After the Congressional Budget Office released its assessment of the American Health Care Act predicting an increase of 24 million Americans without health insurance by 2026, there was an interesting response from Senate Republicans. They suggested certain changes to the bill which, they said, would increase the chances of it being approved by the...
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Category: Healthcare Fraud
Physicians accused of kickback scheme to defraud Tricare of $102 million
A physician is among a dozen doctors, pharmacy owners and marketing pros accused of a kickback scheme that government prosecutors say involved a sham medical study used to get up to $102 million from the publicly-funded federal health program for military family members.
Walter Neil Simmons, 47, of Gilbert, an emergency medicine doctor...
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Radiologists blow whistle on hospital for alleged monopoly and kickbacks
Two radiologists have filed a federal whistleblower lawsuit accusing Bozemen Health Deaconess Hospital of illegally conspiring to maintain its monopoly on radiology services, leading to fraudulent bills being submitted to Medicare and Medicaid.
Frank Rembert and Michael Page allege that Intercity Radiology "Ć® which contracted with the hospital in 2002 wanted to open an...
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Tenet Healthcare pays $513 million to settle whistleblower charges of kickbacks for Hispanic pregnant patient referrals
The U.S. hospital chain, Tenet Healthcare Corporation,will pay over $513 million to resolve criminal charges and civil claims relating to a scheme to defraud the United States and to pay kickbacks in exchange for patient referrals. The criminal and civil complaints filed by theThe Department of Justice and the state of Georgia in 2014...
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Vibra Healthcare pays U.S. $32.7 Mill to end case over unnecessary services in long term care hospitals
National hospital chain Vibra Healthcare LLC will pay Uncle Same $32.7 million to end a False Claims Act whistleblower case alleging billing Medicare and Medicaid for unneceaary services. The government alleged that between 2006 and 2013, Vibra admitted numerous patients to five of its long term care hospitals (LTCH's) and inpatient rehabilitation facilities (IRF's)...
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Largest non profit visiting nurse org sued for defrauding Medicare and Medicaid of hundreds of millions
A 16 year veteran manager of The Visiting Nurse Service of New York has filed a whistleblower suit against the non-profit agency for defrauding Medicare and Medicaid of hundreds of millions of dollars over the years through fraudulent invoices and other practices. The lawsuit, reported by the New York Times charges that...
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Kindred Healthcare pays $3 million to U.S. for faulty billing
HHS' Office of Inspector General said Tuesday that the massive post-acute care provider failed to correct improper billing practices during the fourth year of its five-year corporate integrity agreement, stemming from a prior $25 million False Claims Act settlement with Gentiva Healthcare. Kindred acquired Gentiva in a $1.8 billion deal.According to OIG,...
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North American Healthcare pays $28.5 mill to end case of medically unnecessary rehabilitation at skilled nursing facilities
North American Health Care Inc. (NAHC), its chairman of the board, John Sorenson, and its senior vice president of Reimbursement Analysis, Margaret Gelvezon, have agreed to pay a total of $30 million to resolve allegations that they violated the False Claims Act by causing the submission of false claims to government health care programs...
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Tenet Healthcare pays more than $513 million to settle hospital kickback case
Tenet Healthcare Corp. has announced that it has reached "an agreement in principle" to settle a whistleblower case for more than $513 million, settling that Tenet paid kickbacks to a string of clinics to refer pregnant undocumented Hispanic women to a Tenet hospital for medical treatment in birthing.Court pleadings in the whistleblower case allege...
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Healthcare CEO sentenced to 10 years in prison for fraud resulting in patient deaths
Rafael Chikvashvili, PhD, owner of Owings Mills, a Maryland based diagnostic service has been sentenced to 10 years in prison on counts of healthcare fraud resulting in death, according to the Department of Justice. According to evidence presented at trial, Dr. Chikvashvili was involved in a scheme to defraud Medicare and Medicaid. He and...
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