HHS Report to Congress on Progress of
Report to Congress Fraud Prevention System, Second Implementation Year, June 2014.
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Medicare Fraud Strike Force charges 90 individuals for approximately $260 million in false billing
Attorney General Eric Holder and Department of Health and Human Services (HHS) Secretary Kathleen Sebelius announced today that a nationwide takedown by Medicare Fraud Strike Force operations in six cities has resulted in charges against 90 individuals, including 27 doctors, nurses and other medical professionals, for their alleged participation in Medicare fraud schemes involving approximately $260 million in false billings.
Record-Breaking Recoveries Resulting From Joint HHS/DOJ Effort to Combat Health Care Fraud
Annual report shows that for every dollar spent on health care-related fraud and abuse investigations in the last three years, the government recovered $8.10.
Medicare Fraud strike force charges 89 individuals for approximately $223 million in false billing
Attorney General Eric Holder and HHS Secretary Kathleen Sebelius announce a nationwide takedown by Medicare Fraud Strike Force operations in eight cities.
HHS would increase rewards for reporting fraud to nearly $10 million
Health and Human Services Secretary Kathleen Sebelius today announced a proposed rule that would increase rewards paid to Medicare beneficiaries and others whose tips about suspected fraud lead to the successful recovery of funds to as high as $9.9 million.
October 22, 2014
Michigan - Founder of Detroit-Area Home Health Agencies Pleads Guilty to Health Care Fraud Conspiracy
Detroit, Michigan - The founder of three Detroit-area home health agencies pleaded guilty today in federal court for his role in a $22 million home health care fraud scheme.
October 22, 2014
Colorado - DaVita to Pay $350 Million to Resolve Allegations of Illegal Kickbacks
Denver, Colorado - DaVita Healthcare Partners, Inc., one of the leading providers of dialysis services in the United States, has agreed to pay $350 million to resolve claims that it violated the False Claims Act by paying kickbacks to induce the referral of patients to its dialysis clinics, the Justice Department announced today. DaVita is headquartered in Denver, Colorado and has dialysis clinics in 46 states and the District of Columbia.
October 21, 2014
Florida - Miami-Area Physician Assistant Sentenced to 15 Years in Prison for $200 Million Medicare Fraud Scheme
Miami, Florida - A Miami licensed physician assistant was sentenced today to serve 15 years in prison for participating in a Medicare fraud scheme involving approximately $200 million in fraudulent billings by American Therapeutic Corporation (ATC), a mental health company that was headquartered in Miami.
October 21, 2014
Maryland - Timonium Man Sentenced To 18 Months In Prison For Stealing More Than $680,000 From An NIH Research Grant
Baltimore, Maryland - Chief U.S. District Judge Catherine C. Blake sentenced Jason Dietz, age 34, of Timonium, Maryland, today to 18 months in prison, followed by three years of supervised release, for theft of funds from a federal program, in connection with the theft of $683,705 in grant money from the National Institute for Drug Abuse for research conducted at its facilities in Baltimore. Chief Judge Blake also ordered Dietz to pay restitution of $683,705.
October 20, 2014
Texas - President of Houston Hospital and Three Others Convicted in $158 Million Medicare Fraud Scheme
Houston, Texas - A federal jury in Houston today convicted the president of Riverside General Hospital (Riverside), his son, and two others for their participation in a $158 million Medicare fraud scheme involving false claims for mental health treatment. Ten defendants have now been convicted in connection with the Riverside fraud scheme.
October 10, 2014
Florida - Three Florida Residents Are Charged With Health Care Fraud, Money Laundering And Drug Trafficking
Miami, Florida - Three Miami residents have been charged in a superseding indictment with health care fraud violations stemming from a $23 million Medicare fraud scheme. Two of the defendants are also charged with drug trafficking for submitting fraudulent prescriptions for oxycodone and other drugs to pharmacies.
October 10, 2014
Deleware - Extendicare Health Services Inc. Agrees to Pay $38 Million to Settle False Claims Act Allegations Relating to the Provision of Substandard Nursing Care and Medically Unnecessary Rehabilitation Therapy
Extendicare Health Services Inc. (Extendicare) and its subsidiary Progressive Step Corporation (ProStep) have agreed to pay $38 million to the United States and eight states to resolve allegations that Extendicare billed Medicare and Medicaid for materially substandard nursing services that were so deficient that they were effectively worthless and billed Medicare for medically unreasonable and unnecessary rehabilitation therapy services, the Justice Department and the U.S. Department of Health and Human Services Office of Inspector General (HHS-OIG) jointly announced today. This resolution is the largest failure of care settlement with a chain-wide skilled nursing facility in the department's history.
October 8, 2014
Michigan - Michigan Home Health Agency Owner Pleads Guilty in $22 Million Medicare Fraud Conspiracy
Detroit, Michigan - A former owner and manager of two Detroit-area home health care agencies has pleaded guilty in federal court for his role in a $22 million Medicare fraud conspiracy.
October 2, 2014
Florida - South Florida Doctor And Other Professionals Charged With Health Care Fraud At Biscayne Milieu Health Center, Inc.
Miami, Florida - Wifredo A. Ferrer, United States Attorney for the Southern District of Florida, George L. Piro, Special Agent in Charge, Federal Bureau of Investigation (FBI), Miami Field Office, and Derrick Jackson, Acting Special Agent in Charge, U.S. Department of Health and Human Services, Office of Inspector General's (HHS-OIG), Miami Regional Office, announce that Salo Shapiro, 69, a medical doctor, of Broward County, Marlene Cesar, 63, a licensed nurse practitioner, of Allentown, Pennsylvania and former resident of Miami, and Sonia Gallimore, 73, a licensed mental health counselor, of Broward County, were indicted on charges of conspiracy to commit health care fraud, health care fraud, and false statements related to health care matters, in violation of Title 18, United States Code, Sections 1349, 1347, and 1035.
October 1, 2014
Michigan - Detroit-Area Operator of Adult Day Care Center, Two Home Health Care Company Owners Convicted in $29 Million Medicare Fraud Conspiracy
Detroit, Michigan - A federal jury in Detroit late yesterday convicted the operator of an adult day care center and two individuals who owned and operated a network of home health care companies for their participation in a $29 million Medicare fraud scheme.
September 26, 2014
Texas - Former Owner of Durable Medical Equipment Company Arrested in Health Care Fraud and Money Laundering Scheme
Houston, Texas - A Miami man was arrested today on health care fraud and money laundering charges in connection with an alleged $24 million scheme to defraud Medicare
September 25, 2014
Louisiana - Seven Defendants Indicted and Three Other Defendants Plead Guilty for Their Roles in $56 Million Medicare Fraud Scheme
New Orleans, Louisiana - A New Orleans grand jury today indicted seven defendants for their roles in a $56 million Medicare fraud scheme that operated in New Orleans and surrounding communities. Thirteen defendants have now been charged in this case, three of whom pleaded guilty to their conduct yesterday.
September 24, 2024
Pennsylvania - Shire Pharmaceuticals LLC to Pay $56.5 Million to Resolve False Claims Act Allegations Relating to Drug Marketing and Promotion Practices
Wayne, Pennsylvania - Pharmaceutical company Shire Pharmaceuticals LLC will pay $56.5 million to resolve civil allegations that it violated the False Claims Act as a result of its marketing and promotion of several drugs, the Justice Department announced today. Shire, located in Wayne, Pennsylvania, manufactures and sells pharmaceuticals, including Adderall XR, Vyvanse and Daytrana, which are approved for the treatment of attention deficit hyperactivity disorder (ADHD), and Pentasa and Lialda, which are approved for the treatment of mild to moderate active ulcerative colitis.
September 15, 2014
Maryland - Owner Of Alpha Diagnostics Indicted For $7.5 Million Health Care Fraud Scheme
Baltimore, Maryland - A federal grand jury has indicted the owner of Alpha Diagnostics, Rafael Chikvashvili, age 67, of Baltimore, Maryland, on health care fraud and other charges related to a scheme to defraud Medicare and Medicaid of more than $7.5 million. The indictment was returned on September 11, 2014, and unsealed today. Chikvashvili had an initial appearance today in U.S. District Court in Baltimore and was released under the supervision of U.S. Pretrial Services.
August 8, 2014
California - McKesson Corp. to Pay $18 Million to Resolve False Claims Allegations Related to Shipping Services Provided Under Centers for Disease Control Vaccine Distribution Contract
McKesson Corporation has agreed to pay $18 million to resolve allegations that it improperly set temperature monitors used in shipping vaccines under its contract with the Centers for Disease Control and Prevention, the Justice Department announced today. McKesson is a pharmaceutical distributor with corporate headquarters in San Francisco.
August 4, 2014
Tennessee - Community Health Systems Inc. to pay $98.15 Million to Resolve False Claims Act Allegations
The Justice Department announced today that Community Health Systems Inc. (CHS), the nation's largest operator of acute care hospitals, has agreed to pay $98.15 million to resolve multiple lawsuits alleging that the company knowingly billed government health care programs for inpatient services that should have been billed as outpatient or observation services. The settlement also resolves allegations that one of the company's affiliated hospitals, Laredo Medical Center, improperly billed the Medicare program for certain inpatient procedures and for services rendered to patients referred in violation of the Physician Self-Referral Law, commonly known as the Stark Law. CHS is based in Franklin, Tennessee, and has 206 affiliated hospitals in 29 states.
August 8, 2014
Texas – Pablo Piedra Perez was arrested in Texas after reentering the United States from Mexico
On April 11, 2014, Pablo Piedra Perez was sentenced to 2 years and 7 months in jail and ordered to pay $679,715 in restitution after pleading guilty to a charge of health care fraud. Perez was arrested in September 2013 in Texas after reentering the United States from Mexico.
June 3, 2014
Texas - Vivian Yusuf was arrested at Houston International Airport after arriving on a flight from Nigeria.
In March 2011, Yusuf was indicted on charges of conspiracy to commit health care fraud, health care fraud, and aggravated identity theft. Investigators believe that Yusuf and her co-conspirators billed Medicare for more than $3.4 million for durable medical equipment (DME) that was neither medically necessary nor prescribed by a physician.