Healthcare billing fraud: 10 recent cases 

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From the owner of healthcare software convicted in a $1 billion Medicare scheme, to two Georgia men sentenced for roles in a $522 million scheme, here are 10 healthcare billing fraud cases Becker’s has reported since April 20: 

1. A federal jury found a 55-year-old Michigan nurse and home health agency owner guilty of committing Medicare fraud using patient records stolen from a Detroit hospital.

2. A federal jury in the Southern District of Florida convicted the founder and owner of HealthSplash for his role in a scheme that prosecutors said fraudulently billed Medicare and other federal healthcare programs more than $1 billion for medically unnecessary equipment.

3. A Utah podiatrist and two nurses were indicted on charges of submitting $29 million in fraudulent Medicare claims for medically unnecessary skin substitute services. 

4. Joel Rufus French, a former NFL player who was the beneficial owner of eight durable medical equipment companies and owned a marketing company, was sentenced to more than 16 years in prison for his role in a yearslong Medicare and Civilian Health and Medical Program of the Department of Veterans Affairs fraud scheme.

5. A Huntington Park, Calif., physician and his medical practice agreed to pay more than $6.73 million to resolve False Claims Act allegations of performing medically unnecessary vascular procedures on Medicare beneficiaries. 

6. An optometrist in Brentwood, Tenn., pleaded guilty to defrauding Medicare of $6.9 million. 

7. Two Georgia men were sentenced for their roles in a scheme to submit more than $522 million in fraudulent claims to Medicare, Medicaid and private insurers for medically unnecessary genetic tests. 

8. Two St. Louis-area physicians and a chiropractor were sentenced for their roles in a $4.7 million healthcare fraud and opioid prescription scheme involving Medicare, Medicaid and Tricare.

9. A Florida nursing assistant was sentenced to nine years in prison for his role in an $11.4 million healthcare fraud conspiracy involving medically unnecessary orthotic braces.

10. A Michigan surgeon was sentenced to 12 months in federal prison for his role in a scheme to submit more than $7 million in fraudulent Medicare claims for psychotherapy services that were never rendered. 

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