Maria Paz Garza was the King Midas of incontinence supplies: she turned diapers into dollars—over two and a half million of them, according to the government’s indictment.
She did it through a scheme that charged Texas...more
We have a tie! Danielle Burroughs and Tim Arthur are co-winners of the Low-Return Fraud Award for the month of May.
On May 30 a federal court ordered Danielle to pay a whopping $2.8 million in restitution for her role in a...more
Competition for the 2016 Nerve-of-a-Burglar Award was fierce, with health care providers constantly coming up with new and different ways to scam Medicare and Medicaid. Nevertheless, we have a clear winner: the Michigan...more
On September 1 the Seventh Circuit affirmed dismissal of three of a whistleblower’s four fraud allegations against a mental health clinic, ruling that the allegations were based on the whistleblower’s subjective judgment...more
I.A. Khair of New Jersey ran an ambulance company called K&S Invalid Coach. Presumably, “Invalid” was pronounced IN-va-lid, with the emphasis on the first syllable. Maybe it should have been pronounced in-VAL-id, with the...more
Health clinics may want to review their auditing obligations and practices in light of a June 23 ruling by the Eleventh Circuit.
Allstate decided to look into the billing practices of a group of Florida health clinics. ...more
Oscar Wilde observed, “No good deed goes unpunished.” Whistle-blower Michael Cascio discovered the truth of that saying when a federal court threw out his qui tam case against a national wound care provider that partners...more
It’s easy to fall into the habit of regarding self-referrals and kickbacks as strictly a matter of federal law, governed only by the federal Stark Law and Anti-Kickback Statute. But an April 13 verdict in California provides...more
During his days as a data encounter manager at SCAN, Jim suspected the company had been double-billing Medicare and Medicaid for years. He expressed his concerns within SCAN. When he refused a job reassignment, he was fired....more
Generally, when a doctor is convicted for fraud, the misdeeds are limited to a single category of fraud. Maybe the doctor charged for procedures that weren’t performed; maybe there were kickbacks for referrals; or maybe...more
Last Wednesday the Seventh Circuit affirmed the dismissal of a whistleblower suit brought by a pharmacist against his former employer, the Shopko pharmacy chain, for what he alleged was fraudulent billing of Medicaid by...more
It’s the city that never sleeps. So when it does something, it can do it in a big way. That applies to Medicaid fraud, according to a suit filed yesterday by the U.S. Attorney for the Southern District of New York....more
Danielle Bennion and her co-plaintiffs filed a RICO (Racketeer Influenced & Corrupt Practices Act) action alleging that Mountain View Hospital and co-defendants engaged in a plan of extortion and wire fraud for the purpose of...more
You probably didn’t think Florida’s Halifax Health could make its situation any worse. After all, only two months ago Halifax agreed to pay $85 million to settle just the first half of a Medicare fraud case. That still...more
5/30/2014
/ Damages ,
Destruction of Evidence ,
False Claims Act (FCA) ,
Fraud ,
Halifax Hospital ,
Healthcare ,
Healthcare Fraud ,
Hospitals ,
Medical Records ,
Medicare ,
Penalties ,
Settlement
Yesterday Kentucky’s largest hospital, King’s Daughters Medical Center, in Ashland, announced its agreement to pay $40.9 million to settle charges that it committed Medicare and Medicaid fraud by billing for coronary...more