A November 25 article in Part B News, “Third-party biller fraud may hook your practice, unless you protect yourself,” discussed the federal government’s recent fraud investigation of a medical biller in New York State and...more
The U.S. Attorney’s Office for the Southern District of New York announced on September 18 that cardiologist Klaus Peter Rentrop and his practice, Gramercy Cardiac Diagnostic Services, P.C., agreed to pay $6.5 million to...more
On August 18, the U.S. Department of Health and Human Services’ Office of Inspector General (OIG) published an Advisory Opinion warning that a common arrangement under which surgeons profit from referrals of their patients...more
We’ll wrap up this edition of Fraud Week with a look at two Connecticut behavioral health providers, one bad and one very, very bad. First, Alicia Thompkins, a social worker from Hartford, pleaded guilty on April 27 to...more
Here’s a selection of recent healthcare frauds from New Jersey. On April 17, John Sher of Margate was sentenced to 37 months in prison and ordered to pay $2.77 million in restitution and $327,987 in forfeiture for defrauding...more
Transportation fraud isn’t new, but it’s new to Rivkin Rounds. The U.S. Attorney’s Office for the Southern District of New York recently announced that Yonkers resident Julio Alvarado was sentenced to 95 months in prison for...more
To celebrate the opening of Rivkin Radler’s first Florida office, we’ll cover some recent Florida frauds. The U.S. Department of Justice (DOJ) announced on April 20 that two Miami residents, Dean Zusmer and Lawrence...more
The U.S. Department of Justice (DOJ) announced on April 20 that it has brought criminal charges against 18 defendants across the U.S. for various fraud schemes related to the COVID-19 pandemic. The DOJ seized more than $16...more
The U.S. Department of Justice (DOJ) announced on January 25 that 25 defendants have been indicted in Florida for their involvement in the sale of more than 7,600 fraudulent diplomas, and fake transcripts, from three...more
The U.S. Attorney for the District of Connecticut recently announced that Michael Lonski, a Greenwich psychologist, pleaded guilty to healthcare fraud. Lonski admitted to billing insurers for services that were not rendered,...more
The U.S. Attorney for the Eastern District of New York recently announced that Morris Barnard, a Great Neck gastroenterologist, was sentenced to 30 months in jail for billing Medicare for procedures he never performed....more
The U.S. Attorney’s Office for the District of Connecticut announced on November 3 that Ananthakumar Thillainathan, a physician with offices in Stratford and Milford, pleaded guilty to healthcare fraud and federal kickback...more
Federal and state enforcement activity involving pharmacy fraud tops the list of categories in this edition of Rivkin Rounds’ Fraud Week. We’ll list just a sampling of cases....more
10/28/2022
/ Anti-Kickback Statute ,
Bribery ,
Department of Justice (DOJ) ,
False Claims Act (FCA) ,
Healthcare ,
Healthcare Fraud ,
Kickbacks ,
Medicare ,
Pharmaceutical Industry ,
Pharmacy Benefit Manager (PBM) ,
Prescription Drugs ,
Price Inflation ,
Telemarketing
Home health-related fraud and dentists behaving badly (see this week’s earlier posts) have both been notable recent trends, but the U.S. Department of Justice (DOJ) has been even busier lately cracking down on fraud involving...more
The U.S. Department of Justice (DOJ) announced on October 18 that Oklahoma-based Carter Healthcare LLC and its affiliates, plus two executives, agreed to pay a total of over $30 million to resolve two separate qui tam cases....more
The U.S. Attorney for the District of New Jersey and New York Attorney General Letitia James both announced on October 6 that pediatric dentist Barry L. Jacobson, his management company, and 13 affiliated pediatric dentistry...more
If our most recent Fraud Week post (NY Chiropractor Billed for Non-Existent Acupuncture Services) didn’t already drive home the point, it is worth emphasizing that billing insurers for items or services that weren’t actually...more
8/26/2022
/ Bribery ,
Criminal Conspiracy ,
Department of Justice (DOJ) ,
Enforcement Actions ,
False Billing ,
Health Care Providers ,
Healthcare Fraud ,
Kickbacks ,
Medicare ,
Nurse Practitioners ,
Telemarketing ,
Wire Fraud
On August 15, the U.S. Department of Justice (DOJ) announced that a Long Island chiropractor pleaded guilty to healthcare fraud for billing a private insurance company over $1 million for acupuncture services that were never...more
On July 20, the U.S. Department of Health and Human Services’ Office of Inspector General (OIG) issued a Special Fraud Alert to caution healthcare practitioners who may wish to enter into arrangements with telehealth...more
7/27/2022
/ Coronavirus/COVID-19 ,
Department of Health and Human Services (HHS) ,
Department of Justice (DOJ) ,
False Billing ,
Health Care Providers ,
Healthcare Fraud ,
Kickbacks ,
OIG ,
Physicians ,
Telehealth ,
Unnecessary Medical Procedures
Please join us as Rivkin Radler Partner Eric D. Fader provides an overview of changes in the provision of telehealth services and federal and state regulation of them, since the beginning of the COVID-19 pandemic. New rules...more
10/27/2021
/ Continuing Legal Education ,
Coronavirus/COVID-19 ,
Data Privacy ,
Data Security ,
Health Care Providers ,
Healthcare Fraud ,
Medical Billing Codes ,
Medicare ,
New Rules ,
Out of Network Provider ,
Physicians ,
Telehealth ,
Telemedicine ,
Webinars
On September 17, the U.S. Department of Justice (DOJ) announced criminal charges against 138 defendants for alleged healthcare fraud schemes that resulted in $1.4 billion in losses. Those charged included 23 doctors, 19...more
On May 26, the U.S. Department of Justice (DOJ) announced criminal charges against 14 defendants in six states for participation in healthcare fraud schemes related to the COVID-19 pandemic. The coordinated takedown involved...more
5/27/2021
/ Coronavirus/COVID-19 ,
Department of Justice (DOJ) ,
False Billing ,
Fraud ,
Healthcare Fraud ,
Kickbacks ,
Laboratories ,
Medicare ,
Misappropriation ,
Pharmaceutical Industry ,
Provider Relief Fund ,
Telehealth
The U.S. Department of Justice (DOJ) announced on October 29 that Medtronic USA Inc. agreed to pay $8.1 million to settle allegations that it violated the False Claims Act (FCA) and federal Anti-Kickback Statute by paying...more
11/13/2020
/ Affordable Care Act ,
Anti-Kickback Statute ,
Centers for Medicare & Medicaid Services (CMS) ,
Civil Monetary Penalty ,
Department of Justice (DOJ) ,
Enforcement Actions ,
False Claims Act (FCA) ,
Health Care Providers ,
Healthcare Fraud ,
Medical Devices ,
Medicare
Teva Pharmaceuticals USA Inc. is in the crosshairs of the U.S. Department of Justice (DOJ) on two separate matters. On August 18, the DOJ announced that it filed a lawsuit against Teva and an affiliate, Teva Neuroscience...more
8/27/2020
/ Co-payments ,
Department of Health and Human Services (HHS) ,
Department of Justice (DOJ) ,
False Claims Act (FCA) ,
FBI ,
Healthcare Fraud ,
Kickbacks ,
Medicare ,
Pharmaceutical Industry ,
Prescription Drugs ,
Price-Fixing ,
Private Foundations ,
Settlement
The U.S. Department of Health and Human Services (HHS) and Department of Justice (DOJ) have released the 2019 annual report for their Health Care Fraud and Abuse Control Program. The government recovered almost $3.6 billion,...more
7/23/2020
/ Department of Health and Human Services (HHS) ,
Department of Justice (DOJ) ,
Electronic Medical Records ,
False Claims Act (FCA) ,
FBI ,
Fraud ,
Genetic Testing ,
Healthcare Fraud ,
Home Health Care ,
Medicaid ,
Medical Devices ,
Medicare ,
Prescription Drugs ,
Telehealth