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Florida Woman Faces Significant Consequences for Role in Healthcare Fraud Scheme

A woman from Indian Rocks Beach in Florida owes more than $20.3 million in restitution and could face up to 13 years in federal prison for her role in perpetrating a healthcare fraud scheme. Kelly Wolfe pleaded guilty to conspiracy to commit healthcare fraud and filing false tax returns. She will be sentenced later this Read More

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The Department of Justice Recovered $1.8 Billion in Healthcare Fraud Settlements and Judgments Last Year

A recent report from the Department of Justice (DOJ) indicates the department recovered $1.8 billion from healthcare fraud and false claims cases in the 2020 fiscal year. The cases that led to these recoveries involved many sectors of the healthcare industry, including medical devices, drug manufacturers, hospitals, pharmacies, managed care providers, physicians, hospice organizations and Read More

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Apria Healthcare Group Agrees to Settle Billing Fraud Case for $40.5 Million

Apria Healthcare Group, Inc. (Apria), a durable medical equipment provider that operates throughout the United States, recently agreed to settle a multistate billing fraud claim to the tune of $40.5 million. The lawsuit prompting the settlement alleged Apria routinely submitted false claims to federal health programs like Medicare and Medicaid to obtain reimbursement for non-invasive Read More

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Merit Medical Systems Agrees to Pay $18 Million to Resolve False Claims Act Violations

Merit Medical Systems recently agreed to pay $18 million to resolve claims that it violated the Anti-Kickback Statute and the False Claims Act in paying physicians and healthcare facilities to use their products. As part of the settlement, the organization does not admit any wrongdoing, but will pay out the money that will be split Read More

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Two Memphis Healthcare Facilities Named in Whistleblower Lawsuit

Methodist Healthcare and West Cancer Center, both located in Memphis, Tennessee, were recently named in a whistleblower lawsuit revolving around illegal kickbacks to doctors. Former Methodist University Hospital CEO Jeff Liebman and former Vice Chancellor for the University of Tennessee’s Health Science Center Dr. David Stern filed the whistleblower lawsuit, alleging the fraudulent scheme resulted Read More

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Hospital in West Virginia Reaches $50 Million Settlement in Whistleblower Case

Wheeling Hospital in West Virginia recently agreed to pay $50 million to the federal government to settle a whistleblower case alleging improper kickbacks and payments to doctors that were directed by hospital management. The settlement concluded a case that dates back to 2017, filed by former hospital executive vice president Louis Longo. Longo will receive Read More

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What Whistleblowers Should Know About HIPAA

Potential whistleblowers in a medical setting should be familiar with HIPAA and its implications if they are to establish a viable case that does not violate the rights of other people. It’s generally suggested that whistleblowers have documentary proof to boost their credibility in a case and to demonstrate you have information that can lead Read More

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COVID-19 Fraud Cases are Coming: What To Expect

Healthcare fraud costs American taxpayers billions of dollars every year. With the widespread coronavirus pandemic, it is expected that much of the fraud in 2020 will be related to the COVID-19 crisis. But what will COVID-19 fraud look like? What we’re already seeing This spring, the United States Department of Justice put out a press Read More

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Florida Healthcare Organization Faces Federal Whistleblower Lawsuit for Medicare Fraud Allegations

A former auditor for Lee Health alleges in a federal whistleblower lawsuit that the Florida hospital system routinely defrauded Medicaid and Medicare by inflating doctor’s bills to drive more referrals to its clinics and hospitals. The case specifically points to fraudulent incidents involving certain neurosurgeons, cardiologists, pulmonologists and a cancer doctor who received six- and Read More

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Epic Systems Accused of Healthcare Fraud in Whistleblower Lawsuit

A lawsuit filed against Epic Systems, a digital health care records company based in Verona, Wisconsin, alleges the company systematically overbilled the government for Medicare and Medicaid. The lawsuit was initially filed under the False Claims Act (FCA) in 2015 by Geraldine Petrowski, a former employee for a health care company in North Carolina. Under Read More

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