Four individuals – a medical director, operator and two unlicensed practitioners – at a Texas medial clinic are now in custody on charges related to their alleged participation in a $32 million health care fraud scheme. The individuals allegedly submitted false and fraudulent claims to Medicare and Medicaid for services that were not provided as billed or were not provided by a licensed, qualified and enrolled provider. The medical director and operator allegedly misled patients and staff to believe that the two unlicensed practitioners were in fact licensed to practice medicine in Texas. To read the full DOJ press release, click here.
Oglethrope Inc. and its three Ohio entities have reached a $10.25 million settlement to resolve alleged violations of the False Claims Act for improperly providing free long-distance transportation to patients and for allegedly submitting false claims to Medicare. The settlement resolved allegations that Oglethorpe provided free long-distance van transportation to patients to induce them to seek treatment at their facilities in violation of the Anti-Kickback Statute. The Anti-Kickback Statute prohibits offering, paying soliciting or receiving payment to induce referrals of services covered by federal health care programs. The settlement resolves allegations brought by a whistleblower under the qui tam provision of the False Claims Act. To read the full story, click here.
The chief executive officer of a Michigan and Ohio-based group of pain clinics, Mashiyat Rashid, was sentenced to 15 years in prison for developing and approving a corporate policy to administer unnecessary back injections to patients in exchange for opioid prescriptions. According to the Department of Justice, this scheme resulted in the prescription of more than 6 million doses of medically unnecessary doses. In addition to the prison sentence, Rashid was also ordered to pay over $51 million in restitution to Medicare. Click here for the full article.
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