From a Florida physician allegedly bilking $26 million from insurers to a Tennessee hospital paying $4.1 million to settle a false claims lawsuit, here are eight healthcare billing fraud cases that made headlines in the past month.
1. California physician sentenced to prison over $700K in fraudulent billings
A urologist in California was sentenced to 71 months in prison Feb. 24 for submitting more than $700,000 in fraudulent billings to Medicare.
2. Chicago woman found guilty for role in $7M Medicare billing scheme
Angelita Newton was found guilty of partaking in a scheme to defraud $7 million from the Medicare program. She allegedly helped the owners of a Chicago-based home health company Care Specialists run a billing scheme.
3. Florida physician allegedly bilked $26M from insurers to fund political ambition
Moses D. deGraft-Johnson, MD, was charged with conspiracy to commit healthcare fraud and more than 50 counts of healthcare fraud. Prosecutors allege he submitted false claims to insurers for surgeries he did not perform and for unnecessary procedures.
4. Tennessee hospital to pay $4.1M to resolve false claims allegations
Cookeville (Tenn.) Regional Medical Center agreed to pay $4.1 million to settle allegations that it violated the False Claims Act, Stark Law and the Anti-Kickback Statute.
5. Tenet to pay $1.4M to settle medically unnecessary implant suit
Dallas-based Tenet Healthcare and one of its hospitals in Palm Springs, Calif., will pay $1.41 million to resolve allegations that they knowingly charged Medicare for implanting unnecessary cardiac monitors in patients in violation of the False Claims Act.
6. Florida physician sentenced for role in $40M billing scam
John Agbi, MD, was sentenced to 18 months in prison Jan. 31 for his role in a $40 million Medicare scheme. The scam involved Dr. Agbi and others signing orders for arm, knee and wrist braces that weren't medically necessary and then billing Medicare for the medical devices. Dr. Agbi was responsible for $7.6 million in fraudulent billings.
7. California physician group settles false billing case for $2.9M
Arch Health Partners agreed to pay $2.9 million to resolve allegations that the Poway, Calif.-based physician group submitted false claims to Medicare.
8. California physician gets 15 months in prison for $900M kickback scheme
The former owner of Long Beach, Calif.-based Pacific Hospital received a 15-month prison sentence for his role in a kickback scheme that led to more than $900 million in fraudulent bills being submitted primarily to the California work compensation system.