When Greed Goes Too Far: As Hospice Fraud Skyrockets, Death Toll Rises

A large-scale fraud scheme uncovered earlier this year sheds light on just how vile healthcare administrators can be in their pursuit of financial gain. Novus and Optim Health Services, a hospice provider based in Texas, were found to have submitted over $60 million in false claims to both Medicare and Medicaid – a scheme that […]

It Only Takes One Bad Egg to Spoil the Whole Basket

Hospice care was contrived out of the desire to create a model for end-of-life quality, and generally speaking, hospice facilities provide such care without issue. To do so, these facilities generally encompass a team-oriented approach, with focuses on pain management, emotional support, and spiritual devotion – all of which are expertly tailored to the needs […]

Georgia Hospital Settles Ambulance Fraud Case

The most common types of ambulance fraud are upcoming the billing of Medicare or Medicaid at inflated rates, or for rides that are not medically necessary. This was the case in the recent settlement involving Navicent Health Inc., a healthcare facility that operates the second-largest hospital in Georgia, as well as their own line of […]

Pharma Monster Mylan Dodges Medicaid, Violates False Claims Act

Pill bottle and caduceus symbol

In August of 2017, the massive pharmaceutical conglomerate Mylan underwent allegations that they deliberately violated the False Claims Act in order to avoid paying Medicaid rebates, resulting in a $465 million settlement. According to the Department of Justice, the company misclassified their pioneer drug, EpiPen, as a generic in order to avoid paying appropriate Medicaid […]

Brooklyn Clinic “Employs” Homeless in $70M Medicare Fraud Scheme

As if Medicaid fraud didn’t already victimize the nation’s most needy and impoverished individuals as it is, the now-former owner of a Brooklyn-based healthcare clinic figured out how to further abuse these individuals in the pursuit of lining his own pockets. Over the course of nine years, Victor Lipkin and eight others would recruit and […]

Subacute Nursing Home Provides Substandard Care

A small-town nursing home in New Jersey recently agreed to pay a sum of $888,000 to resolve allegations that they had provided substandard or “worthless” care to patients over the course of a two-year Medicaid fraud scheme. From July 2010 to December 2012, Andover Subacute and Rehab Center Services Two Inc. billed New York Medicaid […]

Texas Doctor’s $400M Medicare Fraud Scheme Uncovered

In an exceptionally heinous example of home healthcare fraud, seven doctors have been apprehended for their roles in a conspiracy to defraud both Medicare and Medicaid alike. Altogether, they have been ordered to pay over $342 million in restitution to recover the money bilked by the extensive false claims submitted over the course of the […]

Texas Company’s Blatant Fraud: The $51,952 Ambulance Ride That Wasn’t

A team of brothers based out of Houston, Texas were recently found to have committed multiple counts of fraud by using their healthcare company to submit over $6 million in false claims to Medicare, Medicaid, and TRICARE. The pair billed the three government programs for services that were not provided, utilizing fraudulent certifications from physicians […]

Healthcare Giant’s Fraud Settlement Marks a Dubious Record

Even fifteen years after their colossal 2002 payout, which is still recognized as the largest fraud settlement in United States history, Hospital Corporation of America (HCA) remains a frequent topic of discussion at the Department of Justice. Surely, it’s not hard to see why; HCA owns and operates 162 hospitals and 113 surgery facilities, the […]

Massachusetts Home Health Facilities Pay Out $14M for False Claims

 A multi-facility home healthcare chain has reached a $14 million settlement to resolve claims which assert their role in a large-scale scheme to defraud MassHealth, Massachusetts’s Medicaid program. From 2010 to 2016, Centrus Premium Home Care Inc. was found to have submitted an array of improper claims regarding medically unnecessary services that are not covered […]