Committing Medicaid fraud is a severe crime that can impact the usage of public funds. This type of fraud can divert financial resources from vulnerable residents who rely on Medicaid for healthcare. Because of its significant impact on the community, authorities have...
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Medicare / Medicaid Fraud
Who suffers in Medicaid fraud incidents?
Fraud is a serious crime that could negatively impact innocent people's lives. It is also true for health care fraud involving funds used to cover the medical needs of unsuspecting citizens. The New York State Office of the Medicaid Inspector General (OMIG) considers...
Detroit health system to pay $29.7 million for kickbacks
VHS of Michigan Inc. (doing business as, The Detroit Medical Center Inc. (DMC)), Vanguard Health Systems Inc. (Vanguard), and Tenet Healthcare Corporation (Tenet) all agreed to pay a total of $29,744,065 to the federal government for providing kickbacks some referring...
Supreme Court overturns circuit court ruling of pharmacies billing Medicare and Medicaid
The Supreme Court Justices of the United States ruled 9-0 to throw out a 7th Circuit Court of Appeals ruling that said that pharmacies for Safeway and SuperValu cannot be held accountable for fraudulent drug billing. Whistleblowers are seeking monetary damages for a...
Bronx nursing home and staff to pay $3.46 million
A U.S. District Attorney for the Southern District of New York and Special Agent in Charge of the New York Regional Office of the U.S. Department of Health and Human Services announced that it settled a fraud lawsuit that alleges that Morris Park Nursing Home engaged...
Podiatrist sentenced for fraudulent Medicare billing
A federal judge sentenced a Michigan podiatrist to seven years in prison for orchestrating a scheme that fraudulently billed Medicare for nearly $2 million. He is also guilty of falsifying records and identity theft. The doctor operated a practice specializing in...
Justice Department launches fraud initiative tied to COVID-19 care
The Department of Justice announced a new coordinated enforcement action to fight COVID-19 healthcare fraud. The targets will include owners of medical businesses, medical professionals and others who attempted various schemes. The DOJ estimates that $490 million were...
2 doctors and others convicted in $31 million Medicare scheme
In January of 2023, Dr. Dean Zusmer and Dr. Lawrence Alexander, both of Miami, were convicted for being part of a scheme where they submitted $31 million in fraudulent claims. The doctors conspired with others to file claims for expensive but unnecessary medical...
A system of affiliated businesses exploit nursing home loophole
The pandemic was difficult for many, but some unscrupulous business owners used that time to their advantage. The Villages of Orleans Health & Rehabilitation Center (VOHRC) in western New York paid its landlord $16 million in rent. However, the landlord was also...
Biden administration targets Medicare Advantage fraud
Medicare watchdogs have been vocal about the insurance companies stealing billions from taxpayers through the emergent Medicare Advantage plan, which is the choice of half of all Medicare beneficiaries. These private plans offered by insurers have lower premiums than...
