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Over 20 Years Standing Up For Whistleblowers In Nationwide Fraud Litigation
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...
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...
The Saratoga Center for Rehabilitation and Skilled Nursing Care had been on the radar of state and federal governments for some time. The nursing home in Ballston Spa, New York, was on a watch list for two years before closing in February 2021. The Department of...
The United States Supreme Court recently agreed to review two cases where the defendants were accused of knowingly making false claims or statements to the U.S. government. The defendants in separate cases U.S. ex rel. Schutte v. SuperValu, Inc. and U.S. ex rel....
Two co-owners of several New York area diagnostic testing facilities were sentenced on December 1 to three years in prison each for their roles in an $18.5 million healthcare fraud scheme. The two owners, who are married, paid kickbacks for referrals if the...
Two men face up to 20 years in prison after admitting that they created a Medicare fraud scheme during the pandemic. According to the Justice Department, Arkadiy Khaimov and Peter Khaim submitted millions of dollars in false Medicare claims and funneled $18 million...
Fraudulent billing continues to be a major issue throughout the healthcare industry. We have discussed various cases and settlements over time. A topic within this realm that seems to grow in importance is the risk adjustment fraud that occurs concerning the...
The pharmaceutical company Biogen Inc. out of Cambridge, Massachusetts, agreed to pay $900 million to settle allegations that the company caused false billing submissions to Medicare and Medicaid. The company was accused of paying illegal kickbacks to doctors who...
As technology for billing and tracking medical expenses has increased in ease and sophistication, challenges still exist for outsourcing companies in the business of billing. Patients have unprecedented access to their digital health records and can track health care...
In its semiannual report to Congress, the House of Human Services and Office of Inspector General (HHS-OIG) announced that its audits and investigations would likely yield about $3 billion in recoveries. The report covers 320 criminal enforcement actions between...