Five Addiction Treatment Docs Charged with Healthcare Fraud and Unlawful Distribution

Five doctors from Redirections Treatment Advocates, LLC, an opioid addiction treatment practice in Pennsylvania and West Virginia, have been indicted on charges of illegally dispensing controlled substances and Medicare and Medicaid fraud.

Read more here: https://www.americanbar.org/groups/health_law/news/2018/05/five_physicians_from.html    

SNFs to see $850 Million Increase in Medicare Payments Per 2018 Budget Act.

According to CMS, SNFs and other post-acute care providers could see increased Medicare payments starting next year, as part of new proposed rules.

 Read more here: https://www.fiercehealthcare.com/payer/cms-rule-dump-medicare-looks-to-boost-acute-care-pay-by-x

Substance Abuse Treatment Facility Settles $1.37 Million Fraud Case

On May 2, 2018, a Connecticut-based substance abuse treatment facility agreed to pay $1.37 million to settle claims of Medicaid fraud.  The New Era Rehabilitation Center was accused of fraudulently billing Medicaid for services relating to methadone addiction.  

Read more here: 

https://www.law.com/ctlawtribune/2018/05/02/connecticut-drug-rehab-center-pays-1-3m-to-settle-claims-it-fraudulently-billed-medicaid-for-work-with-meth-addicts/?slreturn=20180404110337

Healthcare Fraud Enforcement Activities Result in $2.6 Billion Recovery

The Department of Justice (DOJ) and the Department of Health and Human Services announced the recovery of $2.6 billion in taxpayer dollars in 2017. According to the DOJ's recent report, many of these recoveries arose from false claims, fraudulent billing for ambulance transportation services, misrepresentations by EHR providers, and fraudulent billing for physical and occupational therapy services.

Read more here: https://www.justice.gov/opa/pr/department-justice-and-health-and-human-services-return-26-billion-taxpayer-savings-efforts.

Southern California Ambulance Company Employee Sentenced to Prison for Involvement in Medicare Fraud Scheme

Aharon Aron Krkasharyan, a former employee of a Southern California ambulance company, pleaded guilty to one count of conspiracy to commit healthcare fraud related to $1.1 million in fraudulent Medicaire claims. 

Read more here: https://www.justice.gov/opa/pr/former-employee-southern-california-ambulance-company-sentenced-prison-role-medicare-fraud

Ambulance Company to Pay $9 Million to Settle False Claims Act Allegations

On March 28, 2018, Medical Transport LLC, a Virginia Beach-based provider of ambulance services, agreed to pay $9 million to resolve allegations that it violated the False Claims Act by submitting false claims for ambulance transports, the Justice Department announced. 

Read more here: https://www.justice.gov/opa/pr/ambulance-company-pay-9-million-settle-false-claims-act-allegations 

Former Business Manager of Assisted Living Facility Indicted for Stealing Hundreds of Thousands of Dollars from Elderly Victim

The business manager of a Morristown, New Jersey, assisted living facility has been charged with exploiting her position to steal approximately $237,000 from an elderly victim under her care, U.S. Attorney Craig Carpenito announced.

Read more here: https://www.justice.gov/usao-nj/pr/former-business-manager-assisted-living-facility-indicted-stealing-hundreds-thousands

Three Home Health Agency Owners Charged For Involvement In Health Care Fraud Scheme

Three Miami, Florida-area home health agency owners have been indicted for their alleged participation in a health care fraud scheme involving a now-defunct home health agency in Miami.  The indictment alleges that from January of 2011 through November of 2014, the defendants were involved in a fraudulent scheme in which they agreed with the owners and operators of multiple home health therapy staffing companies and others to bill Medicare for services that were never provided, medically unnecessary, or not eligible for Medicare reimbursement. 

Read more here: http://brokernewswire.com/three-miami-based-home-health-agency-owners-charged-for-involvement-in-health-care-fraud-scheme/.

California Sober-Living Home Owner Convicted in $176M Scheme

The co-owner of a Southern California sober-living facility was sentenced to 11 years in prison after pleading guilty in connection to a $175 million fraudulent billing scheme. 

Read more here: https://www.usnews.com/news/best-states/california/articles/2018-03-14/california-sober-living-home-owner-convicted-in-176m-scheme. 

Pennsylvania Hospital and Cardiology Group Agree to Pay $20.75 Million to Settle Allegations of Kickbacks and Improper Financial Relationships

UPMC Hamot, a hospital based in Erie, Pennsylvania and Medicor Associates Inc., a regional physician cardiology practice, have agreed to pay the government $20,750,000 to settle a False Claims Act lawsuit alleging that they knowingly submitted claims to the Medicare and Medicaid programs that violated the Anti‑Kickback Statute and the Physician Self‑Referral Law.   

Read more at: https://www.justice.gov/opa/pr/pennsylvania-hospital-and-cardiology-group-agree-pay-2075-million-settle-allegations