Healthcare billing fraud: 10 recent cases

From a New York City physician indicted in an alleged $20.7 million scheme to a call center owner indicted in a $97 million scheme, here are 10 healthcare billing fraud cases that Becker’s has reported on since Feb. 16:

Advertisement

1. A Florida man and woman were each sentenced to 27 months in prison for their roles in a scheme that submitted $125 million in fraudulent claims to Medicare and Tricare.

2. The former CEO and president of a compounding pharmacy in Florida was sentenced to six months in prison for lying to federal agents during a healthcare fraud scheme investigation.

3. A physician pleaded guilty to accepting kickbacks in a fraudulent telemarketing and medical supply scheme. 

4. An Ohio man who owned four pharmacies was convicted for dispensing a gastroenterology generic drug without prescriptions and overcharging Medicaid.

5. A marketing company owner from California was charged for his alleged role in a fraud and kickback scheme that cost Medicare more than $10 million.

6. A call center owner was indicted on 10 charges for his alleged role in a durable medical equipment kickback scheme that caused Medicare to lose $97 million.

7. A New Jersey federal grand jury issued an updated indictment against a New York City physician for his alleged involvement in a number of Medicare and Medicaid fraud schemes that totaled more than $20.7 million in false claims. 

8. A Lexington, Ky.-based lab agreed to pay nearly $10.5 million to settle allegations it billed Medicare and Medicaid for medically unnecessary urine drug testing.

9. The medical director of several hospice companies was convicted for his role in a $2.8 million Medicare fraud scheme. 

10. The owner of two telemedicine companies was charged and agreed to plead guilty in connection with a $110 million scheme involving medically unnecessary durable medical equipment.  

  

At the Becker's 11th Annual IT + Revenue Cycle Conference: The Future of AI & Digital Health, taking place September 14–17 in Chicago, healthcare executives and digital leaders from across the country will come together to explore how AI, interoperability, cybersecurity, and revenue cycle innovation are transforming care delivery, strengthening financial performance, and driving the next era of digital health. Apply for complimentary registration now.

Download Whitepaper

The cost-saving opportunity most health systems overlook

Many hospitals and health systems scrutinize staffing, service lines, and payer contracts for savings. Fewer look at one of their largest assets: real estate.…

Advertisement

Next Up in Legal & Regulatory Issues

Advertisement

Comments are closed.