Healthcare billing fraud: 10 recent cases

From two pharmacy owners and a physician convicted in a $145 million scheme to two NBA convicted for their roles in a scheme to defraud the league's healthcare plan, here are 10 healthcare billing fraud cases Becker's has reported on since Oct. 31: 

1. Two Dallas physicians were charged with submitting $50 million in fraudulent claims to payers for corticosteroid injections and other services that were not performed and unlawfully distributing hydrocodone. 

2. Two pharmacy owners and a physician were convicted in a Texas federal court for their roles in a $145 million scheme to defraud the Labor Department through the submission of fraudulent claims for prescription compound creams. 

3. The owner of two durable medical equipment companies pleaded guilty to conspiracy for his role in a kickback scheme that resulted in more than $20 million in fraudulent claims submitted to Medicare. 

4. Two former NBA players were convicted for their roles in a scheme to defraud the league's healthcare plan out of $5 million. 

5. The CEO of a Florida pharmacy, his co-owner and the lead sales representative were sentenced in a $54 million bribery and kickback scheme involving Tricare. 

6. The founder of a Missouri-based Christian healthcare sharing ministry pleaded guilty to his role in a $8 million scheme that cheated hundreds of the ministry's members. 

7. The owner of a Louisiana hospice facility was convicted on all 23 counts against him for his role in a $62 million Medicare fraud scheme. 

8. A Rhode Island social worker pleaded guilty to orchestrating a billing fraud scheme that cost Medicare, Medicaid and private insurers $3.5 million. 

9. A Georgia physician agreed to pay $225,000 to resolve allegations she billed government payers for office visits that were not as complex or as lengthy as she claimed. 

10. Nostrum Laboratories and its founder and CEO, Nirmal Mulye, PhD, agreed to pay between $3.8 million and $50 million to settle allegations of underpaying Medicaid rebates.

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