Healthcare billing fraud: 12 recent cases

From a medical biller ordered to pay more than $336 million in restitution to a serial fraudster sentenced to 10 years in prison for his latest scheme, here are 12 healthcare billing fraud cases Becker's has reported on since Jan. 19: 

1. The operator of a medical billing company was sentenced to 12 years in prison and ordered to pay over $336 million in restitution for an elaborate healthcare billing fraud, wire fraud and identity theft scheme.

2. The owner of a Livonia, Mich.-based home health care company was sentenced to nine years in prison for orchestrating a nearly $2.8 million fraud scheme. 

3. A California man convicted multiple times for healthcare fraud was sentenced to 10 years in prison for his latest scheme. 

4. A Spokane, Wash.-based physician agreed to pay $95,000 to resolve allegations he ordered medically unnecessary durable medical equipment as part of a kickback scheme. 

5. A Florida man was arrested on charges of submitting false Medicare claims exceeding $17 million through his two medical supply companies. 

6. Two former leaders at an Arkansas medical supply business took a plea deal amid allegations of a kickback scheme, and they were ordered to pay more than $5 million in restitution. 

7. The U.S. and State of Washington filed a suit against Tacoma, Wash.-based MultiCare Health for allegedly fraudulently billing federal healthcare programs for spine surgeries performed by Jason Dreyer, DO, at Deaconess Hospital in Spokane between 2019 and 2021. 

8. New York City-based NewYork-Presbyterian Hospital agreed to pay $801,000 to resolve allegations that two radiology practices improperly billed federal healthcare programs for  images used in image-guided radiation therapy treatments. 

9. The former and current owners of a Philadelphia pharmacy agreed to pay more than $4.6 million to settle allegations of submitting false claims to Medicare and Medicaid for nonexistent prescriptions. 

10. The former president and CEO of Whittier, Calif-based Santa Maria's Children and Family Center was sentenced to more than 10 years in prison for submitting fraudulent claims to the state's Medicaid program.

11. The former president of New Jersey pharmacies was sentenced to three years of prison after pleading guilty to a three-year healthcare fraud scheme amounting to $32 million.

12. An Idaho-based clinic chain and its owners agreed to pay $2 million to settle allegations they used vulnerable or inexperienced medical staff to fraudulently bill federal healthcare programs.  

 

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