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81. New York man ordered to pay $336M for billing fraud scheme
A New York man has been sentenced to 12 years in prison and ordered to pay over $336 million in restitution for an elaborate healthcare billing fraud, wire fraud and identity theft scheme. Mathew James ...05 February 2024 -
82. Home health company owner gets prison for fraud scheme
The owner of a Livonia, Mich.-based home health care company was sentenced to nine years in prison for orchestrating a nearly $2.8 million fraud scheme. Yogesh Pancholi of Northville, Mich., was excluded ...02 February 2024 -
83. California lab owner gets prison for $234M fraud scheme
A California man convicted multiple times for healthcare fraud was sentenced to 10 years in prison for his latest scheme. Imran Shams, 65, of Glendale, was sentenced to prison for conspiring to conceal ...31 January 2024 -
84. Washington physician settles fraud allegations
... telemedicine company RediDoc between 2018 and 2019, according to a Jan. 29 Justice Department news release. Two owners of RediDoc in 2022 pleaded guilty to their roles in a $64 million fraud and kickback ...31 January 2024 -
85. Owner of 2 medical supply companies arrested in $17M fraud case
... of Modern Medical Equipment and A&E Medical, was charged with conspiracy to commit healthcare fraud, wire fraud and kickbacks. Mr. Swiss is accused of cold-calling Medicare beneficiaries from a call ...31 January 2024 -
86. Former CEO, owner of medical supply company sentenced to prison for kickbacks
... KFSM. In 2022, the owner and CEO were charged with workers' compensation fraud and a kickback conspiracy, according to the Justice Department. They were accused of paying physicians to prescribe and ...29 January 2024 -
87. Philadelphia pharmacy owners to pay $4.6M in billing fraud case
... a lawsuit, the pharmacy's former owner, Pennmark Pharmacy Inc., and current owner, Jai Shri Krishna LLC, were accused of fraudulently billing for high-cost drugs while dispensing cheaper solutions between ...25 January 2024 -
88. Judge upholds Martin Shkreli's lifetime pharma ban
... for hiking the price of a 62-year-old drug called Daraprim from about $17.50 per pill to $750 overnight. Mr. Shkreli was convicted of defrauding investors and sentenced in 2018 to seven years in prison. ...24 January 2024 -
89. Former California clinic owner gets prison for fraud scheme
The former president and CEO of Whittier, Calif-based Santa Maria's Children and Family Center was sentenced to more than 10 years in prison for submitting fraudulent claims to the state's Medicaid program. ...23 January 2024 -
90. Florida health system lobbyist charged with theft, placed on leave
... of using about $100,000 in school funds for personal benefit. The State Attorney's Office filed criminal charges against Ms. Navarro on Jan. 11. The charges, which include fraud and grand theft, stem from ...23 January 2024 -
91. 132,000 patients impacted by North Carolina hospital breach
... have not been verified by the hospital, according to the report. In the Jan. 19 notice on its website, Columbus stated that it is "not aware of any reports of identity fraud or improper use of any information ...23 January 2024 -
92. Ex-Illinois hospital COO pleads guilty in fraud scheme
An attorney who worked as a vice president and COO of an Illinois hospital pleaded guilty Jan. 22 to a federal fraud charge. Robert Spadoni, 59, the former COO of Rush Oak Park (Ill.) Hospital, defrauded ...23 January 2024 -
93. Former pharmacy president pleads guilty to $32M in kickbacks
The former president of New Jersey pharmacies was sentenced to three years of prison after pleading guilty to a three-year healthcare fraud scheme amounting to $32 million. From 2017 to 2020, Elan ...22 January 2024 -
94. Idaho clinics, owner to pay $2M to settle fraud allegations
An Idaho-based clinic chain and its owners have agreed to pay $2 million to settle allegations they used vulnerable or inexperienced medical staff to fraudulently bill federal healthcare programs. AmeriHealth ...19 January 2024 -
95. Nursing home chain owner guilty in $38M fraud
The owner of a shuttered nursing home chain admitted to his role in a $38 million employment tax fraud scheme. Joseph Schwartz, 64, pleaded guilty to willfully failing to pay over employment taxes ...19 January 2024 -
96. Houston hospital leader ordered to pay $11M, prison time
Syed Rizwan Mohiuddin, former president of United Memorial Medical Center in Houston, has been sentenced to 21 months in federal prison and ordered to pay $11 million in restitution of conspiracy to defraud ...18 January 2024 -
97. 'A step in the right direction': Payer, provider groups weigh in on new prior authorization rul
... working with patients and clinicians to ensure safety, quality and value for their members. Prior authorization is an important tool to prevent fraud and direct beneficiaries to high-value, medically appropriate ...17 January 2024 -
98. 11 recent hospital lawsuits, settlements
... a cardiothoracic surgeon at the health system agreed to pay $430,000 to settle allegations of Medicare fraud. 6. Winston-Salem, N.C.-based Novant Health agreed to pay $6.6 million for using an advertising ...17 January 2024 -
99. Woman fired after giving fake name to North Carolina system
Oxford, N.C.-based Granville Health System has fired a woman who was hired using a fake name and has been accused of defrauding medical facilities, NBC affiliate WRAL reported Jan. 15. The health ...17 January 2024 -
100. New Jersey hospital to pay $30.6M settlement for alleged Medicare fraud
... program while certain Silver Lake investors will pay over $12 million to resolve alleged FDCPA violations for the fraudulent transfer of money by the hospital to its investors. 2. The settlement resolves ...17 January 2024