OKLAHOMA CITY (KOKH) — Oklahoma Attorney General John O’Connor announced a settlement on Friday with Tri-State Medical Supplies, a former Oklahoma-based company. O’Connor said the company agreed to resolve allegations that it violated the Oklahoma Medicaid False Claims Act by … Read More
BUFFALO – A Dansville physician has agreed to pay more than $600,000 to resolve allegations that during a five-year period he fraudulently billed Medicare and Medicaid, according to the U.S. Attorney for the Western District of New York. Dr. James … Read More
The state of Iowa has revoked the license of a nurse convicted of conspiring to steal $5 million from the taxpayer-funded Medicare program. According to state records, Mark Hill, 55, who currently lives in Laurel, Mississippi, was first licensed to … Read More
A previously convicted Northridge doctor will pay more than $9.48 million to settle allegations that he submitted false claims to the Medicare and Medi-Cal programs, state Attorney General Rob Bonta announced Friday, Dr. Minas Kochumian allegedly billed the health insurance … Read More
MANDAN, N.D. (KXNET) — Rebecca Anderson, of Mandan, has been ordered to pay $75,904.95 in restitution to the State of North Dakota. Anderson pleaded guilty to Medicaid fraud, a class B felony in state District Court in November 2021. KX … Read More
COLUMBIA, S.C. (WPDE) — A Medicaid Recipient Fraud Unit recently recovered just under $125,000 in fraudulently obtained Medicaid benefits from two people in South Carolina. One person is from the Charleston County area and the second person is in the … Read More
BURLINGTON, Vt. (WCAX) – Scammers are targeting your teeth. The Better Business Bureau reports it has seen an uptick in reports of fraud surrounding common cosmetic procedures like teeth whitening, Invisalign, veneers and other treatments. The BBB says often people … Read More
BOSTON – A statewide grand jury has indicted Four independent clinical laboratories, two laboratory marketing companies in connection with over $2 million in false Medicare claims to Massachusetts, according to Attorney General Maura Healey’s office. The indicted defendants are: Vipin … Read More
Citizens may file whistleblower complaints or qui tam actions against violators (persons or companies) through a variety of mechanisms. The two most common mechanisms for complaint filing in the dental industry are workers via the US Department of Labor especially … Read More
A retired La Jolla dentist who pleaded guilty to federal charges in connection with a charity fraud and tax evasion scheme involving former Chabad of Poway Rabbi Yisroel Goldstein was sentenced Monday to 15 months in custody. Bruce Baker, 75, … Read More
Joshua Maywalt, 42, Tampa, has been sentenced to five years and five months in federal prison for healthcare fraud, aggravated identity theft, filing a false income tax return, and failing to file an income tax return. As part of his … Read More
June 2, 2022 — The U.S. Department of Justice (DOJ) said this week that Caris Life Sciences has agreed to pay almost $2.9 million to resolve allegations that it violated the False Claims Act in an alleged nationwide scheme to … Read More
Benevis, a leading dental support organization (DSO) for practices focused on pediatric dental care and orthodontics, sponsored free dental care for 206 children and adults during its annual Sharing Smiles Day event. Sharing Smiles Day, held on May 22, 2022, … Read More
Three owners and operators of four orthotic brace suppliers were convicted of conspiracy to defraud the United States and for offering and paying illegal kickbacks. The three defendants face up to 55 years in prison each for their roles in … Read More
A Cranberry Township woman and her two Pittsburgh relatives pleaded guilty in federal court to defrauding the Pennsylvania Medicaid program for nearly eight years, resulting in the collection of $87 million in illegal Medicaid payments. According to a news release … Read More
LINDEN – A 39-year-old city woman has been charged with stealing $350,000 in Medicaid funds over a four-year period. Leslie K. Lessen was charged May 23 with one count of theft, a second-degree crime, and two counts of a tampering … Read More
MISSOULA, Mont. — Senior Medicare Patrol is helping to fight against fraud for its first-ever Medicare Fraud Prevention Week starting June 5 through 11. Medicare loses around $60 billion through fraud every year. And it also creates negative impacts on … Read More
HARRISBURG, PA — Attorney General Josh Shapiro announced that Rex Barr, owner of Rides Your Way, a non-medical transportation service provider, pleaded guilty Friday to being involved in a scheme to charge Pennsylvanians for non-medical transportation plans that were not … Read More
PITTSBURGH (KDKA) – Three more people pleaded guilty in an extensive conspiracy to defraud Pennsylvania’s Medicaid program out of millions of dollars, prosecutors announced Friday. Arlinda Moriarty from Cranberry, her sister Daynelle Dickens and their uncle Tony Brown, both from … Read More
BOSTON (WHDH) – One of the owners of a New Bedford independent clinical laboratory has been indicted on a range of criminal charges in connection with an alleged Medicaid fraud scheme, Attorney General Maura Healey announced. William Owens Jr., 60, … Read More
A North Carolina woman has been sentenced to nearly two years in prison for conspiring with others to defraud North Carolina’s Medicaid system by turning in more than $4 million in fake claims for behavioral health services. Sharita Mathis Richardson … Read More
A former Kentucky legislator has admitted he knew his pharmacy was submitting improper bills to insurance programs, but didn’t stop the fraud. Former state Rep. Robert Goforth, 46, pleaded guilty Wednesday in connection with $2.7 million in excess billing. Goforth … Read More
SILSBEE, Texas — A Silsbee doctor is one of six Texas physicians named in an amended federal case alleging medical fraud and kickbacks to doctors for lab tests that were unneeded. The initial case filed by the government named two … Read More
A federal judge in Greeneville, Tennessee, sentenced seven people and seven related corporate entities for deceiving pharmacy benefit managers (PBMs) regarding tens of thousands of prescriptions. The scheme involved using telemedicine to authorize prescriptions and gain insurance information. The leader … Read More
A Coral Springs company has agreed to pay $3.15 million in settlement money to resolve allegations it submitted false Medicare claims to the government after a whistleblower revealed the alleged lawbreaking, prosecutors said. VirtuOx, Inc, which operates Medicare-approved diagnostic testing … Read More
HARRISBURG (PRESS RELEASE) —Attorney General Josh Shapiro announced Southwest Nu-Stop Philadelphia Inc. (Southwest), a Philadelphia-based drug and alcohol treatment facility, and its owner Dr. Lloyd Reid pleaded guilty to Medicaid fraud for paying illegal kickbacks to recovery homes in Philadelphia. … Read More
ATLANTA — The U.S. Attorney in Atlanta announced Friday that ex-Georgia insurance commissioner John Oxendine has been indicted on federal healthcare fraud and money laundering charges. Oxendine was the state’s insurance commissioner from 1995 to 2011, leaving office after a … Read More
DENTON, Texas — The City of Denton passed a resolution Wednesday in favor of Medicare for All, becoming the 100th local government nationwide to endorse the system at a federal level. Denton’s resolution comes days after after the reintroduction of … Read More
The state police made him do it. That’s the excuse Texas Attorney General Ken Paxton gives on his Texas ethics disclosures in place of revealing, as required by law, the addresses of properties he owns in Austin and College Station. … Read More
HOUSTON – Five men accused in a health care fraud scheme involving local pharmacies and a pain clinic are set to make their appearances in Houston federal court, U.S. Attorney Jennifer B. Lowery announced Monday. Charles Willis, 57, appeared for … Read More
AUSTIN (KXAN) — A Texas Health and Human Services director is accused of insurance fraud related to a car fire in March, according to an arrest warrant. The Travis County arrest warrant for Jerrod Wytez Holton was issued May 13, … Read More
SPRING BRANCH — On the first day of early voting for his Republican primary runoff, Attorney General Ken Paxton spoke to a crowd of supporters where he barely acknowledged the contest and totally ignored his well-known challenger, Land Commissioner George … Read More
A federal jury in Dallas, Texas, convicted the owners and operators of four orthotic brace suppliers in Texas and Arkansas today for a $6.5 million illegal kickback scheme, including violations of the federal Anti-Kickback Statute. According to court documents and … Read More
A $5 million healthcare scam run of medical clinics in Miramar and West Miami-Dade ended last week with a 21-year-old office employee sentenced to restitution and prosecutors trying to find the man who got the longest prison sentence. Between those … Read More
The OIG continues to broaden its use of data analysis to help uncover fraud, waste and abuse (FWA) trends in the health care system by assessing potentially problematic behavior patterns. The OIG’s Data Initiative Project Team (DIPT) is using data … Read More
The United States Department of Justice settled a case against a California-based behavioral health provider. Under the terms of the settlement, Prism Behavioral Solutions paid $650,000 to resolve allegations of submitting false claims to state and federal healthcare programs. The … Read More
MIAMI, FL – On Tuesday, May 10, 2022, a federal district judge in Miami sentenced the last of 10 defendants for her role in a health care fraud scheme involving three physical therapy clinics that recruited and paid kickbacks to … Read More
FERRIS, Texas — The city of Ferris, southeast of Dallas, has announced a unanimous approval for residents to receive free healthcare. According to city manager Brooks Williams, Ferris is the first city in the state, and the country to do … Read More
