Hospitals pay $20 million to settle allegations of false claims to Medicare, Medicaid and TRICARE and for unnecessary spinal surgeries

Sanford Health, Sanford Medical Center and the Sanford Clinic (collectively, Sanford)  have agreed to pay $20.25 million to resolve False Claims Act (FCA) allegations that they knowingly submitted false claims to federal health care programs, including Medicare, Medicaid and TRICARE, resulting from violations of the Anti-Kickback Statute and medically unnecessary spinal surgeries. The Anti-Kickback Statute […]

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Tenet Healthcare to pay $66 million to settle whistleblower suit asserting billing Medicare for docs who received kickbacks

Tenet Healthcare Corp. has agreed in principle to pay the federal government about $66 million to settle a whistleblower lawsuit alleging it billed public programs for medical services provided by physicians having improper financial relationships with a hospital partly owned by Tenet. Tenet disclosed the tentative settlement in its recent quarterly filing with the Securities and Exchange […]

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Owner of alcohol and drug rehab center pleads guilty to $48 million Medicaid fraud, operating a drug premises money laundering

Ryan Sheridan, former owner of Braking Point Recovery Centers in Austintown and Whitehall, pleaded guilty to a 60-count indictment. He and five associates were charged in February with conspiracy to commit health care fraud, health care fraud, use of a registration number issued to another to obtain a controlled substance, operating a drug premises, money […]

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Suburban youth counseling center owners indicted on fraud charges for allegedly defrauding Medicaid billing non-reimbursable services

SUMMER MATHESON and TERRENCE EWING, co-owners of Laynie Foundation Inc., and foundation employee RICHARD GRUNDY, have been indicted for fraudulently billed Illinois Medicaid for mental health services not provided. Matheson, Ewing and Grundy also used the Matteson-based foundation to seek payment from Illinois Medicaid for non-reimbursable activities, such as internal case reviews, staff training, clinical […]

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Mental health addiction counselor in Vermont charged with Medicaid fraud

A Vermont mental health addiction counselor Donald Skekel of Putney, has been charged with committing Medicaid fraud after he was allegedly reimbursed for counseling services he never provided. An affidavit from an investigator for the Vermont Attorney General’s Office, said Skekel billed Medicaid for more than 200 60-minute counseling sessions that never occurred between 2015 […]

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Doctor Indicted For Submitting Medicare and Medicaid Claims for Services Performed By Other Physicians

Dr. Antonio Reyes-Vizcarrondo was indicted for one count of conspiracy to commit health care fraud and one count of health care fraud following allegations that he submitted false claims to both Medicare and Medicaid. According to the Department of Justice, Reyes-Vizcarrondo submitted a total of 8,159 claims between 2008 and 2015, resulting in profits of nearly […]

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“Goodie Bag” Doctor Charged in $3.2 Million Healthcare Fraud Scheme Involving Distribution of Oxycodone

Andrew M. Berkowitz, M.D., is facing an indictment of 19 counts of healthcare fraud and 23 counts of distributing oxycodone outside of medical treatment following allegations that he provided each of his patients with a “goodie bag” of prescription drugs after each visit, despite their individual ailments. It is also alleged that Berkowitz fraudulently submitted […]

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Middlesex Rheumatology Physician Admits To Medicaid Fraud By Submitting False Claims Regarding Remicade Drug Use

Crispin Abarientos, M.D., of Middletown, Connecticut, pleaded guilty to one count of health care fraud in Hartford federal court. According to court statements, Abarientos was a physician that operated out of Middlesex Rheumatology and submitted false claims to Medicaid regarding the use of the drug Remicade on behalf of his patients. Remicade is primarily used to […]

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Acadia Healthcare Agrees to $17 Million Settlement Regarding Fraudulent Medicaid Claims

Following allegations of fraudulent Medicaid claims, Acadia Healthcare has agreed to pay a $17 million settlement, according to a recent press release by the Department of Justice. CRC Health operates its subsidiary, Acadia Healthcare, located in Tennessee with treatment centers in West Virginia. The treatment centers are certified to perform basic laboratory testing involving blood and […]

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