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 […]
CA Hospice’s Medicare Fraud: Inflating Patient Lifespans
When a program created to provide important end-of-life services is so often the victim of fraud, should we blame the broken system itself, or instead turn focus to those committing the fraudulent acts? It seems an easy question to answer, but describes the ongoing situation of hospice care – a system which regularly undergoes scrutiny […]
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 […]
Hospice Fraud’s Dire Impact on Late-Life Care Explained
In order to fully grasp the seriousness of Medicare fraud, primarily that pertaining to hospice care, it’s important to discuss the entire purpose for hospice: to provide end-of-life care for those deemed to be terminal. Once a patient is considered qualified for hospice, Medicare no longer provides curative medical care which would ordinarily treat or […]
Pennsylvania Hospice Defrauds Medicare By Preying on Elderly Patients
Six years after the initial complaint, a hospice provider was brought to justice after being found to have conspired to defraud Medicare of more than $9 million. In order to receive these fraudulent reimbursements, the hospice, Home Care Hospice, Inc. (HCH), accepted dozens of patients that did not qualify for Medicare benefits, falsifying documents as […]
Texas Home Health Agency Paid Patient Recruiters Illegal Kickbacks
After a nine-year conspiracy, a Houston-based home health agency has finally been brought to justice after defrauding Medicare for over $13 million. It was found that, between February 2006 and June 2015, the agency submitted falsified medical records and paid kickbacks to patient recruiters, physicians, and Medicare beneficiaries in order to bilk Medicare for services […]
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 […]
Nursing Home’s $125M Settlement in Therapy False Claims Act
The largest national nursing home therapy provider and its subsidiaries have agreed to pay $125 million to settle claims that it provided unreasonable and unnecessary services to patients in order to receive increased Medicare reimbursements, thus violating the False Claims Act. Kentucky-based RehabCare Group Inc. and its parent company, Kindred Healthcare Inc., were accused of […]
When Family Ties Lead to Corruption: A Story of Fraud
In a twisted example of “family bonding,” a mother-and-son team were found to have together violated the False Claims Act by submitting over $25.2 million in claims to Medicare over the course of six years, the majority of which were discovered to be fraudulent. From 2009 to 2015, the pair committed large-scale Medicare fraud through […]
Hospice Fraud: The Staggering Figures
From 2000 to 2011, Medicare has seen a 300% increase in hospice payments, a figure that has only grown since. The question remains – why is hospice so widely targeted when it comes to fraudulent schemes? Well, simply put, it seems an easy target. As evidenced by the amount of money Medicare shells out to […]
Alabama Physician Files Duplicate Claims for Maximum Reimbursement
A $1.4 million settlement ended a year-long suit which alleged that an Alabama physician repeatedly filed false claims to Medicaid, Medicare, and TRICARE, often for procedures that were medically unnecessary. James Crumb, the Mobile-based practitioner who specialized in Mobility Metabolism and Wellness, was found to have filed up to thirty identical false claims for a singular patient […]
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 […]
Texas Home Healthcare Groups Conspire in Major Medicare Fraud
In what is being called the “largest criminal health care fraud takedown in the history of the Department of Justice,” three separate home healthcare facilities were found to have been separately billing Medicare for the same services – which were oftentimes not provided or medically necessary – resulting in the government program paying over $40 […]
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 […]
First Settlement of Its Kind Holds Medical Facility Accountable for AKS Violation
The emergency transportation industry is well-known for being a hotbed of fraud, especially in cases involving shady alliances made with medical facilities; when it comes to settlements involving these schemes, allegations are generally brought against the ambulance companies themselves rather than their counterparts in the agreement – until now. In what is believed to be […]
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 […]