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21. HHS OIG turns down 300-400 'viable' healthcare fraud cases each year
HHS Inspector General Christi Grimm said her office has a "pressing need" for more funding to combat healthcare fraud, waste and abuse. Ms. Grimm said in written testimony submitted to the House Subcommittee ...18 April 2024 -
22. Inside healthcare's imposter proble
It has been over a year since the FBI and Justice Department disclosed "Operation Nightingale," which cracked open a fake nursing degree scheme at three now-shuttered schools. More than 7,600 fraudulent ...16 April 2024 -
23. Ex-hospital director pleads guilty to embezzling $600K+
... She pleaded guilty to various felonies — including theft by unlawful taking, forgery, access device fraud and computer trespassing — and was sentenced to five years probation, according to the report. ...16 April 2024 -
24. Man charged in $70M Medicare fraud scheme
A Mississippi man faces up to 25 years in prison for his alleged role in a Medicare fraud scheme exceeding $70 million. In an indictment unsealed earlier this month in a U.S. District Court in Tampa, ...16 April 2024 -
25. Clinic owner, medical director sentenced to prison for $4M fraud scheme
The owner and the medical director of a Kentucky pain clinic were sentenced for their roles in a $4 million urine drug testing fraud scheme. The owner, Timothy Ehn, 51, of Union, Ky., was sentenced ...15 April 2024 -
26. Biotech CEO sentenced for $28M fraud scheme
The CEO of biotech company Decision Diagnostics Corp., Keith Berman, was sentenced to seven years in prison for a securities fraud scheme that resulted in about $28 million in investor losses and obstruction ...15 April 2024 -
27. Cardiologist pleads guilty to $1.9M fraud
A New Jersey cardiologist and practice owner pleaded guilty to a $1.9 million healthcare fraud scheme. Fazal Panezai, MD, 76, owned and operated Matawan-Aberdeen Heart & Medical Center. He submitted ...15 April 2024 -
28. Columbus Oncology leans on relationship with KeyBank to fund Westerville Medical Campus Cancer Center
... digital solutions to manage financial challenges in healthcare, like the volume of patient deposits, fraud prevention, and high standards for patient service. “We are not looking for the lowest cost model. ...12 April 2024 -
29. Arizona physician pleads guilty to $3.7M fraud scheme
A Peoria, Ariz., physician has pleaded guilty to a healthcare fraud scheme that caused payers at least $3.7 million in losses. Linh Cao Nguyen, MD, pleaded guilty to defrauding several insurers, including ...09 April 2024 -
30. Hospitals' Medicare Advantage problem hits an inflection point
... cited reasons are excessive prior authorization denial rates and slow payments from insurers. Some systems have noted that most MA carriers have faced allegations of billing fraud from the federal government ...05 April 2024 -
31. 3 more sentenced in nurse degree scheme
... 2023, a total of 27 defendants have been charged and convicted for their participation in a sham to sell more than 7,600 fraudulent nursing documents from three now-shuttered schools in South Florida. ...04 April 2024 -
32. Hackers tried to steal hospital's cancer treatment for ransom: Repor
... and copied files containing such data as Social Security numbers, bank account and credit card information, and medical records. City of Hope said it has no evidence of data fraud or misuse but is offering ...04 April 2024 -
33. Former Medicaid supervisor sentenced to 18 months in prison for embezzlement
A former Medicaid supervisor will serve 18 months in prison after pleading guilty to wire fraud, according to an April 3 news release from the Justice Department. Yolanda Brooks, of Indianapolis, ...03 April 2024 -
34. Former UI hospital administrator pleads guilty in 3-decade identity fraud scheme
A former systems architect with the University of Iowa Hospitals and Clinics has pled guilty in a three-decade identity fraud scheme — which began at a hot dog cart and cost the victim 575 days of freedom. ...02 April 2024 -
35. Pennsylvania physician couple pleads guilty to fraud
A physician couple from Hollidaysburg, Pa., has pleaded guilty for their roles in a fraud scheme. John Johnson, MD, 62, conspired with others to defraud health insurance programs by illegally billing ...02 April 2024 -
36. Medical equipment company owner gets prison for role in $87M kickback scheme
A durable medical equipment company owner was sentenced to three and a half years in prison for his role in an $87 million healthcare fraud scheme. Mark Sorensen, 53, of Chicago, owned Symed, a durable ...29 March 2024 -
37. Healthcare billing fraud: 12 recent cases
From a physician couple pleading to their roles in a scheme to a former Georgia insurance commissioner pleading guilty to his role in a $2.5 million scheme, here are 12 healthcare billing fraud cases Becker' ...28 March 2024 -
38. 'Figurehead' lab owner pleads guilty in $30M fraud schem
A Pompano Beach, Fla., man the Justice Department said was the figurehead owner of a lab company pleaded guilty to his role in a $30 million Medicare fraud scheme. Robert Clark, 29, and his co-conspirators ...27 March 2024 -
39. US offers $10M reward for information on ransomware gang behind Change hack
The U.S. Department of State's Rewards for Justice program has offered up to $10 million for tips, like identification or location, on the ALPHV/BlackCat ransomware gang responsible for the Change Healthcare ...27 March 2024 -
40. Pharmacy owner pleads guilty in $36.2M fraud scheme
A Fort Lauderdale, Fla.-based pharmacy owner pleaded guilty to his role in a $36.2 million Medicare fraud scheme. Omar Solari, 35, and his co-conspirators owned and operated pharmacies that from September ...22 March 2024