Medicare Fraud

In the United States, Medicare fraud is a general term that refers to an individual or corporation that seeks to collect Medicare health care reimbursement under false pretenses. There are many different types of Medicare fraud, all of which have the same goal: to collect money from the Medicare program illegitimately.The total amount of Medicare fraud is difficult to track, because not all fraud is detected and not all suspicious claims turn out to be fraudulent. According to the Office of Management and Budget, Medicare "improper payments" were $47.9 billion in 2010, but some of these payments later turned out to be valid.
Posts about Medicare Fraud
  • Prime Pediatrics Dalton GA (New Medicaid Fraud Investigation)

    … The Medicare fraud lawyers at MahanyLaw are investigating a report that Ayman Rifai M.D and Prime Pediatrics are violating Medicaid laws by improperly billing patients. Our investigation is in early stages and no conclusions have been reached. Medicaid is the insurer of last resort in Georgia. That translates to 894,000 low and middle income…

    Due Diligence- 20 readers -
  • Doc Injects Patients with Poison in Shocking Medicare Fraud Plot

    … Pinez, Jonathan Oliver, Giorgi Buleishvili and Eduard Zavalunov. In announcing the sentence, U.S. Attorney Preet Bharara said, “Victor Lipkin spearheaded a scheme that involved recruiting disadvantaged and homeless people to undergo expensive and unnecessary medical tests. Lipkin and his co-defendants submitted over $70 million in bogus claims…

    Due Diligence- 13 readers -
  • Florida Eye Clinic Accused of Medicare Fraud

    … declines prosecution and the case proceeds privately, the award is typically 30% of any recovery. Medicare Fraud and Whistleblower Awards As noted above, this case was filed under the False Claims Act. Qualified whistleblowers who file these claims may be entitled to awards. The Act also has anti-retaliation provisions for those who lose their job because…

    Due Diligence- 20 readers -
  • Fla Hospital Pays $12mm in False Claims Act Whistleblower Case

    … The South Miami Hospital has agreed to pay approximately $12 million to settle charges that it violated the federal False Claims Act. Prosecutors say the nonprofit hospital submitted claims to Medicare for medically unnecessary pacemaker surgeries and cardiac electrophysiology studies. The fraud was tied to a single physician, Dr. John Dylewski…

    Due Diligence- 21 readers -
  • Pharmacist Guilty in Scheme Involving Counterfeit Drugs

    … Walter Beich, a 63-year-old pharmacist from Illinois, pled guilty to a Medicaid and Medicare fraud scheme involving filling prescriptions with counterfeit drugs. According to court records, Beich pled guilty to healthcare fraud and aggravated identity theft. He was facing trial on twelve charges before changing his plea. Beich’s Medicare Fraud…

    Due Diligence- 15 readers -
  • Medicare Fraud to Murder? Man who Owed Money Murdered

    … Readers of this blog know that we have long claimed that Medicare fraud is not a victimless crime. Often patients are harmed, receive substandard care or receive treatments and drugs they do not need simply so some doctor or clinic operator can bill more money to Medicare. Obviously, these schemes also hurt taxpayers. Medicare and Medicaid…

    Due Diligence- 12 readers -
  • 10 FLA Assisted Living Facility Owners Charged with Medicare Fraud

    … a multimillion settlement. Unless you file a sealed lawsuit in federal court (state or federal court for state Medicaid fraud), you are not eligible to receive a large percentage award. These awards are reserved for those who report under the False Claims Act and file a qui tam lawsuit. Don’t be heartbroken or angry and learn you are only eligible to receive $1000! MahanyLaw – America’s Whistleblower Lawyers The post 10 FLA Assisted Living Facility Owners Charged with Medicare Fraud appeared first on Mahany Law. …

    Due Diligence- 16 readers -
  • Medicare Fraud Agency Turns 40… A Look Back

    … was transferred from the Health Care Finance Administration to the OIG’s Office of Investigations. Today the agency oversees almost $1 trillion in annual healthcare spending ($1,000,000,000,000.00). Of that spending, many believe that 10% or almost $100 billion is lost each year to fraud and waste. The HHS OIG claims that in fiscal year 2015, it saved…

    Due Diligence- 19 readers -
  • Medicaid Fraud Doc Accused of Harming Tots

    … habits in every way possible.” Schneider faces five years on each of the 11 counts. At age 78, he could certainly spend the rest of his life behind bars. (Federal Medicare fraud charges are punishable by 10 years in prison, double if a patient was harmed.) Florida Medicaid Fraud and Whistleblower Awards This case was initiated by concerned parents…

    Due Diligence- 25 readers -
  • Health Information Coder to Get $5 Million Award

    …, if the government uses your information, you could receive an award of between $15% and 30%. Here, that means Ms. Daniel will receive a check for at least $4,905,000.00. Not a bad paycheck for standing up to greed and fraud. In this case, Sylvia Daniel may have saved lives too! While some believe that Medicaid fraud is a victimless crime, it isn’t…

    Due Diligence- 10 readers -
  • Kwashiorkor, Upcoding, Medicare Fraud & Whistleblower Awards

    … that bills a 30 minute group session as if she performed a 60 minute intensive one-on-one session or a hospital that pushes doctors to admit patients with diseases they don’t have. Upcoding takes place thousands of times daily in the healthcare field throughout the United States. It is also against the law. Under the federal False Claims Act…

    Due Diligence- 20 readers -
  • Whistleblower Gets $500,000+ in Medicare Patient Referral Scheme

    … and take advantage of the elderly and disabled.” He also acknowledged that the scheme put patients at risk. Whistleblower Awards and Medicare Fraud A healthcare whistleblower reporting Medicare or Medi-Cal fraud is entitled to receive a percentage of whatever the government receives from the wrongdoer. To qualify for a whistleblower award, one…

    Due Diligence- 9 readers -
  • Medicare Fraud: Pharmacy Owner Obstructs Audit

    … with criminal obstruction of the audit. At his arraignment he entered into a plea agreement and pleaded guilty. As part of his plea agreement, Logan admitted that he profited over a million dollars by using non-FDA approved ingredients in his compounded products. When sentenced, Logan faces five years in prison. Sentencing has been set…

    Due Diligence- 25 readers -
  • Drobot Cooperating, Sentencing Delayed – Healthcare Fraud Post

    … It has been well over two years since we reported on this story and Michael Drobot remains a free man. He still has not been sentenced for his role in a massive healthcare fraud that involves allegations of performing spinal surgeries using defective hardware. Victims have been waiting for justice for years and will now have to wait longer…

    Due Diligence- 26 readers -
  • Whistleblower Receives $4.5 Million Award

    … clause with the hospital preventing him from practicing in the area. Feeling that LMC’s actions were illegal, Hammett filed a whistleblower lawsuit under the False Claims Act. Last month the federal government joined Hammett’s lawsuit. The case then settled with Lexington Medical Center agreeing to pay $17 million and enter into a corporate integrity…

    Due Diligence- 9 readers -
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