Upcoding In The ER Could Be Stealing U.S. Tax Dollars
It’s an old and shady practice that has been in the forefront of Medicare and Medicaid fraud for years. Upcoding can hit taxpayers hard and drive emergency room bills to the thousands.
What is Upcoding?
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Category: Healthcare Fraud
Texas mayor-physician charged with $150 million Medicare fraud scheme in hospice and home health services
Ri Bravo Texas Mayor Francisco Pena, a licensed physicians has been indicted with federal charges of money laundering and conspiring with three others to defraud Medicare of $150 million in allegedly phony hospice and home health care services. The 11-count indictment unsealed Wednesday charges Dr. Pena with taking kickbacks to refer patients for services...
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Psychologist Sentenced for Health Care Fraud Involving Medicaid
Wyoming Psychologist Will Serve Prison Time for Health Care Fraud
A Wyoming Psychologist has admitted he committed health care fraud by falsely filing Medicaid claims. Gibson Buckley Condie, 57, of Powell, Wyoming has been sentenced to three years in prison and ordered to approximately $2.28 million in restitution, according...
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Healthcare Fraud Investigations Lead to $2.4 Billion in Recovered Funds
The Justice Department Nets Billions in 2017 Through Healthcare Fraud Cases
The Department of Justice announced that in 2017 it recovered $2.4 billion from federal healthcare fraud cases. According to Health Payer Intelligence, this total added up to well over half of all the money recovered by the DOJ fraud investigations.
Healthcare fraud...
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Controversial Medicaid Restrictions Eased for Some Hepatitis C Patients
It Will Now be Easier for Medicaid Patients to Get Treatment for Hepatitis C in Colorado
Controversial Medicaid restrictions are being pulled back in Colorado. Now, patients seeking treatment for Hepatitis C will no longer have to be in an advanced state of liver failure to have access to certain drugs and procedures. The move...
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Doctor Indicted for Obtaining Controlled Substances (Opioids) by Deception and Health Care Fraud
On November 29, 2017 Charles J. Gartland, D.O., age 59 of Cochranville, PA was indicted by a federal grand jury on charges of opioid diversion and health care fraud.
United States Attorney David J. Freed said the charges of the indictment were handed down based on the belief that...
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News investigation reveals that DEA stripped of power by Congress taking millions from drug maker lobbiests
Big Pharma Knows How Laws Work and They Can Use Them Against the DEA
Why did Congress, in the middle of the greatest drug crisis in the nation pass a law that stripped the Drug Enforcement Administration of its ability to sue companies violating drug distribution laws? The answer...
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Two chiropractors charged with fraud
Dr. Allan Spagnardi and Dr. Stacy Spagnardi have been arraigned on conspiracy and fraud charges for using their chiropractic clinic to submit false claims to private insurance providers.
"These two chiropractors are alleged to have reported fake patient visits in order to enrich themselves through fraudulent insurance claims," said U.S. Attorney Byung J. "BJay" Pak....
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AmerisourceBergen drug wholesaler pleads guilty to illegal distribution and pays $260 mill. fine
AmerisourceBergen Specialty Group, a drug wholesale company providing pharmaceuticals a, pled guilty to illegally distributing misbranded drugs and agreed to pay $260 million to resolve criminal liability for skirting regulatory oversight. The Government says that Between 2001 and 2014, the group's now-defunct subsidiary Medical Initiatives prepared millions of syringes that had been filled...
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MediSys Health pays $4 million to settle DOJ charges of doctor kickbacks
MediSys Health Network Inc., which owns and operates Jamaica Hospital Medical Center and Flushing Hospital and Medical Center, two hospitals in Queens, New York, has agreed to pay $4 million to settle allegations that it violated the False Claims Act by engaging in improper financial relationships with referring physicians, the Justice Department announced today.
The...
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