OFFICE OF INSPECTOR GENERAL

HHS OFFICE OF THE INSPECTOR GENERAL ANNOUNCEMENTS

PRESS RELEASE


PHYSICIAN INDICTED ON HEALTH CARE FRAUD CHARGES


JULY 26 2017 - WHEELING WV - A physician with a pain management clinic in McMechen WV, was indicted by a federal grand jury sitting in Wheeling on June 6 2017 on health care fraud, mail fraud, and wire fraud charges, Acting US Attorney Betsy Steinfeld Jividen announced.


Dr. Roland F. Chalifoux Jr, age 57, of St. Clairsville OH, was indicted on 11 counts of “Health Care Fraud for Travel Dates,” seven counts of “Mail Fraud,” four counts of “Wire Fraud,” and four counts of “Health Care Fraud.” 


The crimes are alleged to have occurred from 2008 to June 2017 in Marshall County and elsewhere in the N. District of WV. Assistant U.S. Attorney Robert H. McWilliams is prosecuting the case on behalf of the government. The U.S. DHHS, DEA, FBI, US Postal Inspection Service and WV Insurance Fraud Investigation Unit are investigating. An indictment is merely an accusation. A defendant is presumed innocent unless and until proven guilty.

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2017 OIG ANNOUNCEMENTS

JULY 2017


July 26, 2017 - Denver Woman Sentenced To 46 Months' Imprisonment For Health Care Fraud
HARRISBURG PA- The US Attorney's Office for the Middle District of Pennsylvania announced that Tammie Sensenig, age 46, of Denver, Pennsylvania was sentenced July 25, 2017, by US District Court Judge William C. Caldwell to serve 46 months' imprisonment for health care fraud. 


July 26, 2016 - Former Home Healthcare Nurse Sentenced for Medicaid Fraud in Case that Resulted in Minor's Death
DAYTON OH - Mollie Parsons, 47, of Middletown, Ohio, was sentenced in U.S. District Court to 36 months in prison for healthcare fraud related to the death of a severely physically disabled minor.


July 26, 2017; U.S. Attorney; Northern District of West Virginia

Marshall County physician indicted on health care fraud charges
WHEELING WV - A physician with a pain management clinic in McMechen, West Virginia, was indicted by a federal grand jury sitting in Wheeling on June 6, 2017 on health care fraud, mail fraud, and wire fraud charges, Acting US Attorney Betsy Steinfeld Jividen announced.


July 26, 2017; U.S. Attorney; Northern District of Texas

Rowlett Woman Sentenced to 48 Months in Federal Prison for Role in Healthcare Fraud Conspiracy
DALLAS TX - Charity Eleda, R.N., 56, of Rowlett, Texas, was sentenced this morning in federal court in Dallas on a health care fraud conspiracy conviction, announced U.S. Attorney John Parker of the Northern District of Texas.


July 25, 2017; U.S. Attorney; Central District of California

Celgene Agrees to Pay $280 Million to Resolve Fraud Allegations Related to Promotion of Cancer Drugs Not Approved by FDA
LOS ANGELES - Celgene Corp., a manufacturer of pharmaceuticals headquartered in Summit, New Jersey, has agreed to pay $280 million to settle fraud allegations related to the promotion of two cancer treatment drugs for uses not approved by the FDA, the Justice Department announced today.


July 24, 2017; U.S. Attorney; Middle District of Florida

Owner Of Tampa Parathyroid Practice Agrees To Pay $4 Million To Resolve False Claims Act Allegations
Tampa, FL - Dr. James Norman, the owner and operator of James Norman, MD, PA, a/k/a James Norman, MD, PA Parathyroid Center, d/b/a Norman Parathyroid Center (collectively, Norman) has agreed to pay $4 million to resolve allegations that he violated the False Claims Act by knowingly engaging in various unlawful billing practices with respect to Medicare and other federal health care programs and their beneficiaries.


July 24, 2017; U.S. Attorney; Middle District of Tennessee

Pain Management Group Agrees To Pay $312,000 To Resolve False Claims Act And Overpayment Allegations
Pain Management Group P.C. ("PMG"), based in Antioch TN, has agreed to pay $312,000 to settle federal and state False Claims Act and overpayment allegations, announced Jack Smith, Acting US Attorney for the Middle District of Tennessee.


July 21, 2017; U.S. Department of Justice 

Houston Physician Convicted of Conspiracy in $1.5 Million Medicare Fraud Scheme
A federal jury convicted a Houston physician today for his role in a scheme involving approximately $1.5 million in fraudulent Medicare claims for home health care services and various medical testing and services.


July 21, 2017; U.S. Attorney; Middle District of Louisiana

Baton Rouge Home Health Company Settles False Claims Act Case For $1.7 Million
BATON ROUGE LA - Acting US Attorney Corey R. Amundson announced that CHARTER HOME HEALTH, a Baton Rouge-based healthcare company, has agreed to settle a civil fraud complaint filed under the federal False Claims Act by paying the US $1.7 million and entering into a Corporate Integrity Agreement.


July 19, 2017; U.S. Attorney; Southern District of Florida

Nine Miami-Dade Assisted Living Facility Owners Sentenced to Federal Prison for Receipt of Health Care Kickbacks
Miami-Dade County assisted living facility owners, Marlene Marrero, 60, of Miami, Norma Casanova, 67, of Miami Lakes, Yeny De Erbiti, 51, of Miami, Rene Vega, 57, of Miami, Maribel Galvan, 43, of Miami Lakes, Dianelys Perez, 34, of Miami Gardens, Osniel Vera, 47, of Hialeah, Alicia Almeida, 56, of Miami Lakes, and Jorge Rodriguez, 57, of Hialeah, were sentenced to prison for receiving health care kickbacks. US District Judge Marcia G. Cooke imposed sentences upon the nine defendants ranging from eight months to one year and one day, in prison. One assisted living facility owner, Blanca Orozco, 69, of Miramar, was sentenced to home confinement. In addition to their federal convictions, all ten defendants were also ordered to serve three years of supervised release, pay restitution and are subject to forfeiture judgments.


July 19, 2017; U.S. Attorney; Western District of Missouri

Two University of Missouri Physicians Plead Guilty to Health Care Fraud
JEFFERSON CITY MO - Tom Larson, Acting US Attorney for the Western District of Missouri, announced today that two physicians at the University of Missouri School of Medicine in Columbia, Mo., have pleaded guilty in federal court, in separate cases, to engaging in a health care fraud scheme that totaled more than $190,000.


July 18, 2017; U.S. Attorney; Western District of Virginia

Danville Doctor Pleads Guilty to Healthcare Fraud, Tax Evasion Charges
Danville VA - A Danville doctor, who billed various insurers for services he never administered to patients, pled guilty today in the US District Court for the Western District of Virginia in Danville to healthcare fraud and tax evasion charges, Acting US Attorney Rick A. Mountcastle announced.


July 17, 2017; U.S. Department of Justice

Three Companies and Their Executives Pay $19.5 Million to Resolve False Claims Act Allegations Pertaining to Rehabilitation Therapy and Hospice Services
Ohio-based Foundations Health Solutions Inc. (FHS), Olympia Therapy Inc. (Olympia), and Tridia Hospice Care Inc. (Tridia), and their executives, Brian Colleran (Colleran) and Daniel Parker (Parker), have agreed to pay approximately $19.5 million to resolve allegations pertaining to the submission of false claims for medically unnecessary rehabilitation therapy and hospice services to Medicare, the Department of Justice announced today. 


July 17, 2017; U.S. Attorney; Southern District of New York

Manhattan U.S. Attorney Announces $4.4 Million Settlement Of Civil Lawsuit Against VNS Choice For Improper Collection Of Medicaid Payments
Joon H. Kim, the Acting US Attorney for the Southern District of New York, announced today that the US has settled a civil fraud lawsuit against VNS CHOICE, VNS CHOICE COMMUNITY CARE, and VISITING NURSE SERVICE OF NEW YORK (collectively, "VNS") for improperly collecting monthly Medicaid payments for 365 Medicaid beneficiaries whom VNS Choice failed to timely disenroll from the VNS Choice Managed Long-Term Care Plan ("Choice MLTCP"). Most of the beneficiaries who should have been disenrolled from the Choice MLTCP were no longer receiving health care services from VNS. Under the terms of the settlement approved today by US District Judge Ronnie Abrams, VNS Choice must pay a total sum of $4,392,150, with $1,756,860 going to the US and the remaining amount to the State of New York. In the settlement, VNS admits that VNS Choice failed to timely disenroll 365 Choice MLTCP members and, as a result, received Medicaid payments to which it was not entitled.


July 14, 2017; U.S. Department of Justice

Clinical Psychologist and Owner of Psychological Services Centers Sentenced to 264 Months for Roles in $25 Million Psychological Testing Scheme Carried out Through Eight Companies in Four States
Two owners of psychological services companies, one of whom was a clinical psychologist, were sentenced yesterday for their involvement in a $25.2 million Medicare fraud scheme carried out through eight companies at nursing homes in four states in the Southeastern U.S.


July 14, 2017; U.S. Attorney; Southern District of Georgia

Southern District Of Georgia Announces Participation in National Health Care Fraud Takedown
SAVANNAH GA - On Thursday, Attorney General Jeff Sessions and DHHS Secretary Tom Price, M.D., announced the largest ever health care fraud enforcement action by the Medicare Fraud Strike Force, involving 412 charged defendants across 41 federal districts, including 115 doctors, nurses and other licensed medical professionals, for their alleged participation in health care fraud schemes involving approximately $1.3 billion in false billings. Of those charged, over 120 defendants, including doctors, were charged for their roles in prescribing and distributing opioids and other dangerous narcotics.


July 14, 2017; U.S. Attorney; Eastern District of New York

Senior Executives Of Medical Drug Re-Packager Plead Guilty To Defrauding Healthcare Providers
Earlier today, in federal court in Brooklyn, Gerald Tighe, the president and owner of Med Prep Consulting Inc. (Med Prep), and Stephen Kalinoski, its director of pharmacy and registered pharmacist-in-charge, pleaded guilty to wire fraud conspiracy in connection with their operation of the now-defunct Tinton Falls NJ-based medical drug re-packager and compounding pharmacy. The pleas were entered before US District Judge I. Leo Glasser.


July 13, 2017; U.S. Department of Justice

National Health Care Fraud Takedown Results in Charges Against Over 412 Individuals Responsible for $1.3 Billion in Fraud Losses
Attorney General Jeff Sessions and DHHS Secretary Tom Price, M.D., announced today the largest ever health care fraud enforcement action by the Medicare Fraud Strike Force, involving 412 charged defendants across 41 federal districts, including 115 doctors, nurses and other licensed medical professionals, for their alleged participation in health care fraud schemes involving approximately $1.3 billion in false billings. Of those charged, over 120 defendants, including doctors, were charged for their roles in prescribing and distributing opioids and other dangerous narcotics. Thirty state Medicaid Fraud Control Units also participated in today's arrests. In addition, HHS has initiated suspension actions against 295 providers, including doctors, nurses and pharmacists.


July 13, 2017; U.S. Attorney; Northern District of New York 

Kinderhook Podiatrist Pleads Guilty to Health Care Fraud, Pays $410,000 to Resolve False Claims Act Liability
ALBANY NY - Podiatrist Perrin D. Edwards, age 64, of Kinderhook NY, pled guilty on Tuesday to health care fraud for illegally charging Medicare and private insurance companies for services that he never provided. Edwards has also paid $410,000 to the US to resolve his civil liability for his submission of false claims for payment to the Medicare.


July 13, 2017; U.S. Attorney; Northern District of Illinois 

National Healthcare Fraud Takedown Results in Charges Against More Than 400 Individuals, Including Several Chicago-Area Medical Professionals
CHICAGO IL - Several Chicago-area medical professionals, including two licensed physicians, are facing federal criminal charges as part of the largest health care fraud enforcement action in Department of Justice history, federal authorities announced today.


July 13, 2017; U.S. Attorney; Southern District of FL 

Seventy-Seven Charged in Southern District of Florida as Part of Largest Health Care Fraud Action in Department of Justice History
Benjamin G. Greenberg, Acting US Attorney for the Southern District of Florida; George L. Piro, Special Agent in Charge, Federal Bureau of Investigation (FBI), Miami Field Office; Shimon R. Richmond, Special Agent in Charge, U.S. DHHS, Miami Regional Office, DHHS-OIG; and Pam Bondi, Florida Attorney General; announced today the largest ever health care fraud enforcement action by the Medicare Fraud Strike Force, involving 412 charged defendants across 41 federal districts, including 115 doctors, nurses and other licensed medical professionals, for their alleged participation in health care fraud schemes involving approximately $1.3 billion in false billings. In the Southern District of Florida a total of 77 defendants were charged with offenses relating to their participation in various fraud schemes involving over $141 million in false billings for services including home health care, mental health services and pharmacy fraud.


July 13, 2017; U.S. Attorney; Central District of California 

As Part of National Health Care Fraud Takedown, Federal Prosecutors in Los Angeles Charge 14 Defendants in Fraud Schemes that Allegedly Cost Public Healthcare Programs nearly $150 Million
LOS ANGELES CA - In the largest-ever health care fraud enforcement action by federal prosecutors, 14 defendants - including doctors, nurses and other licensed medical professionals - have been charged in the Central District of California for allegedly participating in health care fraud schemes that caused approximately $147 million in losses.


July 13, 2017; U.S. Attorney; Eastern District of Arkansas 

Twenty-Four Charged in Arkansas as Part of Largest Nationwide Health Care Fraud Enforcement Action in Department of Justice History
Washington DC - Attorney General Jeff Sessions and DHHS Secretary Tom Price, M.D., announced today the largest ever health care fraud enforcement action by the Medicare Fraud Strike Force, involving 412 charged defendants across 41 federal districts-including the Eastern District of Arkansas. Among the defendants were 115 doctors, nurses and other licensed medical professionals, all alleged to have participated in health care fraud schemes involving approximately $1.3 billion in false billings. Of those charged, over 120 defendants, including doctors, were charged for their roles in prescribing and distributing opioids and other dangerous narcotics. Thirty state Medicaid Fraud Control Units also participated in today's arrests. In addition, HHS has initiated suspension actions against 295 providers, including doctors, nurses and pharmacists.


July 13, 2017; U.S. Attorney; Northern District of Alabama 

U.S. Attorney Charges NW Alabama Compounding Pharmacy Sales Representatives in Prescription Fraud Conspiracy
BIRMINGHAM AL - The U.S. Attorney's Office on Wednesday charged two sales representatives for a Haleyville, Ala.,-based compounding pharmacy for participating in a conspiracy to generate prescriptions and defraud health care insurers and prescription drug administrators out of tens of millions of dollars in 2015.


July 13, 2017; U.S. Attorney; Eastern District of Virginia 

Woman Indicted on Medicaid Fraud and Identity Theft Charges
RICHMOND VA - As part of the largest ever health care fraud enforcement action in DOJ History, a Richmond woman has been charged with healthcare fraud, aggravated identity theft, and making a false statement to federal agents.


July 13, 2017; U.S. Attorney; Middle District of Louisiana 

Baton Rouge-Based Medicare Fraud Strike Force Announces Charges Against Four More Individuals For Health Care Fraud And Related Offenses
BATON ROUGE LA - Acting US Attorney Corey R. Amundson announced today the unsealing of two federal grand jury indictments charging four individuals with health care fraud and related offenses. The cases were unsealed as part of the 2017 National Health Care Fraud Takedown, during which federal, state, and local law enforcement partners announced charges of more than 400 defendants across 41 different federal judicial districts.


July 13, 2017; U.S. Attorney; Southern District of Ohio 

National Health Care Fraud Takedown Includes Two Central Ohio Companies and Owners Charged with False Billing
COLUMBUS OH - A federal grand jury has returned separate indictments charging two central Ohio health care companies and the people who own them with health care fraud. One company allegedly billed government insurance programs for unnecessary medical procedures and the other is accused of billing government insurance programs for pain and scar creams that recipients said they never requested or wanted.


July 13, 2017; U.S. Attorney; Northern District of California 

Charges Filed Against Northern California Physician For Unlawfully Dispensing Oxycodone
SAN FRANCISCO CA - Christopher Owens, a physician licensed to practice in California, was indicted on Tuesday with unlawfully prescribing oxycodone, announced U.S. Attorney Brian J. Stretch and Drug Enforcement Administration Special Agent in Charge John J. Martin. The indictment alleges that between September of 2012 and June of 2015, Owens, 50, now of Indianapolis, IN, intended to act outside the course of usual professional practice and without a legitimate medical purpose when he prescribed oxycodone on numerous occasions. In sum, Owens is charged with 36 counts of distributing oxycodone, in violation of 21 U.S.C. § 841(a)(1) and (b)(1)(C).


July 13, 2017; U.S. Department of Justice

Miami-Based Physician Pleads Guilty for Role in Pain Pill Diversion and Medicare Fraud Scheme
A licensed physician in Miami pleaded guilty in federal court yesterday for his role in a multi-faceted $4.8 million health care fraud scheme that ran from April 2011 to February 2017, involving the submission of false and fraudulent claims to Medicare and the illegal prescribing of Schedule II (e.g., oxycodone and hydrocodone) and Schedule IV (e.g., alprazolam) controlled substances.


July 12, 2017; U.S. Attorney; Southern District of Texas

Two Men Indicted in Medicare Fraud Scheme in Rio Grande Valley
McALLEN TX - A former laboratory technician at a medical clinic in Mission and an account representative for a toxicology testing company have been indicted in connection with a scheme to defraud Medicare, announced Acting U.S. Attorney Abe Martinez.


July 11, 2017; U.S. Attorney; Northern District of Texas

Woman Indicted for Running Health Care Fraud Scheme from Prison
DALLAS TX - Alexis C. Norman, 46, of Midlothian TX, has been indicted on felony offenses stemming from a health care fraud conspiracy she ran from prison that involved the submission of more than $810,000 in false claims to Medicaid, announced U.S. Attorney John Parker of the Northern District of Texas.


July 11, 2017; U.S. Attorney; District of Connecticut

Drug Company Sales Rep Admits Role in Kickback Scheme Related to Fentanyl Spray Prescriptions
Deirdre M. Daly, US Attorney for the District of Connecticut, announced that NATALIE LEVINE, 33, of Scottsdale AZ, waived her right to be indicted and pleaded guilty today before U.S. District Judge Michael P. Shea in Hartford to one count of engaging in a kickback scheme that defrauded federal healthcare programs.


July 10, 2017; U.S. Attorney; Southern District of New York

Brooklyn Pharmacy Owner/Operator Charged With Defrauding Medicare And Medicaid Programs Of Approximately $9 Million
Joon H. Kim, the Acting US Attorney for the Southern District of New York, William F. Sweeney Jr., the Assistant Director-in-Charge of the New York Office of the New York Office of the Federal Bureau of Investigation ("FBI"), Scott J. Lampert, Special Agent in Charge of the New York Regional Office for the DHHS-OIG, and Dennis Rosen, Inspector General of the NY State Office of the Medicaid Inspector General ("OMIG"), announced today the unsealing of a criminal Complaint charging defendant SUNITA KUMAR with operating a health care fraud scheme utilizing two pharmacies in Brooklyn, New York, through which KUMAR submitted approximately $9 million in fraudulent claims to Medicaid and Medicare. KUMAR was arrested this morning and was presented in Manhattan federal court today before U.S. Magistrate Judge Andrew J. Peck.


July 7, 2017; U.S. Attorney; Eastern District of California

Wal-Mart Pays $1.65M to Settle False Claims Act Allegations of Improper Medi Cal Billings
SACRAMENTO CA - Wal-Mart Stores Inc. has paid $1.65 million to resolve allegations that it violated the federal False Claims Act when it knowingly submitted claims for reimbursement to California's Medi Cal program that were not supported by applicable diagnosis and documentation requirements, U.S. Attorney Phillip A. Talbert announced today.


July 6, 2017; U.S. Attorney; Northern District of Georgia

Hospice to pay $2.4 Million to resolve False Claims Act Allegations
ATLANTA - Compassionate Care Hospice Group, Inc., ("CCH Group") has agreed to pay $2.4 million to resolve allegations that CCH Group and its subsidiary Compassionate Care Hospice of Atlanta, LLC, ("CCH Atlanta") submitted or caused the submission of false claims to Medicare and Medicaid by engaging in improper financial relationships with contracted physicians. CCH Group is a Florida corporation with its principal place of business in Parsippany, New Jersey, and subsidiaries and affiliates in numerous states.


July 6, 2017; U.S. Attorney; District of New Jersey

Hospice Company To Pay $2 Million To Resolve Alleged False Claims Related To Unnecessary Hospice Care
NEWARK NJ - A hospice company in Bensalem PA, has agreed to pay to the US $2 million to resolve allegations that it provided unnecessary hospice services, Acting U.S. Attorney William E. Fitzpatrick announced today.


July 6, 2017; U.S. Attorney; Eastern District of Pennsylvania

Defunct Philly Hospice's Owners/Operators to Pay Millions to Settle Civil False Claims Suit
PHILADELPHIA PA - Acting US Attorney Louis D. Lappen announced today that Matthew Kolodesh, Alex Pugman, Svetlana Ganetsky, and Malvina Yakobashvili have agreed to pay millions of dollars to settle False Claims Act allegations that they and their now-defunct company, Home Care Hospice, Inc. (HCH), falsely claimed and received taxpayer dollars for hospice services that were either unnecessary or never provided. Previously, a federal jury found Kolodesh guilty on, and Pugman and Ganetsky pleaded guilty to, related criminal charges.


July 5, 2017; U.S. Attorney; Eastern District of Missouri

U.S. Reaches $8.3 Million Civil Settlement with Reliant Care Group and Reliant Affiliated Entities
ST LOUIS MO: The US Attorney's Office for the Eastern District of Missouri announced today that the US, Reliant Care Group, Reliant Care Management Company, Reliant Care Rehabilitative Services, and a number of Reliant affiliated skilled nursing facilities (Reliant) reached a civil settlement that will resolve the US' claims against Reliant under the False Claims Act for knowingly submitting false claims to Medicare for providing unnecessary physical, speech, and occupational therapy to nursing home residents.


JUNE 2017



June 30, 2017; U.S. Attorney; Southern District of Alabama

Pain Management Doctor Arrested in Health Care Fraud Cases
Acting US Attorney Steve Butler of the Southern District of Alabama and Alabama Attorney General Steve Marshall announced today that Dr. Rassan M. Tarabein, 58, a neurologist residing in Fairhope, Alabama, was arrested by law enforcement officials on federal and state criminal charges relating to health care fraud. On June 16, 2017, a state grand jury in Montgomery County, Alabama returned a 2-count indictment against Dr. Tarabein, charging him with Medicaid fraud and theft of property in the first degree. On June 28, 2017, a federal grand jury for the Southern District of Alabama returned a 22-count superseding indictment against Dr. Tarabein, charging him with health care fraud, making false statements relating to health care matters, lying to a federal agent, unlawfully distributing schedule II controlled substances, and money laundering. Later today, Dr. Tarabein is scheduled for an initial appearance on the federal charges before United States Magistrate Judge P. Bradley Murray in Mobile, Alabama. Dr. Tarabein operated the Eastern Shore Neurology and Pain Center, a private clinic in Daphne, Alabama where he provided services relating to neurology and pain management, such as spinal injections.


June 30, 2017; U.S. Department of Justice

Detroit Area Medical Biller Sentenced to 50 Months in Prison for Her Role in a $7.3 Million Dollar Healthcare Fraud Scheme
A Detroit-area medical biller was sentenced today to 50 months in prison for her role in a $7.3 million Medicare and Medicaid fraud scheme involving medical services that were billed to Medicare and Medicaid but not rendered as billed.


June 30, 2017; U.S. Attorney; Western District of North Carolina

Carolina Healthcare System Agreems To Pay $6.5 Million To Settle False Claims Act Allegations
CHARLOTTE NC - U.S. Attorney Jill Westmoreland Rose announced today that the Charlotte-Mecklenburg Hospital Authority, dba Carolinas Healthcare System (CHS), has agreed pay the Government $6.5 million to resolve allegations that the company violated the False Claims Act, by "up-coding" claims for urine drug tests in order to receive higher payment than allowed for the tests.


June 30, 2017; U.S. Attorney; Western District of Pennsylvania

Physician Sentenced to 7 Years in Prison for Accepting Kickbacks and Failing to Remit Employment Taxes
JOHNSTOWN PA - A resident of Hollidaysburg, Pa. has been sentenced in federal court to 84 months in prison, 60 months of which will be concurrent with a sentence imposed in the Southern District of Florida; three years' supervised release; and was ordered to pay restitution to the Internal Revenue Service of $722,476.55 and to HHS of $2,300,000, on his convictions of conspiring to commit an offense against the United States and willfully failing to remit employment taxes, Acting US Attorney Soo C. Song announced today.


June 30, 2017; U.S. Attorney; Western District of Washington

Former CFO of Health Insurance Company Sentenced to Prison for Embezzlement
The former CFO of Soundpath Health was sentenced today in U.S. District Court in Seattle to a year and a day in prison for embezzling more than $631,000 from his employer, announced U.S. Attorney Annette L. Hayes. The embezzlement was part of a complex wire fraud scheme that 58-year-old ZACHARY AUGUSTUS SMULSKI used in an attempt to fund his own start-up companies. When the Comptroller at Soundpath Health discovered that SMULSKI had hidden company funds, SMULSKI transferred the money to Soundpath and left the company. Today SMULSKI paid $29,514 in restitution. U.S. District Judge Robert S. Lasnik imposed three years of supervised release to follow prison and told SMULSKI, "it was a crime done for selfish reasons."


June 29, 2017; U.S. Attorney; Middle District of Tennessee

Durable Medical Equipment Manufacturer Agrees To Pay $2.715 Million To Resolve False Claims Allegations
Innovative Therapies, Inc. ("ITI") and its ultimate parent company Cardinal Health, Inc. ("Cardinal") have agreed to pay $2.715 million to settle False Claims Act allegations, announced Jack Smith, Acting US Attorney for the Middle District of Tennessee. The settlement concerns conduct initiated by ITI before being purchased by Cardinal in August 2014 and resolves a qui tam action filed by a whistleblower in May 2015.


June 28, 2017; U.S. Department of Justice

Los Angeles Hospital Agrees to Pay $42 Million to Settle Alleged False Claims Act Violations Arising from Improper Payments to Physicians
PAMC Ltd., and Pacific Alliance Medical Center Inc., which together own and operate Pacific Alliance Medical Center, an acute care hospital located in Los Angeles, California, have agreed to pay $42 million to settle allegations that they violated the False Claims Act by engaging in improper financial relationships with referring physicians, the Justice Department announced today. Of the total settlement amount, $31.9 million will be paid to the Federal Government, and $10 million will be paid to the State of CA.


June 28, 2017; U.S. Attorney; Middle District of Florida

Former WellCare, Inc. General Counsel Pleads Guilty To Making A False Statement To Florida Medicaid Program
Tampa FL - Acting US Attorney W. Stephen Muldrow announces that WellCare's former General Counsel, Thaddeus M.S. Bereday (52, Tampa) has pleaded guilty to one count of making a false statement to the Florida Medicaid program. He faces a maximum penalty of five years in federal prison. A sentencing date has not yet been set.


June 28, 2017; U.S. Attorney; District of Maine

Manchester Physician Agrees to Pay $133,464 to Settle Civil Health Care Fraud Case
Portland ME: Acting US Attorney Richard W. Murphy today announced that Charles G. Landry, D.O. ("Dr. Landry") has entered into a civil settlement agreement with the United States in which he will pay $133,464 to resolve allegations that from January 2011 through August 2014 he submitted false claims to Medicare.


June 27, 2017; U.S. Department of Justice

Physician and Wife to Pay $1.2 Million to Settle False Claims Act Allegations that They Billed Medicare and Medicaid for Unapproved Drugs
Dr. Anindya Sen and Patricia Posey Sen will pay $1.208 million to resolve state and federal False Claims Act allegations that their medical practice billed Medicare and Tennessee Medicaid (TennCare) for anticancer and infusion drugs that were produced for sale in foreign countries and not approved by the U.S. FDA for marketing in the US, the DOJ announced today. Dr. Sen owns and operates East Tennessee Cancer & Blood Center and East Tennessee Hematology Oncology and Internal Medicine located in Greeneville and Johnson City, Tennessee. Mrs. Sen managed Dr. Sen's medical practice from 2009 through 2012.



June 26, 2017; U.S. Department of Justice

Cardiac Monitoring Companies and Executive Agree to Pay $13.45 Million to Resolve False Claims Act Allegations
AMI Monitoring Inc. aka Spectocor, its owner, Joseph Bogdan, Medi-Lynx Cardiac Monitoring LLC, and Medicalgorithmics SA, the current majority owner of Medi-Lynx Cardiac Monitoring LLC, have agreed to resolve allegations that they violated the False Claims Act by billing Medicare for higher and more expensive levels of cardiac monitoring services than requested by the ordering physicians, the Department of Justice announced today. Spectocor and Bogdan have agreed to pay $10.56 million, and Medi-Lynx and Medicalgorithmics have agreed to pay $2.89 million.


June 26, 2017; U.S. Department of Justice 

Orlando Doctor and Infusion Clinic Owner Sentenced to 64 Months and 90 Months in Prison for Role in Medicare Fraud
An Orlando medical doctor and an infusion clinic owner were sentenced to 64 months in prison and two years supervised release, and 90 months and two years supervised release, respectively, today for their roles in a $13.7 million Medicare fraud conspiracy that involved submitting claims for expensive infusion-therapy drugs that were never purchased, never provided and not medically necessary.


June 26, 2017; U.S. Attorney; Eastern District of Tennessee

Former Clinical Pharmacy Manager Sentenced to Serve 16 Months in Prison for $4.4 Million TennCare Fraud Scheme
GREENEVILLE TN - On June 26, 2017, Amber Reilly, 33, of Jonesborough, Tennessee, was sentenced by the Honorable J. Ronnie Greer, U.S. District Judge, to serve 16 months in federal prison for healthcare fraud, which resulted in at least a $4.4 million loss to TennCare. Upon her release from prison, she will be supervised by U.S. Probation for three years.


June 26, 2017; U.S. Attorney; Western District of Oklahoma

Norman Orthopedic Practice Pays $1,537,796 to Resolve Allegations of False Claims Submitted to Federal and State Programs for Medical Services
Oklahoma City OK - Orthopedic AND Sports Medicine Center-Norman, P.C., and its physician-owners, Dr. Mark Moses, Dr. David Bobb, Dr. William Harris, Dr. Vytautus Ringus, Dr. Steven Schultz, and Dr. Brad Vogel (collectively "OSC") have paid $1,537,796 to settle civil claims stemming from allegations that they submitted false claims to Medicare, Medicaid, the Department of Veterans Affairs, and TRICARE.


June 23, 2017; U.S. Attorney; District of Wyoming

Colorado Podiatrist Sentenced to Prison for Health Care Fraud
A Fort Collins podiatrist was sentenced to serve six (6) months in prison and pay a $20,000 fine for fraudulently billing Medicare for routine foot care services, announced Acting US Attorney John Green.


June 22, 2017; U.S. Attorney; Southern District of Alabama

Local Physician, Dr. James M. Crumb, and Mobile Based Physician Group, Coastal Neurological Institute, P.C., paid $1.4 million to Settle False Claims Act Allegations
Acting US Attorney Steve Butler, of the Southern District of Alabama, announced today that Dr. James M. Crumb, a Physical Medicine and Rehabilitative specialist currently practicing in Mobile, Alabama as Mobility Metabolism and Wellness, P.C. (MMW), and Coastal Neurological Institute, P.C. (CNI), a local neurosurgeon physician group, collectively paid $1.4 million to resolve allegations that they violated the False Claims Act ("FCA") by engaging in fraudulent schemes to maximize payment from the Medicare, Medicaid, and TRICARE health care programs.


June 22, 2017; U.S. Attorney; Southern District of Ohio

Athens County Home Health Care Agency Owner Pleads Guilty to $2M in Fraud
COLUMBUS OH - Cheryl McGrath, 49, of Guysville, Ohio, pleaded guilty today in U.S. District Court to health care fraud and willful failure to pay over tax.


June 22, 2017; U.S. Attorney; Western District of Missouri

Former Physician Sentenced for Health Care Fraud
KANSAS CITY MO - Tom Larson, Acting US Attorney for the Western District of Missouri, announced today that a former Kansas City, Mo., physician who lost his medical license due to an earlier fraud scheme, has been sentenced in federal court for his role in a fraud scheme that involved disability examinations of veterans.


June 21, 2017; U.S. Attorney; District of New Jersey

Five Doctors Plead Guilty in Connection with Test-Referral Scheme with New Jersey Clinical Lab
Newark NJ - Five doctors today admitted taking bribes in connection with a long-running and elaborate test referral scheme operated by Biodiagnoatic Laboratory Services LLC (BLS), of Parsippany, New Jersey, its president and numerous associates, Acting U.S. Attorney William E. Fitzpatrick announced.


June 20, 2017; U.S. Attorney; District of New Jersey

Bergen County Doctor Sentenced to 41 Months in Prison for Taking Bribes in Test-Referral Scheme
NEWARK NJ - A family doctor practicing in Bergen County, New Jersey, was sentenced today to 41 months in prison for accepting bribes in exchange for test referrals as part of a long-running and elaborate scheme operated by Biodiagnostic Laboratory Services LLC (BLS), of Parsippany, New Jersey, its president and numerous associates, Acting U.S. Attorney William E. Fitzpatrick announced.


June 16, 2017; U.S. Department of Justice

Genesis Healthcare, Inc. Agrees To Pay Federal Government $53.6 Million To Resolve Allegations Of Medically Unnecessary Rehabilitation Therapy And Hospice Services
SAN FRANCISCO CA - The Justice Department announced today that Genesis Healthcare, Inc. (Genesis) will pay the federal government $53,639,288.04, including interest, to settle six federal lawsuits and investigations regarding the submission of false claims for medically unnecessary therapy and hospice services, and grossly substandard nursing home care. Genesis, headquartered in Kennett Square, Pennsylvania, owns and operates through its subsidiaries skilled nursing facilities, assisted/senior living facilities, and a rehabilitation therapy business. According to the allegations in the lawsuits, companies and facilities acquired by Genesis violated the False Claims Act. The settlement announced today resolves the claims and investigations into the allegations.


June 15, 2017; U.S. Attorney; Eastern District of Michigan

Former Doctor Sentenced to 23 Years in Prison for Distributing Prescription Drugs, Health Care Fraud and Money Laundering
Sardar Ashrafkhan of Ypsilanti, Michigan, was sentenced today to 23 years in prison for participating in a conspiracy to distribute prescription pills, conspiracy to commit health care fraud, and money laundering, Acting U.S. Attorney Daniel Lemisch announced.


June 14, 2017; U.S. Department of Justice 

Mother and Daughter Co-Owners of Seven Miami, Florida-Area Home Health Agencies Each Sentenced to Over 10 Years in Prison for Roles in $20 Million Home Health Care Fraud Schemes
A mother and daughter who secretly co-owned and operated seven home health care agencies in the Miami, Florida area were each sentenced to over 10 years in prison today for their roles in a $20 million Medicare fraud conspiracy that involved paying illegal health care kickbacks to patient recruiters and medical professionals.


June 14, 2017; U.S. Attorney; Middle District of Florida

Jacksonville Man Sentenced For Perpetrating Fraud Schemes While Illegally Collecting Disability And Medicaid Benefits
Jacksonville FL - US District Judge Brian J. Davis today sentenced Douglas Thompson (52, Jacksonville) to 27 months in federal prison for wire fraud and theft of government property. The Court also ordered him to pay $149,218.26 in restitution to the victims of his crimes.


June 13, 2017; U.S. Attorney; Southern District of Georgia

Dodge County Pharmacy and Pharmacist Agree To Pay Over $2 Million to Resolve False Claims Act and Controlled Substances Act Allegations
SAVANNAH GA: Rhine Drug Company and Andrew "Carter" Clements, Jr. agreed to pay a total of $2.175 million to resolve allegations that they violated the False Claims Act and the Controlled Substances Act. This settlement is the largest False Claims Act recovery with a pharmacy or pharmacist and largest recovery of civil penalties under the Controlled Substances Act in the history of the Southern District of Georgia.


June 13, 2017; U.S. Attorney; Southern District of Texas

RGV Durable Medical Equipment Company Owner and Four Others Sentenced in Health Care Fraud Scheme
McALLEN TX - The owner of a Rio Grande Valley area durable medical equipment (DME) company has been ordered to federal prison for her role in a scheme to defraud Texas Medicaid through fraudulent billings, announced Acting U.S. Attorney Abe Martinez. Maria Teresa Paz Garza, 41, of McAllen, was previously found guilty by a jury on all counts on Feb. 24, 2017, following a seven-day trial and six hours of deliberation.


June 13, 2017; U.S. Attorney; Northern District of Texas

Owner of Apple of Your Eye Healthcare Services, Inc. Sentenced to 210 Months in Federal Prison for Role in Healthcare Fraud Conspiracy
DALLAS TX - Wilbert James Veasey, Jr., 65, of Dallas, was sentenced this morning in federal court in Dallas on a health care fraud conspiracy conviction, announced U.S. Attorney John Parker of the Northern District of Texas.


June 13, 2017; U.S. Attorney; Northern District of New York

University of Rochester to Pay More Than $100,000 to Resolve False Claims Act Lawsuit
SYRACUSE NY  - US Attorney Richard S. Hartunian and New York State Attorney General Eric. T. Schneiderman announced today that the University of Rochester (UR), which among other things operates a teaching hospital based in Rochester NY, will pay $113,722.10 to resolve allegations that it violated the federal and New York False Claims Acts by improperly using a billing modifier on certain healthcare claims at UR's Flaum Eye Institute, resulting in UR receiving payments to which it was not entitled.


June 13, 2017; U.S. Attorney; District of New Jersey

Cherry Hill Doctor And Son Admit Defrauding Medicare, Agree To $1.78 Million Settlement
CAMDEN NJ - A doctor and his chiropractor son today admitted conspiring to defraud Medicare by using unqualified people to give physical therapy to Medicare recipients, Acting U.S. Attorney William E. Fitzpatrick announced.


June 12, 2017; U.S. Department of Justice

Lexington, Kentucky, Jury Convicts Clinical Psychologist for Role in $600 Million Social Security Disability Fraud Scheme
A federal jury in Lexington KY, today convicted a clinical psychologist for his role in a Social Security disability fraud scheme that included a former Social Security Administration (SSA) administrative law judge and that involved the submission of thousands of falsified medical documents to the SSA, obligating the SSA to pay more than $600 million in lifetime benefits to claimants predicated on these fraudulent submissions.


June 9, 2017; U.S. Attorney; Southern District of Florida

Miami-Area Man Charged For Role in $63 Million Health Care Fraud Scheme
A Miami-area man was charged in an indictment unsealed today for his alleged participation in a $63 million health care fraud scheme involving a now-defunct community mental health center located in Miami.


June 7, 2017; U.S. Attorney; Southern District of Florida

Shelter Worker Charged With Attempting to Coerce and Entice An Unaccompanied Alien Minor
Benjamin G. Greenberg, Acting US Attorney for the Southern District of Florida; Special Agent in Charge Shimon R. Richmond of the U.S. DHHS-OIG Miami Regional Office; and Mark Selby, Special Agent in Charge, U.S. Immigration and Customs Enforcement, Homeland Security Investigations (ICE-HSI), Miami Field Office, announced the Indictment of Merice Perez Colon.


June 7, 2017; U.S. Attorney; District of Idaho

Fruitland Woman Sentenced to 60 Months in Prison for Health Care Fraud and Aggravated Identity Theft
BOISE ID - Cherie R. Dillon, 62, of Fruitland, Idaho, was sentenced yesterday to 60 months in prison to be followed by three years of supervised released for health care fraud and aggravated identity theft, Acting U.S. Attorney Rafael Gonzalez announced. Chief U.S. District Judge B. Lynn Winmill also ordered Dillon to pay restitution in the amount $549,605.19 and to forfeit $847,016 proceeds from the offenses, although those sums are preliminary pending a hearing on August 9, 2017.


June 7, 2017; U.S. Attorney; Western District of North Carolina

School Counselor Pleads Guilty To Health Care Fraud Scheme
ASHEVILLE NC - Joseph Frank Korzelius, owner of Western Carolina Counseling Services and a school counselor in the Polk County school system, admitted today to defrauding the North Carolina Medicaid Program of over $400,000, by submitting false and fraudulent reimbursement claims. Korzelius, 46, of Tryon, N.C., appeared before U.S. Magistrate Judge Dennis L. Howell and pleaded guilty to one count of health care fraud.


June 6, 2017; U.S. Attorney; District of New Jersey

Paterson Doctor And Wife, Woodland Park Doctor, Charged In Test-Referral Bribe Scheme With New Jersey Clinical Lab
NEWARK NJ - A cardiologist with a practice in Paterson, New Jersey, his wife, and a doctor with a practice in Woodland Park, New Jersey, were charged today with accepting bribes in exchange for test referrals as part of a long-running scheme involving Biodiagnostic Laboratory Services LLC (BLS), of Parsippany, New Jersey, Acting U.S. Attorney William E. Fitzpatrick announced.


June 5, 2017; U.S. Attorney; District of Connecticut

Physical Therapist Sentenced for Obstruction and Tax Fraud Offenses
Deirdre M. Daly, US Attorney for the District of Connecticut, announced that DANIELLE FAUX, 49, of Weston, was sentenced today by U.S. District Judge Stefan R. Underhill in Bridgeport to two years of probation, the first six months of which FAUX must spend in home confinement, for obstruction and tax fraud offenses. Judge Underhill also ordered FAUX to perform 100 hours of community service and pay a $3,000 fine.


June 5, 2017; U.S. Attorney; Eastern District of New York

Manhattan Doctor Arrested For Illegal Distribution of Oxycodone
A criminal complaint was unsealed today in federal court in Brooklyn charging medical doctor Martin Tesher with writing thousands of illegal prescriptions for Schedule II controlled substances, particularly opioids such as oxycodone, without a legitimate medical purpose. Tesher was arrested earlier today in Manhattan, and his initial appearance is scheduled for this afternoon before US Magistrate Judge Lois Bloom.


June 2, 2017; U.S. Attorney; Eastern District of Virginia

Fredericksburg Hospitalist Group Pays $4.2 Million to Settle Civil Fraud Case
RICHMOND VA - Fredericksburg Hospitalist Group, P.C. (FHG), and 14 of its member shareholders have agreed to pay approximately $4.2 million to settle a federal False Claims Act (FCA) case brought under the qui tam whistleblower provisions of the FCA.


June 1, 2017; U.S. Attorney; Southern District of Texas

Medicare Fraudster Given Maximum Prison Sentence
HOUSTON TX - A Houston woman and a California man have been ordered to federal prison for conspiring to defraud Medicare through so-called diagnostic testing labs in the Houston area, announced Acting U.S. Attorney Abe Martinez. Zaven "George" Sarkisian, 55, of Fresno, California, and Konna Hanks, 48, of Houston, pleaded guilty Dec. 9 and 2, 2015, respectively.

MAY 2017

May 31, 2017 - Electronic Health Records Vendor to Pay $155 Million to Settle False Claims Act Allegations

One of the nation's largest vendors of electronic health records software, eClinicalWorks (ECW), and certain of its employees will pay a total of $155 million to resolve a False Claims Act lawsuit alleging that ECW misrepresented the capabilities of its software, the Justice Department announced. The settlement also resolves allegations that ECW paid kickbacks to certain customers in exchange for promoting its product. ECW is headquartered in Westborough, Massachusetts.


May 31, 2017; U.S. Attorney; District of New Jersey

Skilled Nursing Facility To Pay $888,000 To Resolve Alleged False Claims Related To Materially Substandard Care

NEWARK NJ - A skilled nursing facility in Sussex County, New Jersey, has agreed to pay to the US and the State of New York $888,000 to resolve allegations that it provided materially substandard or worthless nursing services to some patients, Acting U.S. Attorney William E. Fitzpatrick announced today.


May 31, 2017; U.S. Attorney; District of Massachusetts

Former Tufts Health Plan Employee Sentenced for Disclosing Personal Patient Information
BOSTON MA - A former employee of Tufts Health Plan was sentenced today in federal court in Boston for stealing personal identifying information belonging to hundreds of customers. The stolen data included names, dates of birth, and Social Security numbers, primarily of customers over the age of 65.


May 31, 2017; U.S. Attorney; Eastern District of Louisiana

Marrero Woman Pleads Guilty to $536,724 in Health Care Fraud
Acting U.S. Attorney Duane A. Evans announced that MONICA SYLVEST, age 52, of Marrero, pled guilty today to a Bill of Information charging her with health care fraud.


May 30, 2017; U.S. Department of Justice

Medicare Advantage Organization and Former Chief Operating Officer to Pay $32.5 Million to Settle False Claims Act Allegations
Freedom Health Inc., a Tampa, Florida-based provider of managed care services, and its related corporate entities (collectively "Freedom Health"), agreed to pay $31,695,593 to resolve allegations that they violated the False Claims Act by engaging in illegal schemes to maximize their payment from the government in connection with their Medicare Advantage plans, the Justice Department announced today. In addition, the former Chief Operating Officer (COO) of Freedom Health Siddhartha Pagidipati, has agreed to pay $750,000 to resolve his alleged role in one of these schemes.


May 30, 2017; U.S. Attorney; District of Connecticut

Bristol Woman Convicted of Defrauding Medicaid Program
Deirdre M. Daly, US Attorney for the District of Connecticut, Phillip Coyne, Special Agent in Charge for the U.S. DHHS, Office of Inspector General, and Chief State's Attorney Kevin T. Kane today announced that on May 26, a jury in Bridgeport convicted RONNETTE BROWN, 44, of Bristol, on 23 counts of health care fraud and one count of conspiracy to commit health care fraud. The trial before U.S. District Judge Victor A. Bolden began on May 22 and the jury returned a verdict of guilty on all counts of the indictment on Friday afternoon.


May 30, 2017; U.S. Attorney; District of Minnesota

Minnesota Mental Health Nonprofit And Its Leaders To Pay $4.5 Million To Resolve Fraud Allegations
Acting US Attorney Gregory G. Brooker and Minnesota Attorney General Lori Swanson today announced that Complementary Support Services and its related entities (collectively "CSS"), TERI DIMOND and HERBERT STOCKLEY have agreed to pay a total of $4.52 million to resolve allegations that they violated the False Claims Act (FCA) and Minnesota False Claims Act by defrauding Medicaid, a program jointly funded by the federal government and State of Minnesota to provide health care to low-income Minnesotans. CSS will pay the government $4 million, DIMOND agreed to pay $400,000, and STOCKLEY agreed to pay $120,000.


May 23, 2017; U.S. Department of Justice 

Houston-Area Psychiatrist Convicted of Health Care Fraud for Role in $158 Million Medicare Fraud Scheme
A federal jury convicted a Houston-area psychiatrist today for his role in a $158 million Medicare fraud scheme.


May 23, 2017; U.S. Attorney; Northern District of New York

Albany Physician Pays $100,000 And Agrees To 15-Year Period Of Exclusion From Medicare For Submitting False Claims
ALBANY NY - Dr. Michael Esposito has agreed to pay $100,000 for billing Medicare despite his exclusion from all federal health care programs, announced US Attorney Richard S. Hartunian. Dr. Esposito is an endocrinologist who treated patients in the Capital Region until earlier this year, when the New York State Board of Professional Medical Conduct ordered him to stop practicing medicine because he had engaged in professional misconduct.


May 22, 2017; U.S. Attorney; Eastern District of Missouri

United States Reaches $291,288 Civil Settlement with Dr. Sherry Ma and Aima Neurology, LLC Related to Botox® and Myobloc® Injections
St. Louis MO: Acting US Attorney Carrie Costantin announced today that the US, Sherry X. Ma, M.D., of Ladue, Missouri, and AIMA Neurology, LLC, reached a civil settlement that will resolve the US claims against Dr. Ma and AIMA Neurology under the False Claims Act for false Medicare billings related to Dr. Ma's Botox® and Myobloc® injections. 


May 19, 2017; U.S. Attorney; Eastern District of Missouri

Medical Resident Pleads Guilty to Fraudulently Obtaining Prescription Opioid Pain Medications
St. Louis MO - Kyle Betts pled guilty today to fraudulently obtaining pain relief drugs, including Percocet® and Norco®, by writing over 70 false prescriptions.


May 19, 2017; U.S. Attorney; Eastern District of Michigan

Farmington Hills Doctor Sentenced to 19 Years in Prison for Distributing Prescription Drugs and Health Care Fraud
A Farmington Hills MI, doctor was sentenced yesterday to 19 years in prison for participating in a conspiracy to distribute prescription pills and conspiracy to commit health care fraud, Acting U.S. Attorney Daniel Lemisch announced.


May 18, 2017; U.S. Department of Justice

Missouri Hospitals Agree to Pay United States $34 Million to Settle Alleged False Claims Act Violations Arising from Improper Payments to Oncologists
Two Southwest Missouri health care providers have agreed to pay the United States $34,000,000 to settle allegations that they violated the False Claims Act by engaging in improper financial relationships with referring physicians, the Justice Department announced today. The two Defendants are Mercy Hospital Springfield f/k/a St. John's Regional Health Center, and its affiliate, Mercy Clinic Springfield Communities f/k/a St. John's Clinic. Among other health care facilities, the Defendants operate a hospital, clinic, and infusion center in Springfield, Missouri.


May 18, 2017; U.S. Attorney; District of New Jersey

New York Doctor Pleads Guilty In Connection With Test-Referral Scheme With New Jersey Clinical Lab
NEWARK NJ - An internal medicine doctor practicing in Yonkers, New York, today admitted taking bribes in connection with a long-running and elaborate test referral scheme operated by Biodiagnostic Laboratory Services LLC (BLS), of Parsippany NJ, its president and numerous associates, Acting US Attorney William E. Fitzpatrick announced.


May 18, 2017; U.S. Attorney; Middle District of Tennessee

Final Group Of Physicians And Owner Of Medical Practice Plead Guilty In Medical Kickback Scheme
Pam Gardner, 55, of Springfield, Tennessee, pleaded guilty yesterday, to conspiracy to solicit and receive cash kickbacks in exchange for making patient referrals, announced Jack Smith, Acting US Attorney for the Middle District of Tennessee.


May 17, 2017; U.S. Attorney; Northern District of Ohio

Cleveland Heights woman sentenced to 10 years in prison, son to seven years for $8 million home healthcare fraud
A Cleveland Heights woman was sentenced to 10 years in prison for leading a $8 million healthcare fraud conspiracy in which participants provided forged documents and fraudulent forms to bill for services that were not provided, law enforcement officials said.


May 16, 2017; U.S. Department of Justice

United States Intervenes in Second False Claims Act Lawsuit Alleging that UnitedHealth Group Inc. Mischarged the Medicare Advantage and Prescription Drug Programs
For the second time in two weeks, the US has filed a complaint against UnitedHealth Group Inc. (UHG) that alleges UHG knowingly obtained inflated risk adjustment payments based on untruthful and inaccurate information about the health status of beneficiaries enrolled in UHG's Medicare Advantage Plans throughout the US, the Justice Department announced today. Today's action follows the government's filing of a complaint earlier this month in US ex rel. Swoben v. Secure Horizons, a related action that also alleges that UHG submitted false claims for payment to the Medicare Program. 


May 16, 2017; U.S. Attorney; District of New Jersey

Omnicare Inc. Agrees To $8 Million Settlement In False Claims Act Case
NEWARK NJ - The U.S. Attorney's Office of the District of New Jersey, the U.S. DOJ and 28 states have reached an $8 million settlement with Omnicare Inc. resolving allegations arising from a whistle-blower suit filed under the False Claims Act. The agreement was announced today by Acting U.S. Attorney William E. Fitzpatrick.


May 12, 2017; U.S. Department of Justice

Former Administrative Law Judge Pleads Guilty for Role in $550 Million Social Security Disability Fraud Scheme
A former administrative law judge for the Social Security Administration (SSA) pleaded guilty in federal court today for his role in a scheme to fraudulently obtain more than $550 million in federal disability payments from the SSA for thousands of claimants.


May 11, 2017; U.S. Attorney; Middle District of Louisiana

Patient Marketer For All-Star Medical Supply Sentenced To Prison For Health Care Fraud
BATON ROUGE LA - Acting US Attorney Corey R. Amundson announced that U.S. District Judge Shelly D. Dick sentenced DEMETRIAS TEMPLE, age 56, of New Orleans, Louisiana, to serve ten (10) months in federal prison following her conviction for health care fraud. TEMPLE was ordered to make restitution to the Medicare program totaling $100,000 and pay a $100 special assessment. TEMPLE was ordered to forfeit an additional $100,000 as the proceeds of her criminal activity. Finally, following her release from prison, TEMPLE will be required to serve a two-year term of supervised release.


May 11, 2017; U.S. Attorney; Southern District of New York

Acting U.S. Attorney Announces $54 Million Settlement Of Civil Fraud Lawsuit Against Benefits Management Company For Improper Authorization Of Medical Procedures
Joon H. Kim, the Acting US Attorney for the Southern District of NY, and Scott Lampert, Special Agent in Charge of the New York Regional Office for the Office of Inspector General for the DHHS-OIG, announced today that the US simultaneously filed and settled a civil fraud lawsuit against benefits management company CaRECORE NATIONAL LLC ("CARECORE"), now part of eviCore healthcare, for authorizing medical diagnostic procedures paid for with Medicare and Medicaid funds over a period of at least eight years without properly assessing whether the procedures were necessary or reasonable. The settlement, approved in Manhattan federal court by U.S. District Judge Richard J. Sullivan, resolves CARECORE's civil liabilities to the United States under the federal False Claims Act. Under the settlement, CARECORE must pay a total of $54 million, of which $45 million will be paid to the US and $9 million will be paid to the states that are named as plaintiffs in the suit. CARECORE also admitted and accepted responsibility for, among other things, improperly approving prior authorizations requests for hundreds of thousands of diagnostic procedures paid for with Medicare Part C and Medicaid funds.


May 11, 2017; U.S. Attorney; Northern District of Illinois

Chicago Dermatologist Convicted on Federal Fraud Charges for Billing Health Insurance Programs for Medically Unnecessary Treatments
CHICAGO IL - A federal jury has convicted a Chicago dermatologist on fraud charges for billing health-insurance programs for purported pre-cancerous treatments that were not medically necessary.


May 10, 2017; U.S. Attorney; Eastern District of Louisiana

Six Individuals Found Guilty of Health Care Fraud
Acting U.S. Attorney Duane A. Evans announced that on May 9th, after over four weeks of trial, a federal jury returned guilty verdicts against six individuals charged with committing approximately $13,655,094 in Medicare fraud.


May 10, 2017; U.S. Attorney; District of Oregon

Mary Holden Ayala Charged with Theft of Over $800,000 From Oregon Foster Care Agency Give Us This Day
PORTLAND OR -A federal grand jury in Portland has charged Mary Holden Ayala, 56, a longtime resident of Portland, with theft of over $800,000, money laundering and filing false personal tax returns. Ayala served as the President and Executive Director of Give Us This Day (GUTD), an Oregon state-licensed private foster care agency and residential program for hard-to-place foster youth, until its closing in September of 2015. 


May 9, 2017; U.S. Attorney; Central District of California

Oncology Therapy Center in High Desert Pays $3 Million to Resolve Allegations of Providing Radiation Treatments without Doctor Present
LOS ANGELES CA - A Lancaster-based radiation therapy center has paid $3 million to resolve allegations that it submitted fraudulent bills over a nearly 10-year period to three government-run healthcare programs for unsupervised radiation oncology services.


May 9. 2017; U.S. Attorney; Northern District of Alabama

Sales Rep for North Alabama Compounding Pharmacy Charged in $13 M Insurance Conspiracy
BIRMINGHAM AL - Federal prosecutors today charged a sales representative for a Haleyville, Ala.,-based compounding pharmacy with conspiracy in a multi-faceted scheme to generate prescriptions and defraud Blue Cross Blue Shield of Alabama and one of its prescription drug administrators out of over $13 million in one year. Acting U.S. Attorney Robert O. Posey, Federal Bureau of Investigation Special Agent in Charge Roger Stanton, United States Postal Inspector in Charge, Houston Division Adrian Gonzalez, U.S. DHHS OIG Special Agent in Charge Derrick L. Jackson, and Defense Criminal Investigative Service Special Agent in Charge John F. Khin announced the charges.


May 8, 2017; U.S. Department of Justice 

Third Detroit-Area Physician Convicted in $17.1 Million Health Care Fraud Scheme
A third Detroit-area physician was convicted today for his role in a $17 million Medicare fraud scheme involving medically unnecessary physician visits.


May 8, 2017; U.S. Attorney; District of Connecticut

Morris Woman Sentenced to 10 Months in Federal Prison for Health Care Fraud
Deirdre M. Daly, US Attorney for the District of Connecticut, announced that ANNE CHARLOTTE SILVER, 63, of Morris, was sentenced today by U.S. District Judge Victor A. Bolden in Bridgeport to 10 months of imprisonment, followed by three years of supervised release, for committing health care fraud. Judge Bolden also ordered SILVER to provide 100 hours of community service upon her release from prison, and to pay restitution of $1.6 million.


May 8, 2017; U.S. Attorney; District of Kansas

Kansas Medical Supplier to Pay $1 Million To Settle False Claim Allegations
KANSAS CITY KS - A Dodge City medical equipment supplier has agreed to pay $1 million to settle allegations it submitted false claims to the Medicare program, U.S. Attorney Tom Beall said today.


May 4, 2017; U.S. Attorney; Eastern District of Texas

Smith County Husband and Wife Sentenced in Health Care Fraud Conspiracy
TYLER TX - A Smith County couple has been sentenced for health care fraud violations in the Eastern District of Texas announced Acting U.S. Attorney Brit Featherston today.


May 4, 2017; U.S. Attorney; Western District of Virginia

Third Member of Healthcare Conspiracy Pleads Guilty
Abingdon VA - A Bristol woman, who along with a husband and wife were accused of healthcare fraud, pled guilty today to related charges, Acting US Attorney Rick A. Mountcastle, Virginia Attorney General Mark R. Herring and Nick DiGiulio, Special Agent in Charge, Philadelphia Regional Office for U.S. HHS Office of Inspector General announced today.


May 2, 2017; U.S. Department of Justice

United States Intervenes in False Claims Act lawsuit Against UnitedHealth Group Inc. for Mischarging the Medicare Advantage and Prescription Drug Programs
The US has intervened and filed a complaint in a lawsuit against UnitedHealth Group Inc. (UHG) that alleges UHG obtained inflated risk adjustment payments based on untruthful and inaccurate information about the health status of beneficiaries enrolled in UHG's largest Medicare Advantage Plan, UHC of California, the Justice Department announced today. Yesterday's action follows the government's intervention in February of this year in US ex rel. Poehling v. UnitedHealth Group. Inc., a related lawsuit in the Central District of CA that also alleges that UHG defrauded the Medicare Program. government is scheduled to file a complaint in that matter no later than May 16. 


May 2, 2017; U.S. Attorney; Western District of North Carolina

Hickory Pathology Lab Agrees To Pay The United States $601,000 To Settle False Claims Act Allegation
CHARLOTTE NC - U.S. Attorney Jill Westmoreland Rose announced today that Piedmont Pathology in Hickory, N.C., has agreed to pay the United States $601,000 to settle allegations that it violated the False Claims Act by submitting false claims to Medicare and Medicaid for medically unnecessary procedures. 


May 1, 2017; U.S. Attorney; District of Kansas

Kansas Chiropractor to Pay $1 Million-plus To Settle False Claim Allegations
KANSAS CITY, KAN. - A Kansas City area chiropractor has agreed to pay more than $1 million to settle allegations his offices submitted false claims to Medicare for treating patients with peripheral neuropathy, U.S. Attorney Tom Beall said today.


May 1, 2017 - 

Poplar Healthcare to Pay Nearly $900,000 to Resolve A False Claims Act Allegations
PROVIDENCE RI - Acting US Attorney Stephen G. Dambruch and Philip Coyne, Special Agent-in-Charge of the Boston Office of Inspector General for the DHHS-OIG, today announced that Poplar Healthcare PLLC, and Poplar Healthcare Management, LLC ("Poplar"), of Memphis, TN, have entered into a civil settlement agreement with the US, under which Poplar will pay $897,640 to resolve allegations under the federal False Claims Act. The government alleges that Poplar, directly and through a subsidiary known as GI Pathology, promoted and billed the government for diagnostic tests that the government contends were not medically necessary.


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