The Nassau County District Attorney recently charged Joseph Golyan, a Great Neck gastroenterologist, with collecting Social Security and other government benefits over a four-year period, while simultaneously billing Medicare for care he was providing to Medicare beneficiaries. He allegedly collected over $100,000 in disability benefits, while billing Medicare over $700,000, during the relevant period. The
OIG Audit of MACs Finds Deficiencies
The 12 regional Medicare Administrative Contractors (MACs) were recently audited by the U.S. Department of Health and Human Services’ Office of Inspector General (OIG). Each of the MAC jurisdictions was found by the OIG to have failed to meet Medicare cost report oversight requirements in at least one year during the 2019-2021 fiscal years under
Lab Operator Convicted in Drug-Testing Scheme
Conspiracies to rip off the Medicare system are prevalent due to the vast amounts of money flowing through the program. On February 25, Sherif Khalil of Redondo Beach, California man was convicted by a federal jury in Detroit for stealing $4 million from the Medicare program.
Khalil conspired with others to generate orders for medically
Provider and Beneficiaries Conspired to Defraud Louisiana’s Medicaid Program
Healthcare fraud is prevalent within state Medicaid programs due to the massive amounts of money flowing through the system. In Louisiana, the Estate of Yolanda Burnom and her former company, Community Healthcare Solutions, LLC, recently agreed to pay $4.6 million to settle a False Claims Act lawsuit.
The allegations included providing incentives to Medicaid beneficiaries
Online DME Company Billed Insurers for Unnecessary Medical Supplies
DMERx, an online DME platform, served as the basis for a massive fraud against Medicare and other insurers. Gregory Schreck, a Kansas man who was the vice president of DMERx, orchestrated a sophisticated fraud scheme to bill Medicare and other insurers over $1 billion, resulting in payments of over $350 million. The scheme used DMERx’s
Drug Testing Lab to Pay $27 Million to Resolve FCA Claims
One of the nation’s largest urine drug testing laboratories recently settled with the federal government by paying $27 million to resolve alleged violations of the federal False Claims Act (FCA) and state statutes. Precision Toxicology (d/b/a Precision Diagnostics), headquartered in San Diego, allegedly provided medically unnecessary urine drug testing and offered free items to physicians
Know When to Bill Facility Fee for Telehealth Services!
The U.S. Attorney’s Office for the District of Connecticut recently announced that Supportive Care Holdings, LLC and its related companies agreed to pay the federal government nearly $4,600,000 to resolve allegations of submitting false claims. The Supportive Care companies provide behavioral health services via telehealth to patients residing in skilled nursing facilities.
Supportive Care’s companies
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
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
Mental Health Parity – After Years of Failure to Comply, Enforcement is Underway!
Regulators are now better armed to cite and fine health plans that are not complying with the Mental Health Parity and Addiction Equity Act (MHPAEA) of 2008. A recent report to Congress highlights the enforcement work to date and illustrates the extent to which many plans are noncompliant with the law. The result is that