Department of Justice (DOJ) | The Health Law Firm Blog

Miami “Rock Doc” Arrested on Medicare Fraud Charges

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

An osteopathic physician in Miami, Florida, dubbed the “Rock Doc,” was arrested on September 30, 2013. He is charged with twelve (12) counts of health care fraud, according to the Department of Justice (DOJ). The “Rock Doc” is accused of falsely billing the Medicare program for physical therapy procedures, such as massages and electrical stimulation, which were not necessary. If convicted the doctor faces up to ten (10) years in prison and a $250,000 fine.

Click here to read the press release from the DOJ.

In 2010, this osteopathic physician was the feature of a Wall Street Journal article called “Confidentiality Cloaks Medicare Abuse.” The article looked into the billing practices of the “Rock Doc” and many other doctors performing […]

By The Health Law Firm|2024-03-14T10:00:52-04:00June 1, 2018|Categories: Health Care Industry, Medicare, Medicare Audit, Medicare Fraud, The Health Law Firm Blog|Tags: defense attorney, defense lawyer, Department of Justice (DOJ), doctor, false claims, florida health attorney, Florida health lawyer, health care fraud, Health Care Fraud Prevention and Enforcement Action Team (HEAT), health care fraud scheme, health care kickbacks, health law The Health Law Firm, M.D., medically necessary services, medicare, medicare audit, Medicare beneficiaries, Medicare fraud, Medicare fraud scheme, Miami Medicare fraud, Miami Medicare scheme, osteopathic physician, physical therapy fraud, physical therapy services, physician|Comments Off

Ohio Hospital Settles Whistleblower Case to Resolve False Claims Act Allegations

By Lance O. Leider, J.D., Attorney, The Health Law Firm

A group of doctors accused of performing an unusually high number of heart procedures on patients at an Ohio hospital has settled a whistleblower lawsuit, according to the Department of Justice (DOJ). The settlement agreement covers accusations that the doctors and the hospital billed Medicare for unnecessary cardiac procedures from 2001 to 2006.

Click here to read the press release from the DOJ.

The Ohio hospital agreed to pay the U.S. government $3.9 million, and the physician group agreed to pay $541,870 to settle the accusations.

Former Hospital Manager Speaks Up.

In October of 2006, the hospital’s former manager of the catheterization lab filed a whistleblower complaint. In the lawsuit the former employee said doctors at the Ohio hospital would allegedly encourage nurses […]

By The Health Law Firm|2024-03-14T10:00:43-04:00June 1, 2018|Categories: Health Care Industry, In the News, The Health Law Firm Blog, Whistleblower|Tags: Department of Justice (DOJ), false billing, false claims, false claims act, legal representation, medicare, medicare audit, Medicare false claims, Medicare fraud, qui taim, qui tam suits, unnecessary procedures, whistleblower, whistleblower attorney, whistleblower lawyers, whistleblower protection|Comments Off

Miami Medical Clinic Owner Pleads Guilty to $20 Million in Medicare Fraud

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

The owner of a Miami-based medical clinic pleaded guilty on January 8, 2014, for her involvement in several health care fraud schemes that allegedly cost the Medicare program around $20 million. The schemes allegedly involved fraudulent billing for home health care services and therapy prescriptions to patients that may not have required them, according to the Associated Press. The owner operated Merfi Corp., a medical clinic that employed physicians, physician assistants and other medical professionals authorized to dispense prescriptions for home health care services.

Click here to read the Associated Press article.

The medical clinic owner faces up to 10 years in prison and is scheduled to be sentenced in March 2014.

Medicare Fraud Scheme Involved Kickbacks and Brides.

According to an article on Home […]

By The Health Law Firm|2024-03-14T10:00:54-04:00June 1, 2018|Categories: Medicare, Medicare Audit, The Health Law Firm Blog|Tags: defense attorney, defense lawyer, Department of Justice (DOJ), false claims, Florida health care attorney, Florida health care lawyer, health care fraud, Health Care Fraud Prevention and Enforcement Action Team (HEAT), health care fraud scheme, health care kickbacks, health law, home health care company, kickbacks, medical clinic, medicare, medicare audit, Medicare beneficiaries, Medicare fraud, Medicare fraud scheme, Medicare Fraud Strike Task Force, patient recruiter, the health law firm|Comments Off

Medicare Put the Hospice Industry Under the Microscope

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

It’s no surprise to anyone that Medicare is cracking down on hospices around the country. According to a report by the Office of Inspector General (OIG), eighty-two percent (82%) of hospices’ claims did not meet Medicare coverage requirements. That is why Medicare is investigating the industry as a whole. Specific details on what Medicare is looking for can be found in the 2013 OIG Work Plan. Click here to read the 2013 OIG Work Plan.

So far, Medicare has kept true to its word. During the week of January 7, 2013, the federal government announced it is suing a Central Florida hospice for Medicare fraud, according to the Orlando Sentinel. (Click here to read the […]

Duke University Health System Pays $1 Million to Settle Allegations of False Claims in Whistleblower Lawsuit

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

On March 21, 2014, Duke University Health System in Raleigh, North Carolina, settled a whistleblower/qui tam lawsuit, according to the Department of Justice (DOJ). The lawsuit, filed in 2012, stated that the three-hospital academic medical center is alleged to have fraudulently inflated its Medicare bills by unbundling a number of cardiac services and billing for physician assistants’ (PAs) time illegally. Duke University Health System agreed to pay $1 million to resolve these allegations.

Click here to read the press release from the DOJ.

Duke University Health System Accused of Submitting False Claims to Federal Health Care Programs.

According to the complaint, the lawsuit was originally filed by a former health care bill coder and quality-control auditor for Duke’s revenue-cycle subsidiary, Duke Patient Revenue Management […]

By The Health Law Firm|2024-03-14T10:00:56-04:00June 1, 2018|Categories: False Claims Act, The Health Law Firm Blog, Whistleblower|Tags: billing for bundled claims, defense attorney, defense lawyer, Department of Justice (DOJ), Duke University Health System, false claims act, FCA, Florida Medicare, fraud defense, fraud prevention, fraud schemes, government health programs, health care fraud, health law firm, legal representation, medicaid, medicare, Medicare billing, Medicare fraud, North Caroline health care fraud, PA, physician assistant, physician assistant billing, qui tam, qui tam attorney, qui tam lawsuit, qui tam lawyer, the health law firm, TRICARE, unbundling, whistleblower, whistleblower lawsuit, whistleblower lawyer, whistleblower protection|Comments Off

Phony Florida Physician Uses Silicone and Krazy Glue – Arrested Twice for Practicing Medicine Without a License

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

A South Florida man was arrested on February 6, 2013, for allegedly injecting people with silicone in a West Palm Beach motel room. He has been charged with practicing medicine without a license. According to the Sun Sentinel, this was the man’s second arrest within two months for the same crime.

Click here to read the entire article from the Sun Sentinel.

This “Krazy” Tale.

Police say this fake physician injected his customers with buttocks-enhancing silicone injections. He would then allegedly seal up the skin wounds with Krazy Glue. Victims said he would not wear gloves or protective clothing during the procedures. Each victim was charged $200 for each visit. This phony health professional was also arrested in January 2013, when two victims told investigators similar […]

Kansas Cancer Treatment Center and Owner Pay $2.9 Million Settlement for Alleged False Claims Act Violations

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

A whistleblower or qui tam lawsuit against a cancer treatment facility in Kansas has been settled. On April 14, 2014, the Hope Cancer Institute and its owner agreed to pay $2.9 million to resolve allegations that they violated the False Claims Act by defrauding Medicare, Medicaid and the Federal Employee Health Benefits Program. According to the complaint, it is alleged that the cancer treatment facility submitted false claims for drugs and services that were not provided to beneficiaries.

Click here to read the entire whistleblower complaint filed in 2012.

The complaint identifies three former employees of Hope Cancer Institute as the plaintiffs or “relators” in this case.

Owner Allegedly Instructed Employees to Submit Inflated Claims and Altered Medical Records.

According to the Department of Justice (DOJ), […]

By The Health Law Firm|2024-03-14T10:00:56-04:00June 1, 2018|Categories: False Claims Act, Medicare, Medicare Audit, Medicare Fraud, Our Firm, qui tam, The Health Law Firm Blog, Whistleblower|Tags: defense attorney, defense lawyer, Department of Justice (DOJ), false claims act, FCA, Florida Medicare, fraud defense, fraud prevention, fraud schemes, government health programs, health law firm, Hope Cancer Institute, legal representation, medicare, medicare audit, Medicare fraud, Medicare overbilling, qui tam lawsuit, the health law firm, whistleblower, whistleblower lawsuit, whistleblower protection, whistleblower settlement|Comments Off

Florida Man Sentenced to Prison for Role in Florida Hospital Data Theft

By Lance O. Leider, J.D., The Health Law Firm

A Davenport, Florida, man was sentenced to four years in prison for paying off two Florida Hospital employees to illegally access patient records, according to the Department of Justice (DOJ). A judge sentenced Sergie Kusyakov on April 10, 2013. He was charged with conspiracy and wrongful disclosure of individual identifiable health information.

Click here to read the press release from the DOJ.

Ex-Employees Sold Patient Information to a Co-Conspirator.

Mr. Kusyakov’s sentence stems from a privacy breach at Florida Hospital back in October 2011. The breach involved thousands of patient records that were illegally accessed between 2009 and 2011. Apparently Mr. Kusyakov was paying hospital employee Dale Munroe and his wife to illegally access thousands of records of patients treated at multiple Florida Hospital locations. Mr. Munroe was sentenced in January 2013. […]

By The Health Law Firm|2024-03-14T10:00:47-04:00June 1, 2018|Categories: Health Care Industry, HIPAA, In the Know, In the News, The Health Law Firm Blog|Tags: audit attorneys, confidentiality of medical records, defense attorney, defense lawyer, Department of Justice (DOJ), Federal Bureau of Investigation (FBI), health care attorney, health care audits, health care lawyer, Health Insurance Portability and Accountability Act (HIPAA), HIPAA audits, HIPAA compliance, HIPAA Privacy Complaint, HIPAA Privacy Regulation, legal representation, medical records, patient records, privacy breach|Comments Off

Two Separate Lawsuits Against Novartis Pharmaceuticals Corporation Allege Illegal Kickbacks and False Claims

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

Novartis Pharmaceuticals Corporation (NPC) is currently fielding two different lawsuits, filed just days apart from each other, by the U.S. Department of Justice (DOJ). The first lawsuit was filed on April 23, 2013, alleging the company gave illegal kickbacks to pharmacists. A second lawsuit was filed on April 26, 2013, alleging illegal kickbacks were paid by NPC to health care providers. According to the DOJ, the government’s complaint seeks damages and civil penalties under the False Claims Act, and under the common law for paying kickbacks to doctors to induce them to prescribe NPC products that were reimbursed by federal health care programs.

Click here to read the entire press release from the DOJ.

NPC Accused of Treating Health Care Professionals to Expensive Dinners, Product Discounts […]

By The Health Law Firm|2024-03-14T10:00:48-04:00June 1, 2018|Categories: Health Care Industry, In the News, Medicare, Medicare Fraud, The Health Law Firm Blog, Whistleblower|Tags: anti-kickback statute, attorney's fees, CHAMPUS, defense attorney, defense lawyer, Department of Justice (DOJ), doctor, doctor kickbacks, false billing, false claims, false claims act, Florida health care attorney, Florida health care lawyer, health law, hospital, kickbacks, legal representation, medicaid, medicaid audit, Medicaid false claims, Medicaid fraud, medical group, medicare, medicare audit, Medicare false claims, Medicare fraud, Novartis Pharmaceuticals Corporation (NPC), pharmacist, pharmacy, physician, qui taim, qui tam relator, qui tam suits, the health law firm, TRICARE, unnecessary procedures, Veterans Administration, whistleblower, whistleblower attorney, whistleblower lawyer, whistleblower protection|Comments Off

Generic Drug Maker Ranbaxy Pleaded Guilty to Claims of Adulterated Drugs-Must Pay $500 Million Fine

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

Generic drug maker Ranbaxy USA Inc., pleaded guilty to drug safety violations and will be responsible for paying $500 million in criminal and civil fines, according to the Department of Justice (DOJ). The fines will resolve claims that the manufacturer sold inferior drugs and made false statements to the U.S. Food and Drug Administration (FDA) about manufacturing practices at two factories in India. This announcement was made by the DOJ on May 13, 2013. This settlement is the largest drug settlement to date involving a generic drug manufacturer and drug safety.

To read the entire press release from the DOJ, click here.

Ranbaxy USA Inc., is a subsidiary of Indian generic pharmaceutical manufacturer Ranbaxy Laboratories Limited. The entities listed in the settlement include: Ranbaxy, […]

By The Health Law Firm|2024-03-14T10:01:14-04:00May 15, 2018|Categories: Pharmacy, Pharmacy Law|Tags: adulterated drugs, Civil forfeiture, defense attorney, defense lawyer, Department of Justice (DOJ), false claims act, false statements, Florida Office of the Attorney General (AG), Food and Drug Administration (FDA), forfeiture, generic drug manufacturer, generic pharmaceutical manufacturer, Medicaid Fraud Control Unit (MFCU), pharmacist attorney, pharmacist lawyer, pharmacy attorney, pharmacy lawyer, Ranbaxy USA Inc., the health law firm, U.S. Food and Cosmetic Act|Comments Off