Healthcare billing fraud: 6 recent suits, settlements

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From Cleveland Clinic's Akron (Ohio) General Health System paying $21 million to resolve false claims allegations to a surgeon losing Medicare billing privileges, here are six cases that have made headlines since June 1:

1. Ohio health system to pay $21M to resolve false claims allegations
Akron General Health System, acquired by Cleveland Clinic in 2015, will pay $21.25 million to resolve allegations that it violated the False Claims Act, the U.S. Justice Department said July 2. 

2. Connecticut physician ordered to pay $15M in billing fraud case
A Connecticut primary care physician was ordered to pay nearly $15 million over allegations of an illegal billing scheme, the state's attorney general said June 28.

3. Iowa judge rules surgeon convicted of tax evasion can't bill Medicare
An Iowa surgeon can't bill as a licensed Medicare provider because of a series of felony convictions tied to tax evasion, an Iowa judge ruled. 

4. Texas physician gets 7 years in prison for fraud scheme
A Texas physician was sentenced to seven years in federal prison for his alleged role in a healthcare fraud scheme that included submitting false claims to Tricare, the U.S. Justice Department said June 24. 

5. Centene to settle drug overbilling allegations for $143M
Centene reached no-fault agreements to resolve allegations that the health insurer's pharmacy benefit manager misrepresented pharmacy costs for Medicaid beneficiaries, according to a June 14 news release.

6. Massachusetts anesthesia provider pays $260K to resolve surprise billing allegations
South Shore Anesthesia Associates reached an agreement with Massachusetts officials to settle allegations that it used surprise billing tactics against patients at Weymouth, Mass.-based South Shore Hospital. The anesthesia provider, also based in Weymouth, will pay Massachusetts $260,000, which includes a $185,000 civil penalty, according to the state's attorney general.

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