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Cardiologist, Neurologist, And Others Charged In $50 Million Health Care Fraud Scheme, And Civil Suit Filed Against Clinic And Participants In The Fraud

Defendants Provided False Patient Medical Information and used the Identities of Doctors Who Did Not Work at the Clinic to Submit More Than $50 Million in Fraudulent Health Care Claims Preet Bharara, the United States Attorney for the Southern District of New York, William F. Sweeney Jr., the Assistant Director-in-Charge of the New York Field…

2016 False Claims Act Enforcement Summary –

The U.S. Department of Justice’s enforcement efforts for 2016 fell short of those of the year prior. In 2016, there were 106 announced settlements against health care providers with recoveries amounting to approximately $1.14 billion compared to total quantity of settlements and settlement dollar figures of 2015: 195 settlements and recoveries of nearly $2 billion….

Owner Of Durable Medical Equipment Company And Three Physicians Charged With Health Care Fraud And Aggravated Identity Theft

SAN JUAN, P.R. – On February 13, 2017, a Federal Grand Jury in the District of Puerto Rico returned a superseding indictment charging Dr. Dante A. Rodríguez-Rivera, Javier Efraín Siverio-Echevarría, Dr. George D. Alcántara-Cardi, Dr. Martha Nieves, Javier Antonio Aguirre- Estrada, and Carlos Maldonado-López with multiple counts of conspiracy to commit health care fraud, health…

The Department of Health and Human Services Office of Inspector General Releases Final Rule Effective February 13, 2017

Amendments Alter Regulations Relating to Exclusion Authority of HHS OIG Section 1001.301 expands exclusion authority to a conviction of obstruction in the event of an audit. In an effort to hold individuals and entities accountable to provide access and information during an exclusion audit conducted by the Department of Health and Human Services Office of…

21 Medicare Health Plans Warned To Fix Provider Directory Errors

On January 18, 2017, Kaiser Health News published this story written by Phil Galewitz and Susan Jaffe. Federal officials this month warned 21 Medicare Advantage insurers with high rates of errors in their online network directories that they could face heavy fines or have to stop enrolling people if the problems are not fixed by Feb….

Former IRS Employee Pleads Guilty to Health Care Fraud

Lynchburg, VIRGINIA – A former employee of the Internal Revenue Service pled guilty today in the United States District Court for the Western District of Virginia in Lynchburg to health care fraud charges related to his misuse of government health insurance benefits, Acting United States Attorney Rick A. Mountcastle announced. Ronald Lewis Hooper, 69, of…

Pain Management Physician Resolves Georgia False Medicaid Claims Act Allegations

ATLANTA – Today, Georgia Attorney General Chris Carr joined the United States Attorney’s Office for the Northern District of Georgia, the United States Attorney’s Office for the Eastern District of Kentucky and Attorney General Andy Beshear of the Commonwealth of Kentucky in announcing that pain management physician, Dr. Robert Windsor, has agreed to the entry…

New Orleans Woman Indicted for Conspiracy to Receive and Pay Illegal Health Care Kickbacks

U.S. Attorney Kenneth A. Polite announced that SAQUENA GRIFFIN, a/k/a “QUEENIE,” age 34, of New Orleans was charged today with conspiracy to pay and receive illegal Medicare kickbacks which resulted in Medicare paying $378,274 to a local home health. According to the Indictment, GRIFFIN was a recruiter and marketer for Comprehensive Nursing and Home Health…

ATTORNEY GENERAL LAXALT ANNOUNCES GUILTY PLEA OF CALIFORNIA MAN FOR COMPLEX HEALTHCARE INSURANCE SCAM

Las Vegas, NV –   Nevada Attorney General Adam Paul Laxalt announced that Richard Raymond Ruppert, 53, of California, pleaded guilty for his role in a healthcare insurance scam. Ruppert pleaded guilty to one count of Multiple Transactions involving Fraud or Deceit in the Course of an Enterprise or Occupation, a category “B” felony, and…

Excluded and Unlicensed New Jersey Dentist Who Assumed Identity of Another Dentist Agrees to Settlement of $1.1 Million and 50-Year Exclusion to Resolve Civil Monetary Penalty Case

Washington, DC – Unlicensed New Jersey dentist Roben Brookhim who assumed identity of another dentist agreed to pay $1.1 million and accept a 50-year exclusion from participating in Federal health care programs as part of a settlement to resolve his administrative liability for presenting false claims to Medicaid, billing for services furnished by an excluded…