Healthcare billing fraud: 10 recent cases

From an Arizona couple pleading guilty to a $1.2 billion scheme to the sentencing of a “serial healthcare fraudster,” here are 10 healthcare billing fraud cases Becker’s has reported on since Jan. 22: 

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1. A federal jury found a New York City physician guilty of causing the submission of more than $24 million in fraudulent Medicare claims for unnecessary laboratory tests and orthotic braces.  

2. Four pharmacy owners were sentenced for their involvement in a scheme to defraud Medicare, Medicaid and Blue Cross Blue Shield of Michigan out of more than $13 million. 

3. A man the New York Attorney General’s Office described as a “serial healthcare fraudster” was sentenced to between eight and one-third to 25-years in state prison for his role in a Medicaid fraud scheme. 

4. An Arizona couple pleaded guilty to causing more than $1.2 billion in fraudulent claims to be submitted to Medicare and other health insurance programs for unnecessary wound grafts that were applied to elderly and terminally ill patients.

5. Chesapeake (Va.) Regional Medical Center pleaded not guilty to charges of healthcare fraud, conspiracy to defraud the U.S., and interfering with government functions.

6. A Madison, Miss., man was sentenced to 37 months in prison for his role in a more than $12 million Medicare and Medicare Advantage fraud scheme.

7. A Philadelphia-based mental health clinic and its psychiatrist owner agreed to pay $900,000 to settle allegations that they fraudulently billed Medicaid for medication management appointments that were too short to comply with applicable regulations.

8. A federal appeals court upheld the conviction of Anita Jackson, a Raleigh, N.C.-based otolaryngologist, who was sentenced to 25 years in prison and three years of supervised release for her role in a $46 million Medicare fraud scheme. 

9. The part owner and operator of a home health company was sentenced to 12 years in prison for her role in a $100 million fraud scheme.

10. A former Montana nurse practitioner was sentenced to five years in federal prison over falsely billing an insurance company $62 million for vitamin B-12 injections.

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