Healthcare billing fraud: 7 recent cases

From a California health plan and three providers agreeing to pay $70.7 million, to a former anesthesiologist sentenced to 10 years in prison, here are seven healthcare billing fraud cases Becker's has covered since Aug. 12: 

1. Centene to pay $32M to settle Medicaid overcharging allegations in Washington

Centene agreed Aug. 24 to pay $19 million to the state of Washington and $13 million to the federal government to settle allegations it overcharged the state Medicaid program for pharmacy benefit management services.

2. Former Wichita chiropractors accused in $3.7M healthcare fraud scheme

A federal grand jury returned an indictment Aug. 19 charging brothers Bradley Eck and Todd Eck for their alleged roles in a healthcare fraud scheme that resulted in more than $3.7 million in payments from Medicare and Tricare over three years.

3. Texas physician, employee indicted in $3.5M Medicare fraud scheme

McAllen, Texas, physician Osama Nahas, MD, and his employee Isabel Pruneda were indicted Aug. 19 for allegedly paying kickbacks to adult day care companies to gain Medicare beneficiary information.

4. California health plan, providers to pay $70.7M to settle billing fraud claims

Gold Coast Health Plan, Ventura County Medical Center, Dignity Health and Clinicas del Camino Real agreed to pay $70.7 million Aug. 18 to settle claims they violated federal and state false claim act laws by submitting improper claims to the state's Medicaid program.

5. Home healthcare owner gets prison for $10M Medicare fraud scheme

Houston home healthcare owner Naomi Moore was sentenced Aug. 16 to 60 months in prison after admitting to fraudulently billing Medicare by using the names of beneficiaries who were not patients at either of the businesses she owned. 

6. California physician who fraudulently billed insurers $600M gets 10 years in prison

Randy Rosen, MD, a former anesthesiologist in Beverly Hills, Calif., was sentenced to 10 years in prison Aug. 16 for stealing nearly $38 million through an insurance fraud scheme that paid patients at sober living homes to undergo medically unnecessary testing and surgeries.

7. California physician, practice paying $2M to settle fraud allegations

Azizulah Kamali, MD, of Stockon, Calif., and his medical practice agreed Aug. 12 to pay nearly $2 million after admitting to submitting claims to Medicare for surgically implanted neurostimulator devices even though they did not perform surgery or implant neurostimulators.

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