From Community Health Network agreeing to a $345 million False Claims Act settlement to the sentencing of an orthopedic surgeon for his role in an upcoding scheme, here are 11 healthcare billing fraud cases Becker's has reported since Dec. 12:
1. Ballwin, Mo.-based Total Access Urgent Care will pay more than $9.1 million to settle allegations it submitted false claims to Medicare and other federal healthcare programs.
2. The former CEO of Apache Behavioral Health Services in Whiteriver and Cibecue, Ariz., was charged in a scheme to defraud millions of dollars from the federally funded tribal healthcare provider.
3. Newark, Del.-based ChristianaCare is paying $47.1 million to resolve an over six-year-old kickback lawsuit filed by the health system's former chief compliance officer. Ronald Sherman accused the health system of infringing both anti-kickback laws and the False Claims Act through its relationship with Newark-based physician group Neonatology Associates.
4. A Florida nurse practitioner faces 20 years in prison for a $192 million Medicare fraud scheme that left her ordering more cancer genetic tests than any other provider in the United States.
5. The operator of a marketing company pleaded guilty to his role in a scheme that resulted in more than $127 million in fraudulent claims being submitted to healthcare benefit programs for durable medical equipment.
6. Indianapolis-based Community Health Network agreed to a $345 million settlement to resolve allegations that, dating back to 2008, it violated the False Claims Act and Stark law.
7. A Pennsylvania pain clinic CEO was sentenced to 30 months in prison for her role in a scheme to defraud Medicare and HHS.
8. The U.S. Attorney's Office filed a complaint under the False Claims Act against Steward Health Care System and its subsidiaries, alleging violations of the physician self-referral law and submission of false claims to Medicare.
9. A Massachusetts-based orthopedic surgeon was convicted by a federal jury for his role in an upcoding scheme.
10. Three people have been charged for their alleged roles in a scheme to defraud Minnesota's Medicaid program out of nearly $11 million.
11. Audu Ozigi, a former operator of home health agencies, was sentenced to 168 months in federal prison followed by three years of supervised release after he was found guilty of conspiracy to commit healthcare fraud, falsifying patient files and fraudulently billing Medicare and Medicaid.