Healthcare billing fraud: 10 recent cases

Here are 10 healthcare billing fraud cases Becker's has reported since May 30:

1. Two Florida pharmacies will pay $7.4M to settle allegations they overcharged Medicare and Tricare for medically unnecessary compounded medications. 

2. Columbia, S.C.-based Bon Secours St. Francis Health System, St. Francis Hospital and St. Francis Physician Services agreed to pay $36.5 million to resolve allegations that it made illegal kickback payments to surgeons tied to the volume or value of referrals. 

3. Rachel Peay-Goodman, MSN, RN, a nurse practitioner in Idaho, was found civilly liable for unlawfully prescribing controlled substances and submitting a false claim to Medicare

4. A Fayetteville, N.C.-based cardiologist and his practice agreed to pay more than $5 million to resolve allegations of false Medicare and Medicaid claims linked to atherectomy procedures. 

5. A North Carolina mental health clinic owner pleaded guilty to a $4.7 million Medicaid fraud scheme in which he submitted over 1,500 fraudulent claims to the program. 

6. The former executive director of an Ohio counseling center was sentenced to three years in prison for leading a $3.5 million Medicaid fraud scheme. 

7. A physician assistant from Monroe, N.C., was found guilty for his role in a genetic testing scheme involving $10 million in fraudulent Medicare claims. 

8. The former chief compliance officer of a Florida pharmacy holding company was convicted for his role in a $50 million Medicare fraud scheme. 

9. An Arkansas lab owner was sentenced to 15 years in prison and ordered to pay nearly $30 million in restitution for his role in a $134 million healthcare fraud and money laundering scheme.

10. A Philadelphia-based physician practice and two physicians agreed to pay $1.5 million plus interest to settle allegations that they misrepresented the severity of illness and services rendered to increase Medicare Advantage and Medicare Part B reimbursements.

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