A New York acupuncturist recently admitted to billing Amtrak’s health care benefit plan for services that were never provided and were medically unnecessary. From January 2019 through June 2022, Punson Figueroa of Long Island City, New York paid Amtrak employees hundreds of thousands of dollars in cash kickbacks in order to use their personal and
Litigation
NYC Man Pleads Guilty in $3.5 Million COVID-19 Kickback Scheme
On February 26, David Weathers of the Bronx pleaded guilty in federal court in New Jersey for his role in a COVID-19 kickback conspiracy. The government had charged Weathers with soliciting kickbacks in return for referrals of COVID-19 test samples, in violation of the federal Anti-Kickback Statute (AKS).
At the other end of the scheme…
CA Pharmaceutical Company Settles AKS and FCA Claims in NJ
The U.S. Attorney’s Office for the District of New Jersey recently announced a $750,000 settlement with Sentynl Therapeutics Inc., a California-based specialty pharmaceutical company. The settlement resolved allegations that Sentynl improperly provided kickbacks to a physician to induce prescriptions of its opioid products in violation of the federal Anti-Kickback Statute (AKS).
The Government alleged that…
Warning: Minor Errors Can Mean Big Takebacks for AWV Claims
A March 11 article in Part B News, “Warning: Minor Errors Can Mean Big Takebacks for AWV Claims,” discussed how compliance shortcomings can cause problems for claims to Medicare for annual wellness visits (AWVs). Rivkin Radler’s Mary Aperance was quoted in the article.
“Routine internal audits should be conducted to hone in…
NY Nursing Home Settles Fraud Suit
On March 4, the New York Attorney General announced an $8.6 million settlement with Fulton Commons Care Center, a nursing home located in East Meadow, NY. The settlement resolves an action brought against Fulton in 2022 claiming financial fraud, physical abuse, mistreatment of residents, and covering up resident complaints.
The AG had previously sued the…
Montefiore Medical Center Settles HIPAA Breach for $4.75 Million
On February 6, the U.S. Department of Health and Human Services (HHS) announced a $4.75 million settlement with Montefiore Medical Center (MMC) for a breach of unsecured electronic protected health information (ePHI). The settlement stems from an internal investigation that found that an employee of the New York hospital system sold patient information to an…
NY Man Jailed for 12 years for $600 Million Healthcare Fraud
A Long Island man who impersonated the general counsel of the NFL and an NBA player as part of his scheme for multiple frauds will now serve jail time. Sentenced in federal court in Central Islip, Matthew James used physicians throughout the country to bill health insurers fraudulently to the tune of hundreds of millions…
CT Psychologists Convicted for Medicaid Fraud
On December 19, Michael Lonski, a Greenwich psychologist, was sentenced to a 27-month prison term and three more years of supervised release for a scheme to defraud Medicaid. Lonski submitted over 80,000 claims from 2014 to 2019, and in calendar year 2017 he submitted claims for services on all but one day—including holidays and weekends.
NJ Hospital and Investors to Pay $30.6 Million to Settle FCA Claims
The U.S. Department of Justice recently announced that Silver Lake Hospital, a long-term care hospital in Newark, New Jersey, and some of its investors agreed to pay $30.6 million to settle claims that they violated the False Claims Act (FCA) and the Federal Debt Collection Procedures Act (FDCPA). The hospital allegedly overbilled Medicare by claiming…
Health Network Pays $345 Million for Compensating Physicians Above FMV
Community Health Network, Inc., based in Indianapolis, Indiana, has paid $345 million to settle alleged violations of the False Claims Act (FCA). The lawsuit was initiated through a whistleblower complaint that was filed in 2014 by the network’s former Chief Financial Officer. The suit alleged that, between 2008 and 2009, the network recruited hundreds of…