Healthcare billing fraud: 11 recent cases

From Dignity Health and two Tenet affiliates agreeing to a $22.5 million settlement, to a Florida physician getting more than three years in prison for his role in a $4.5 million scheme, here are 11 healthcare billing fraud cases Becker's has reported since Dec. 2.  

1. Connecticut psychologist pleads guilty to $2.6M billing fraud

Connecticut psychologist Michael Lonski pleaded guilty to a $2.6 million billing fraud scheme. He admitted to billing for services not rendered, including billing insurers for deceased patients, and for dates of service when he or his fellow provider were out of the country. Connecticut Medicaid lost $1.1 million due to the scheme.     

2. 2 pharmacy workers arrested in $10M fraud scheme

New York pharmacy workers Hua Huang and Huiling Wu were arrested for their alleged role in a Medicare and Medicaid fraud scheme that reached $10.5 million via medically unnecessary prescriptions. 

3. Tenet-owned Massachusetts hospital to pay $1.78M to settle false claim allegations

Worcester, Mass.-based St. Vincent Hospital will pay more than $1.78 million to settle allegations it received impermissible payments from Medicare by inflating charges and failing to fully reimburse the government. 

4. Medical marketing company owner charged in $64M fraud scheme

James Feeley, the owner of a medical marketing company, was charged in connection with an alleged billing fraud and kickback scheme that defrauded federal payers out of at least $64 million.   

5. Medical equipment company CEO gets 80 months for $50M fraud scheme

Tanya Grant was sentenced to 80 months in prison for the healthcare fraud scheme that caused two companies she controlled to bill Medicare for more than $50 million in durable medical equipment between 2014 and 2021. 

6. Florida physician gets 40 months for kickbacks, bribes

Steven Chun, MD, was sentenced to 40 months in prison for his role in a scheme involving the fentanyl spray Subsys that caused Medicare Part D to pay more than $4.5 million for prescriptions he wrote.  

7. Dignity, 2 Tenet affiliates to resolve billing fraud allegations for $22.5M

San Francisco-based Dignity Health, along with Tenet affiliated California facilities Twin Cities Community Hospital and Sierra Vista Regional Medical Center paid $22.5 million to settle allegations it submitted claims to Medi-Cal for services that were not allowed medical expenses, did not reflect the fair market value of the enhanced services provided or were duplicated services.  

8. 9 arrested in Florida for allegedly orchestrating $37M scheme to defraud Blue Cross Blue Shield

Nine Florida residents were arrested for allegedly paying kickbacks to employees of JetBlue Airways, AT&T and TJX Companies — who were Blue Cross beneficiaries — to be patients at 30 South Florida physical therapy clinics the defendants owned. 

9. New Jersey opioid treatment group to pay $3.15M to settle fraud allegations

Camden (N.J.) Treatment Associates agreed to pay $3.15 million to resolve criminal and civil allegations it solicited kickbacks, obstructed a federal audit and fraudulently billed Medicaid. 

10. New York testing facility owners get prison for $18M fraud scheme

New York City-based testing facility owners Tea Kaganovich, and Ramazi Mitaishvili were each sentenced to three years in prison for their roles in an $18 million healthcare fraud scheme. 

11. Minnesota psychologist pleads guilty to defrauding BCBS Minnesota

Prior Lake, Minn.-based psychologist Charles Jorenby pleaded guilty to billing Blue Cross Blue Shield of Minnesota for fraudulent treatment of 29 members of the Shakopee Mdewakanton Sioux Community.

Copyright © 2023 Becker's Healthcare. All Rights Reserved. Privacy Policy. Cookie Policy. Linking and Reprinting Policy.

 

Featured Whitepapers

Featured Webinars