheme.

8. A Missouri home health owner was sentenced to five years in prison for a pair of fraud schemes, including defrauding the state's Medicaid program out of $1.2 million.  

9. A Georgia physician could face more than $27 million in fines after a jury found he had violated the False Claims Act by submitting false diagnoses to Medicare. 

10. A chain of Georgia urgent care clinics will pay $1.6 million to settle allegations they overcharged Medicare by upcoding COVID-19 evaluation and management claims. 

11. An Illinois physician was sentenced to six months in prison and fined $1 million for billing fraudulent claims to Medicare and Blue Cross Blue Shield of Illinois. 

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