Healthcare billing fraud: 12 recent lawsuits, settlements

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From a Texas heart hospital paying $48 million to resolve billing fraud allegations to a dialysis company hit with a false claims lawsuit, here are 12 cases that made headlines since Dec. 1. 

1. New York surgeon to pay $783K to resolve fraudulent billing case
A New York vascular surgeon and his medical practice agreed to pay $783,200 to resolve a civil case alleging fraudulent billing.

2. Virginia medical group to pay $2.1M to settle billing fraud case
Allergy and Asthma Associates, a medical practice in Roanoke, Va., agreed to pay $2.1 million to resolve allegations of fraudulent billing. 

3. West Virginia hospital to pay $320K settlement in improper billing case
Grant Memorial Hospital in Petersburg, W.Va., agreed to pay a $320,175 settlement for allegedly submitting false medical claims to insurers.

4. Dialysis company hit with False Claims Act suit
A former employee filed an amended whistleblower complaint against Fresenius Medical Care North America, alleging the dialysis company had unlawful arrangements with hospitals and nephrologists that violated the False Claims Act and Anti-Kickback Statute.

5. Athenahealth settles kickback allegations for $18M+
Watertown, Mass.-based Athenahealth agreed to pay $18.25 million to settle allegations it violated the False Claims Act by paying illegal kickbacks to sell its EHR products.

6. Texas clinic to reimburse Medicare $331K for improper billing allegations
Longview-based Spinal Decompression Clinic of Texas agreed to pay CMS $330,898 to resolve allegations it submitted improper claims for procedures that used a periarticular stimulation device, which doesn't qualify for reimbursement.

7. Physician's False Claims Act suit against Mississippi hospital rejected
A False Claims Act lawsuit brought against Jackson-based Central Mississippi Medical Center was dismissed Jan. 5 by a federal judge in Mississippi, but the judge ruled the physician still may pursue claims of retaliatory discharge and harassment.

8. 3 Tennessee providers pay $1.7M to settle false claims allegations
Three spine care providers in Tennessee agreed to pay a total of $1.72 million to resolve allegations they submitted improper claims to Medicare and TennCare for electro-acupuncture using a device that does not qualify for reimbursement.

9. Florida woman agrees to settle charges in $400M healthcare fraud case
A Florida businesswoman agreed to settle criminal and civil charges from an alleged scheme involving the submission of more than $400 million in false claims to Medicare and the Civilian Health and Medical Program of the VA.

10. Massachusetts home health agency to pay $10M to settle false claims charges
A Massachusetts home health company and its CEO will pay $10 million to settle charges of falsely billing the state's Medicaid program.

11. Texas hospital pays $48M to settle false claims allegations
Plano-based Texas Heart Hospital of the Southwest agreed to pay $48 million to resolve allegations that it knowingly submitted false claims to Medicare.

12. Massachusetts physician accused of $10.6M in billing fraud
A psychiatrist in Natick, Mass., was arrested Dec. 10 in connection with charges that he billed Medicare and private payers for more than $10 million in treatments he did not provide.

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