Medicare Fraud | The Health Law Firm Blog

Signing False Medicare Claims Lands Nurse Behind Bars for 30 Months

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

A Detroit-area registered nurse was sentenced on November 19, 2012, to 30 months in federal prison for his alleged part in a nearly $13.8 million Medicare fraud scheme. According to a Department of Justice (DOJ) press release, he will serve probation after being released from prison. He was also ordered to pay more than $450,000 in restitution, together with his co-defendants.

Click here to read the entire press release from the DOJ.

Nurse Signed Medical Records for Services Never Rendered.

According to the nurse’s plea agreement, from […]

By The Health Law Firm|2024-03-14T10:00:41-04:00June 1, 2018|Home health care facility, Medicare, Medicare Fraud, The Health Law Firm Blog|

Former Daytona Beach Chiropractor Will Spend More Than 15 Years Behind Bars

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

A former Daytona Beach chiropractor will spend more than 15 years in federal prison for an alleged health care fraud scheme and illegally prescribing pills, according to the Federal Bureau of Investigation (FBI), Jacksonville Division. He was also ordered to pay more than $2 million in restitution to his victims. The former chiropractor was sentenced on November 29, 2012, by a United States District Judge who called his fraud scheme “sophisticated.”

Click here to read the press release from the FBI.

I previously […]

By The Health Law Firm|2024-03-14T10:00:41-04:00June 1, 2018|DEA, Medicare, Medicare Fraud, The Health Law Firm Blog|

Phony Medical Equipment Supplier will Spend 30 months in Prison for Medicare Fraud

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

A Los Angeles medical equipment supplier will spend 30 months in prison for submitting nearly $1 million in false claims to Medicare. The claims were almost all for expensive, high-end power wheelchairs. The man was sentenced on October 5, 2012.

To see the press release from the Department of Justice (DOJ), click here.

Man Owned and Operated a Phony Durable Medical Equipment Supply Company.

In February 2012, the defendant in this case pleaded guilty to owning and operating a fake durable medical equipment (DME) supply company, […]

By The Health Law Firm|2024-03-14T10:00:38-04:00June 1, 2018|Medicare, Medicare Audit, Medicare Fraud, The Health Law Firm Blog|

E&M Services Now Under Review by the Recovery Audit Contractors (RACs)

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

In September 2012, the Centers for Medicare and Medicaid Services (CMS) made the decision to allow Recovery Audit Contractors (RACs) to begin reviewing the billing codes for office visits for healthcare providers. Those at issue are the codes referred to as evaluation and management (E&M) codes. These claims had previously been off-limits to RACS.

Connolly, Inc., the contractor for RAC audit services for 15 states and two U.S. territories, will sort through claims filed by doctors and hospitals from as far back as October 1, 2007. According to an article […]

By The Health Law Firm|2024-03-14T10:00:37-04:00June 1, 2018|In the Know, Medicare, Medicare Audit, Medicare Fraud, The Health Law Firm Blog|

Whistleblower Lawsuit Alleging Medicare Fraud Against Blackstone Medical, Inc., Dismissed

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

A whistleblower lawsuit against Blackstone Medical, Inc., alleging Medicare fraud against Parrish Medical Center, was dismissed by a U.S. District Judge in Tampa, Florida, on August 15, 2012. According to Orthopedics This Week, the case was unsealed on August 8, 2012, but dismissed without prejudice, all pending motions were denied as moot, and the clerk was directed to close the case, just one week after.

To see a copy of the order of dismissal, click here.

Whistleblower Originally Filed False Claims and Kickback Complaint.

According to the […]

By The Health Law Firm|2024-03-14T10:00:37-04:00June 1, 2018|Medicare, Medicare Fraud, The Health Law Firm Blog, Whistleblower|

Medicare Fraud Lands More Than 30 Suspects Behind Bars in South Florida

By Dr. Thu Pham, O.D., Law Clerk

On October 4, 2012, federal authorities arrested 33 suspects in South Florida for allegedly filing fraudulent Medicare claims totaling $205 million. Payment of bribes and kickbacks, as well as payments to patient recruiters were an issue in this investigation.

To read the entire article from the Miami Herald, click here.

Feds Focus on Crackdown of Medicare Fraud Nationwide.

These arrests are part of a nationwide initiative to crack down on theft committed by individuals against Medicare. Peter Budetti, the Medicare anti-fraud czar states that the goal is to catch the fraud before the fraudsters “can successfully bill Medicare.” Previously, fraud was caught only after the funds were disbursed and spent.

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By The Health Law Firm|2024-03-14T10:01:49-04:00May 15, 2018|Clinical Social Worker, Intern, Marital and Family Therapist, Medicare Audit, Medicare Fraud, Mental Health Counselor, Mental Health Counselor Law, Psychology|

Whistleblower Case Against Tennessee-Based Nursing Care Company

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

The Office of Inspector General (OIG) of the U.S. Department of Health and Human Services (HHS) is investigating a Tennessee-based nursing care company. The company runs more than 200 skilled nursing homes (SNFs), assisted living facilities (ALFs), retirement living communities, home care services, and Alzheimer’s centers across the country. The nursing care company is accused of defrauding Medicare of millions of dollars for unnecessary and expensive therapy treatments from 2006 to 2011, according to the Wall Street Journal.

Click here to read the entire […]

By The Health Law Firm|2024-03-14T10:01:57-04:00May 15, 2018|ALFs, Medicare Fraud, Nursing Law Blog|

Detroit Nurse Will Spend Time Behind Bars for Signing False Medicare Claims

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

A Detroit-area registered nurse was sentenced on November 19, 2012, to 30 months in federal prison for his alleged part in a nearly $13.8 million Medicare fraud scheme. According to a Department of Justice (DOJ) press release, he will serve probation after being released from prison. He was also ordered to pay more than $450,000 in restitution, together with his co-defendants.

Click here to read the entire press release from the DOJ.

Nurse Paid Handsomely for Signing False Claims.

According to the nurse’s plea agreement, from December […]

By The Health Law Firm|2024-03-14T10:01:56-04:00May 15, 2018|Medicare Fraud, Nurse License|

Have You Received a Notice of Termination of Your Medicare Provider Number?

By Danielle M. Murray, J.D.

Have you received a notice of termination of your Medicare provider number? Medicare has been revoking the Medicare provider numbers of many different Medicare providers including psychologists and other mental health providers, based on returned mail sent to old addresses which have not been updated or based on inspection team site visits to old addresses.

Often the termination is retroactive to a much earlier date the change or move may have been determined to have occurred. Even if the mailing address is correct or was changed, the physical address of the business must have been updated, as well. It is usually an incorrect or old physical […]

By The Health Law Firm|2024-03-14T10:01:05-04:00May 15, 2018|Medicare Audit, Medicare Fraud, Mental Health Counselor, Mental Health Counselor Law, Psychology|

Medicare and Medicaid Audits of Psychologists and Other Mental Health Professionals – Part 2

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

Over the past year I have observed an increasing number of Medicare and Medicaid audits being initiated against psychologists and other mental health professionals.

I have recently seen a number of audits initiated against psychologists and mental health professionals who treat assisted living facility (ALF) and skilled nursing facility (SNF) residents. Most often these are audits by the Medicare Administrative Contractor (MAC), because this area of medical practice has been identified as one fraught with fraud and abuse. Sometimes these are only “probe” audits, initial audits requesting one (1) to five […]

By The Health Law Firm|2024-03-14T10:01:49-04:00May 15, 2018|Medicaid audit, Medicare Audit, Medicare Fraud, Mental Health Counselor, Mental Health Counselor Law, Psychology|