Fraud and Abuse

According to a September 28 report on News 12 Long Island, Hicksville dentist Suleman Nasimi and his Queens practice, Tooth Fresh Meadows, face felony charges arising from allegations that Medicaid paid more than $300,000 for dental services from January 2020 through August 2024 that were not provided. Prosecutors allege that the claims included more…

On October 15, Assistant Attorney General Colin M. McDonald issued a Memo announcing new coordination between the National Fraud Enforcement Division (NFED) and the U.S. Department of Health and Human Services Office of Inspector General (OIG) regarding self-disclosure in criminal health care fraud matters.[1]

The Memo notes that in the area of health care…

Earlier this month, an owner of Brooklyn-based Happy Family Social Adult Day Care Center, Inc., Family Social Adult Day Care Center, Inc. and Responsible Care Staffing, Inc., a home health care fiscal intermediary operating under the Consumer Directed Personal Assistance Program (CDPAP), pleaded guilty to defrauding Medicaid of approximately $65 million for social adult day…

On October 1, Assistant Attorney General Colin M. McDonald issued a memo on “Corporate Enforcement in the Fight Against Fraud” (the “Memo”), announcing an “all-tools approach to investigating and prosecuting our health care, government, tax, and trade fraud priorities.”[1] The Memo includes directives to ensure that the National Fraud Enforcement Division (NFED) “efficiently and…

The U.S. Department of Justice (DOJ) announced on September 24 that the Chief Operating Officer of Fast Lab Technologies, LLC pleaded guilty to conspiracy to commit healthcare fraud in connection with a nationwide COVID-19 billing scheme that resulted in more than $500 million in fraudulent claims.

According to DOJ, the New York-based laboratory company offered…

In August, Assistant Attorney General Colin McDonald issued a memorandum (the “Memo”) announcing the enforcement priorities of the National Fraud Enforcement Division (also known as NFED), which the U.S. Justice Department (DOJ) established in April of this year.[1]   

McDonald noted that NFED “has quickly established a nationwide footprint” since launching in April and…

An article in the September 17 issue of Part B News, “Medicare exclusions not just for OIG anymore: RFK Jr.,” discussed various types of possible disciplinary actions against Medicare providers. Rivkin Radler’s Chris Kutner was quoted in the article.

“I don’t think there’s a percentage of the population that really understands the…

Two Long Island ophthalmology practices have agreed to return $2.3 million in payments from state and federal government programs based on the ordering of unnecessary trans-cranial doppler ultrasounds (TCDs). The lawsuit brought by a whistleblower under the False Claims Act (FCA) against Mark D. Fromer, P.C., dba Fromer Eye Centers, and Floral Park Ophthalmology P.C.

With the New York Medicaid Program facing scrutiny by the U.S. Department of Health and Human Services (HHS) for a perceived lack of oversight and compliance integrity involving certain types of providers (including personal care and home health providers), the New York Department of Health (DOH) recently announced certain program administrative measures that seem designed…