Healthcare billing fraud: 11 recent cases

Andrew Cass –  Becker’s Hospital Review

From the conviction of a New Jersey physician for submitting more than $5.4 million in fraudulent claims to the indictment of a Mississippi man for his role in a $70 million Medicare fraud scheme, here are 11 healthcare billing fraud cases Becker’s reported since April 9:  

1. A New Jersey physician was convicted for submitting more than $5.4 million in fraudulent claims to Medicare as part of a telemarketing scheme.

2. Three owners of an independent laboratory were charged for their alleged roles in a $36 million fraud scheme.

3. The owner of a Houston-based mental health practice pleaded guilty to charges of conspiracy to commit healthcare fraud through false claims to Medicare and kickbacks.

4. The owner of a Pittsburgh-based healthcare facility was indicted on 33 charges of healthcare fraud, making false statements relating to healthcare matters and money laundering.

5. The owner of a Connecticut behavioral health practice was sentenced to 15 months in prison for billing Medicaid for thousands of services he and his staff were not licensed to provide.

6. The manager of medical clinics in New York City was resentenced to nine years in prison and ordered to pay $39 million in restitution for his role in a healthcare fraud scheme and tax avoidance conspiracy.

7. A Mississippi man faces up to 25 years in prison for his alleged role in a Medicare fraud scheme exceeding $70 million.

8. The owner and the medical director of a Kentucky pain clinic were sentenced for their roles in a $4 million urine drug testing fraud scheme.

9. A New Jersey cardiologist and practice owner pleaded guilty to a $1.9 million healthcare fraud scheme.

10. The owner of Holy Health Care Services, a Washington, D.C.-based mental health services provider, was sentenced to three years in prison for his role in a Medicaid fraud scheme.

11. A Peoria, Ariz., physician pleaded guilty to a healthcare fraud scheme that caused payers at least $3.7 million in losses.

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