Federal Jury Convicts South Florida Doctors of Medicare Fraud

 

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

Two South Florida doctors, one Miami-area therapist, and two other individuals were convicted by a federal jury for their participation in a Medicare fraud scheme. The scheme allegedly involved more than $205 million in fraudulent billings by American Therapeutic Corporation (ATC), a corporation which provided mental health care services. The jury reached a decision on June 1, 2012. To see the Department of Justice press release, click here.

The two doctors and the therapist were each found guilty of one count of conspiracy to commit health care fraud. The other two individuals were each found guilty of one count of health care kickbacks. Sentencing has not yet been scheduled. The maximum penalty for each conspiracy count and each […]

South Florida Man Admits to a $42 Million Medicare Fraud Scheme

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

The owner and operator of a Miami home health care agency pleaded guilty for his part in a $42 million home health Medicare fraud scheme, according to the Department of Justice (DOJ), the FBI and the Department of Health and Human Services (DHHS). The 43 year-old man pleaded guilty before a U.S. district court judge to one count of conspiracy to commit health care fraud on August 2, 2012.

To see the entire press release from the Department of Justice (DOJ), click here.

First Part of the Fraud Operation Involved Kickbacks and Bribes.

The Miami man was the owner of a Florida home health agency that claimed to provide home health care and physical therapy services to eligible Medicare recipients.

In […]

Major Medicare Offender Sentenced to Prison for Multi-Million Dollar Health Care Fraud Scheme

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

The former owner of four mental health facilities in South Florida and North Carolina was sentenced to fourteen (14) years in federal prison on February 25, 2013. The former business owner pleaded guilty to defrauding Medicare out of tens of millions of dollars from 2004 through 2011, according to the Department of Justice (DOJ). He had previously been convicted of cocaine trafficking but decided to move to Medicare fraud supposedly because he thought it would be safer. In total the former mental health facility owner was indicted for defrauding the government of nearly $63 million. As part of his plea, he was ordered to repay $28 million.

Click here to read the press release from the DOJ.

Unnecessary Services, Illegal Kickbacks and Fake Mental Health Records.

The scheme, headed by the former business […]

Strike Force Busts 89 People, Mostly Health Care Professionals, in Nationwide Crackdown on Medicare Fraud

8 Indest-2008-5By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

In a nationwide takedown nearly 100 people, including doctors, nurses and other medical professionals, in eight cities were all allegedly charged in separate Medicare fraud schemes. These individual scams involved approximately $223 million in false billing, according to the Department of Justice (DOJ) and the Department of Health and Humans Services (DHHS). On May 14, 2013, more than 400 law enforcement officials with the Medicare Fraud Strike Force spread out between Miami, Detroit, Los Angeles, New York, New Orleans, Houston, Chicago and Tampa to make the arrests of these 89 people, according to the DOJ.

Click here to read the press release from the DOJ.

Medicare Schemes Could Not Have Happened Without the Help of Health Professionals.

According to an article in Reuters, one out […]

The Affordable Care Act Offers the Government New Tools to Fight Healthcare Fraud

By Catherine T. Hollis, J.D., The Health Law Firm

In 2013, the government reported recovery of a record-breaking $10.7 billion in healthcare fraud in the past three years, according to the U.S. Department of Health and Human Services (HHS) and the U.S. Department of Justice (DOJ). The HHS credits the Affordable Care Act’s tough stance on fraud for improving the efforts to fight Medicare fraud.

The increase in fraud recovery is attributed in part to the Act’s proactive approach to preventing fraud. The Act contains several initiatives that address Medicare fraud, resulting in increased fraud-fighting tools available to the government. The joint effort between the HHS, the DOJ and the Health Care Fraud Prevention and Enforcement Action Team has been a primary driving force in seeking out fraud and securing recoveries. The HHS and DOJ’s website highlights some of the Act’s “powerful steps” toward fighting fraud, waste and abuse. Click here to […]

Health Care Professionals and Providers Beware: The Health Care Fraud Prevention and Enforcement Action Team (HEAT) Is Catching Fire

8 Indest-2008-5By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

In May 2009, the Department of Health and Humans Services (HHS) and the Department of Justice (DOJ) created the Health Care Fraud Prevention and Enforcement Action Team (HEAT). HEAT’s mission is to focus its efforts on preventing and deterring fraud and to enforce current anti-fraud laws around the country. To date, almost 1,400 individuals have been charged in connection with schemes involving more than $4.8 billion in fraudulent billings in these HEAT takedown operations.

To learn more about HEAT, click here to visit the website.

The Success of the HEAT Team.

According to the website, between 2008 and 2011, HEAT actions led to a seventy-five percent (75%) increase in individuals charged with criminal health care fraud. So far there have been six nationwide HEAT sting operations.

In […]

Two South Florida Doctors Convicted of Fraudulently Billing American Therapeutic Corporation (ATC)

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

A federal jury convicted two South Florida doctors, one Miami-area therapist, and two other individuals for their participation in a Medicare fraud scheme. The scheme allegedly involved more than $205 million in fraudulent billings by American Therapeutic Corporation (ATC), a corporation which provided mental health care services. The jury reached a decision on June 1, 2012.


To see the Department of Justice press release, click here
.

The two doctors and the therapist were each found guilty of one count of conspiracy to commit health care fraud. The other two individuals were each found guilty of one count of health care kickbacks. Sentencing has not yet been scheduled. The maximum penalty for each conspiracy count and each count of health care fraud is ten years in prison plus […]

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