Healthcare Billing Fraud:10 Recent Cases

Here are ten cases of healthcare billing fraud that Becker’s has covered since February 16th, ranging from a New York City doctor charged in an alleged $20.7 million conspiracy to a contact center owner charged in a $97 million scheme:

1. For their participation in a conspiracy that filed $125 million in false claims to Medicare and Tricare, a man and woman from Florida received sentences of 27 months in jail each.
2. The former president and CEO of a Florida compounding pharmacy received a six-month jail term for lying to federal officials when they were looking into a healthcare fraud conspiracy.
3. In a fraudulent telemarketing and medical supply scheme, a doctor entered a guilty plea.
4. A guy from Ohio who owned four pharmacies was found guilty of overcharging Medicaid and distributing a generic medication for gastroenterology without a prescription.
5. A California-based marketing firm owner was accused of participating in a fraud and kickback scam that cost Medicare over $10 million.
6. A contact center owner was accused of participating in a durable medical equipment kickback scam that cost Medicare $97 million, leading to his indictment on ten counts.
7. A New Jersey federal grand jury returned an amended indictment against a physician practicing in New York City for his alleged participation in multiple Medicare and Medicaid fraud schemes involving fraudulent claims totaling over $20.7 million.
8. A lab in Lexington, Kentucky, agreed to pay over $10.5 million to resolve claims that it overcharged Medicare and Medicaid for drug tests that were not medically required.
9. The medical director of many hospice businesses was found guilty of Medicare fraud totaling $2.8 million.
10. The owner of two telemedicine businesses was accused of a $110 million conspiracy involving medically inappropriate durable medical equipment, and he entered a guilty plea.