For those of you still following this 15 year orthodontic debacle, in a long-awaited decision, the Fifteenth Court of Appeals has reversed a trial court’s ruling and held that Alexandra Alvarez, Joshua LaFountain, and Christine Ellis, DDS, are not entitled … Read More
Almost 15 years ago, on May 13, 2011, WFAA’s Byron Harris uttered the famous phrase, “Nobody has ever died from crooked teeth,” which ushered in the Great Texas Medicaid Fraud Debacle. To think that today, in 2026, TDMR would still … Read More
A Swansea dentist accused of defrauding Illinois Medicaid of thousands of dollars over a period of several years has pleaded guilty to the scheme. Yun Sup Kim, 48, of St. Louis, appeared at the federal courthouse in Benton on Thursday … Read More
Tenet Healthcare Corporation and its affiliated hospital Desert Regional Medical Center (DRMC), a general medical and surgical hospital located in Palm Springs, California, have agreed to pay $1.41 million to resolve allegations that they violated the False Claims Act by … Read More
Acting United States Attorney A. Lance Crick announced today that ResMed Corp., a manufacturer of durable medical equipment (DME) for sleep apnea and other sleep-related disorders, has agreed to pay more than $37.5 million to resolve allegations under the False … Read More
Dr. Ian Reynolds, 71, of Friendswood, Texas, agreed to pay the United States $300,000 to resolve False Claims Act allegations that he accepted illegal kickback payments from OK Compounding, LLC, announced U.S. Attorney Trent Shores. This is the twelfth kickback … Read More
SACRAMENTO, Calif. — The founder and former CEO of a chain of Central Valley rural health clinics will sell 13 properties, remitting proceeds to the United States and the state of California, to resolve allegations that she submitted millions of … Read More
Years before Hattiesburg businessman Wade Walters was indicted on 37 charges related to a $510 million health care fraud, his name circulated in federal documents as one of four people who planned and orchestrated the plot. In earlier court documents, … Read More
Ohio Attorney General Dave Yost joined other states and the federal government in announcing a settlement with Avanir Pharmaceuticals over allegations that the company paid kickbacks to medical professionals and engaged in off-label marketing tactics to promote its flagship drug … Read More
Avanir Pharmaceuticals (Avanir), a pharmaceutical manufacturer based in Aliso Viejo, California, was charged for paying kickbacks to a physician to induce prescriptions of its drug Nuedexta, the Department of Justice announced today. The Northern District of Ohio also announced indictments … Read More
A Texas federal judge dismissed a False Claims Act lawsuit alleging Dallas-based Baylor Scott & White Health overbilled Medicare by improperly upcoding claims, according to Law360. The whistleblower lawsuit, filed in 2017, alleges Baylor Scott & White Health submitted more … Read More
BIRMINGHAM, Ala., June 28, 2019 /PRNewswire/ — Encompass Health Corporation (EHC) (“Encompass Health” or the “Company”) today settled a seven-year False Claims Act (“FCA”) investigation by the Department of Justice (“DOJ”), together with related qui tam or “whistleblower” lawsuits, for … Read More
OKLAHOMA CITY – OKLAHOMA HEART HOSPITAL, LLC, AND OKLAHOMA HEART HOSPITAL SOUTH, LLC, have agreed to pay $2,800,000 to settle civil claims stemming from allegations that they submitted false claims to Medicaid, announced First Assistant U.S. Attorney Robert J. Troester. … Read More
Memphis, TN – Decatur Hospital Authority, d/b/a Wise Health System in Decatur, Texas will pay $431,182.96 to the United States to resolve allegations of billing false claims to Medicare for genetic testing panels for surgical patients that were not medically … Read More
HARTFORD — Connecticut Attorney General William Tong on Thursday announced a $252,913 settlement with New Haven dentist Robert Sorrentino to resolve allegations that he violated the False Claims Act by submitting false claims for oral surgery and maxillofacial services to … Read More
CHARLOTTE, N.C. – A woman is accused of running a Medicaid fraud scheme that took millions of dollars in medical care away from North Carolina families who deserve it. It involved many false claims to Medicaid and, experts said, ultimately … Read More
United States Attorney John H. Durham, Special Agent in Charge Phillip Coyne of the U.S. Department of Health and Human Services, Office of Inspector General, and Connecticut Attorney General William Tong today announced that DR. BASSAM AWWA and his medical … Read More
Union General Hospital in Blairsville, Ga., agreed to pay $5 million to resolve allegations that it violated the False Claims Act and Stark Law, according to the Department of Justice. The U.S. Attorney’s Office for the Northern District of Georgia … Read More
The Department of Justice has announced that it obtained $2.5 billion in settlements and judgments from cases involving healthcare fraud in 2018. The healthcare fraud settlements are part of more than $2.8 billion the government obtained through False Claims Act … Read More
Berger Montague is pleased to announce that the government has intervened in a False Claims Act lawsuit filed by shareholder Shauna Itri, along with co-counsel, against a cardiovascular center in Texas. The lawsuit alleges that the cardiologist group defrauded the … Read More
Prime Healthcare Services, Inc., Prime Healthcare Foundation, Inc., and Prime Healthcare Management, Inc. (collectively Prime), and Prime’s Founder and Chief Executive Officer, Dr. Prem Reddy, have agreed to pay the United States $65 million to settle allegations that 14 Prime … Read More
NEWARK, N.J. – A Somerset, New Jersey, man was sentenced today to 20 months in prison for defrauding the Veterans Affairs program by billing for services he never performed, U.S. Attorney Craig Carpenito announced. Apostolos Voudouris, 44, previously pleaded guilty … Read More
Health Quest Systems, Inc. and certain of its subsidiaries (Health Quest) and Putnam Health Center (PHC) have agreed to pay over $14.7 million to resolve allegations of violations of the False Claims Act by submitting inflated and otherwise ineligible claims … Read More
January 17, 2018 – Law enforcement agencies and federal healthcare administrators including HHS, the Office of the Inspector General (OIG), the FBI, and US Attorney’s Offices across the country investigated provider healthcare schemes that defrauded Medicare and Medicaid more than … Read More
YUMA, Ariz. – The Justice Department announced on Wednesday that it has settled False Claims Act allegations against dental management company Benevis LLC (formerly known as NCDR LLC) and more than 130 of its affiliated Kool Smiles dental clinics for … Read More
A former WakeMed Health employee filed a lawsuit against a large electronic health record vendor under the False Claims Act for allegedly fraudulent practices in its medical claims software, according to court documents. Geraldine Petrowski, of North Carolina, alleges the … Read More
HOUSTON, Oct. 19, 2017 /PRNewswire/ — Joel M. Androphy and Janis Gorton of the Berg & Androphy law firm, along with the United States and the State of Texas, have reached a $5 million settlement in False Claims Act litigation … Read More
The state has filed a False Claims Act lawsuit against a Fairfield dentist alleging that he engaged in a long-term, pervasive scheme to defraud Connecticut’s Medicaid program out of more than $900,000. Aram Agadjanian, also known as Aram Yuri Agadzanov, … Read More
Santa Fe, New Mexico’s St. Vincent Regional Medical Center and its Irving, Texas-based partner Christus Health have agreed to pay $12.24 million plus interest to settle allegations that they made illegal donations to county governments under a discontinued state matching … Read More
HARTFORD, Conn. (Legal Newsline) — Connecticut Attorney General George Jepsen announced June 6 that a Stamford-based dentist, Georgy Betser, his wife, Irina Betser, and their companies will forfeit $755,956.30 and be excluded from participation in the state’s Medicaid program for … Read More
A three-year-old Washington state law that allows whistleblowers to bring Medicaid fraud lawsuits is working. That’s according to a review by legislative auditors that urges lawmakers to renew the law before it expires next year. Medicaid is a nearly $10 … Read More
Law360, New York (August 27, 2015, 2:12 PM ET) — A Texas federal judge recused himself Wednesday from a False Claims Act suit against a medical center, days after the defendants revealed his cousin could be a key witness. The … Read More
On June 9, 2015, the U.S. Department of Health and Human Services Office of Inspector General (OIG) issued a Fraud Alert focused on compensation arrangements paid to physicians. See, “Physician Compensation Arrangements May Result in Significant Liability” [link:https://oig.hhs.gov/compliance/alerts/guidance/Fraud_Alert_Physician_Compensation_06092015.pdf]. The Fraud … Read More
The recent Kellogg Brown & Root Servs., Inc. v. United States ex rel. Carter Supreme Court decision is a very glass half-full/half-empty ruling for healthcare providers. Source: Supreme Court decision expands False Claims Act liability for providers
May 12, 2015 — The Small Smiles dental chain has agreed to pay $39 million according to the proposed settlement filed in bankruptcy court in Nashville, TN. The lawsuits included claims for alleged “unnecessary, inappropriate, unsafe, and excessive dental procedures” … Read More
Forbes magazine has dubbed 2014 “The Year of the Whistleblower.” For healthcare providers, this designation has translated into millions of dollars in fines and penalties and the initiation of criminal investigations. Just last month, the Health Care Fraud Prevention and … Read More
First Annual Recovery to Exceed $5 Billion; Over 700 Whistleblower Lawsuits for Second Consecutive Year The U.S. Department of Justice obtained a record $5.69 billion in settlements and judgments from civil cases involving fraud and false claims against the government … Read More
Federal False Claims Act cases are tough on defendants and their lawyers. The stakes are always high with the risk of treble damages, significant penalties per claim and the imposition of relator attorney fees. And the government and the whistleblowers … Read More
The HHS OIG’s contractor self-disclosure program provides a means for contractors to self-disclose potential violations of the False Claims Act and various Federal criminal laws involving fraud, conflict of interest, bribery or gratuity. The Federal Acquisition Regulation (FAR) requires certain … Read More
