Healthcare Fraud

  • Texas Doctor Bilks Medicare for Nearly $400 Million in Large-Scale Fraud, Forgery Scheme

    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-Based Home Healthcare Facilities Work Together to Defraud Medicare

     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 […]

  • 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 […]

  • 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 […]

  • 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 […]

  • 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 […]

  • Kickbacks Prove That Sharing Is Not Always Caring

    A $42 million settlement marks the end of a four-year investigation which alleged that PAMC Ltd. And Pacific Alliance Medical Center, Inc. together submitted false claims to both the federal government and the State of California and consequently used the reimbursements to violate the Anti-Kickback Statue and Stark Laws. The settlement will be split between […]

  • 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 […]

  • Nation’s Largest Nursing Home Therapy Provider Pays $125 Million False Claims Act Settlement

     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 […]