From CVS Pharmacy settling allegations that it improperly billed federal health programs to the Justice Department dismissing an indictment against the former owner and CEO of a Texas hospital, here are 10 healthcare billing fraud cases that Becker’s has reported since Oct. 28:
1. CVS Pharmacy will pay $37.76 million to resolve allegations that it over-dispensed insulin pens and improperly billed federal health programs over a 10-year period.
2. A physician in River Forest, Ill., was accused of receiving Medicaid and Medicare payments totaling over $1 million for prescriptions he did not provide to patients.
3. Mt. San Rafael Hospital and Rural Health Clinic in Trinidad, Colo., and three of its physicians agreed to pay a combined $650,000 to settle allegations that they improperly prescribed opioids and submitted invalid claims to Medicare and other federal healthcare programs.
4. Vohra Wound Physicians Management and its owner, Ameet Vohra, MD, agreed to pay $45 million to resolve allegations that they knowingly submitted false claims to Medicare.
5. A physician from Cordele, Ga., pleaded guilty to his role in a $24 million Medicaid fraud scheme.
6. Aesculap Implant Systems, an orthopedic and spine device maker, agreed to pay $38.5 million in order to resolve False Claims Act allegations.
7. A Kansas City, Mo.-based man was sentenced to 10 years in prison for orchestrating a $174 million Medicare fraud scheme involving false claims for cancer genetic testing and cardiovascular genetic testing.
8. A federal jury in Florida convicted an insurance brokerage president and the CEO of a marketing company for their roles in a scheme to fraudulently enroll individuals in subsidized ACA plans to obtain commission payments from insurers.
9. An Alabama-based physician pleaded guilty to a $6 million telemedicine fraud scheme involving medically unnecessary durable medical equipment and genetic testing.
10. The Department of Justice dismissed charges against two individuals — the former CEO of two El Paso, Texas-based long-term acute care hospitals and the owner of one of them — withdrawing its felony indictment alleging wire fraud.
