Healthcare billing fraud: 10 recent cases

From Walgreens agreeing to pay more than $100 million to settle false claims allegations, to a physician indicted in an alleged $32.7 million Medicare scheme, here are 10 healthcare billing fraud cases Becker’s has reported since Sept. 10: 

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1. A Louisiana physician was indicted for his alleged role in a scheme to defraud Medicare of more than $32.7 million by submitting claims for medically unnecessary definitive urine drug testing services.

2. CVS subsidiary Oak Street Health agreed to pay $60 million to settle accusations that it violated the False Claims Act by offering kickbacks to third-party insurance agents in return for referring older adults to its primary care clinics.

3. The managers of a Matteson, Ill.-based youth counseling center were sentenced to prison for defrauding the state’s Medicaid program of $2.5 million.

4. Dakota Dunes, S.D.-based Dunes Surgical Hospital, United Surgical Partners International and USP Siouxland agreed to pay $12.76 million to resolve allegations that the surgical center violated the False Claims Act through improper relationships with two physician groups. 

5. Walgreens agreed to pay $106.8 million to resolve allegations of violating the False Claims Act by fraudulently billing government healthcare programs for prescriptions never dispensed. 

6. A licensed professional counselor was indicted on 10 counts of healthcare fraud and three counts of aggravated identity theft for allegedly submitting $2 million in false claims to Texas’ Medicaid program. 

7. Centene’s Fidelis Care reached a $7.6 million settlement agreement with New York Attorney General Letitia James for billing Medicaid for services provided by an individual convicted of a crime.

8. A Wilmington, Del.-based physician agreed to pay more than $1 million to settle allegations he violated the False Claims Act by ordering medically unnecessary durable medical equipment for Medicare and Federal Employees Health Benefits Program patients. 

9. The CEO of a Massachusetts behavioral health company agreed to plead guilty to six counts of healthcare fraud. 

10. Medical device manufacturer THD America agreed to pay $700,000 to settle allegations it knowingly caused physicians to use incorrect codes to obtain inflated reimbursement from Medicare and Medicaid. 

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