Healthcare billing fraud: 18 recent cases

The following healthcare billing fraud cases have been reported by Becker's since Jan. 20. 

Editor's Note: This webpage was updated March 1 and will continue to be updated. 

Feb. 10-Feb. 28

1. An Ohio physician pleaded guilty to 20 counts of healthcare fraud, 31 counts of illegally prescribing patients opioids and other controlled substances, and one count of illegally distributing controlled substances. 

2. UPMC, its chair of cardiothoracic surgery and University of Pittsburgh Physicians agreed to pay $8.5 million to the Justice Department to resolve a whistleblower suit brought by a former UPMC physician.

3. Dallas-based Cornerstone Healthcare Group and Houston-based Cornerstone Hospital Medical Center agreed to pay more than $21.6 million to settle claims that the long-term acute care facility improperly billed Medicare.

4. Indianapolis-based Community Health Network is pushing back against the Justice Department's questions related to yearslong false claims allegations.

5. The co-owner of a Connecticut-based insurance firm pleaded guilty to his role in a $40 million scheme to steal client healthcare funds and defraud lenders. 

6. A Mississippi physician was sentenced to five years in prison and ordered to pay $15 million after being convicted in a hospice fraud scheme. 

7. A federal jury convicted a Virginia pharmacist for his role in a prescription drug scheme that aimed to defraud Medicare of $1 million. 

Jan. 20-Feb. 9 

8. Sangita Patel, MD, a Troy, Mich.-based physician, was named in a criminal complaint filed with the U.S. District Court of the Eastern District of Michigan alleging that she prescribed drugs that were not medically necessary and billed Medicare for nonexistent telehealth visits.

9. A federal jury convicted the owner and manager of a medical equipment supply company for a scheme to defraud Medicare Advantage and Medicaid managed care plans of more than $3.8 million. 

10. The Justice Department charged 23 Michigan residents for their alleged involvement in two schemes to defraud Medicare of more than $61.5 million by paying kickbacks and bribes and billing CMS for unnecessary medical services that were not provided.

11. A cardiac monitoring company agreed to pay $673,200 to settle allegations that it submitted false claims to federal healthcare programs. 

12. Labcorp is settling a $19 million kickback and false claims lawsuit brought by two whistleblowers who alleged the company defrauded government healthcare programs by providing blood draws to providers who were receiving cash kickbacks from one to two other labs named in the suit. 

13. A Florida chiropractor and surgeon were convicted of a $31 million scheme to defraud Medicare by billing for medically unnecessary medical equipment. 

14. A Florida-based marketer pleaded guilty to buying and selling more than 2.6 million Medicare beneficiary identification numbers and other personal identifying information. 

15. Anita Jackson, MD, 59, an otolaryngologist who practiced in Raleigh, N.C., faces prison time after being convicted of 20 counts, including adulterating medical devices and fabricating health records.

16. Two medical equipment company and pharmacy owners were indicted as part of a $14.5 million Medicare fraud scheme. 

17. A Chicago pharmacy owner was convicted for his role in a $25 million kickback scheme to obtain Medicare and other government payments. 

18. A Louisiana clinic owner was sentenced to over six years in prison for misdiagnosing children with mental illnesses and fraudulently billing Medicaid upward of $1.8 million. 

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