From a Virginia mental health executive charged in a $49 million Medicaid fraud case to a Chicago man sentenced to 20 years in prison for his role in a $365 million Medicare telehealth scheme, here are 10 healthcare billing fraud cases that Becker’s has reported on since Oct. 15:
1. The co-owner and COO of Advancing Communities Everywhere, a mental health provider in the Richmond, Va., area, was arrested on federal charges alleging the company billed Virginia Medicaid more than $49 million for crisis services it did not deliver as billed.
2. A federal jury convicted a Gainesville, Fla., woman who owned one durable medical equipment company and managed several others for her role in an $8.6 million Medicare fraud scheme involving medically unnecessary orthotic braces.
3. A Chicago man was sentenced to 20 years in federal prison for his role in a Medicare telehealth and durable medical equipment fraud scheme that caused more than $365 million in false claims.
4. A Texas physician and a retired U.S. Postal Service employee were charged in an alleged scheme to bill a federal workers’ compensation program about $19 million for orthopedic equipment and services that patients didn’t need or never received.
5. The owner of telemedicine company TelevisitMD was sentenced to 20 years in prison for leading a $46.2 million Medicare fraud conspiracy that ran for more than six years.
6. The Justice Department charged 15 defendants, including six medical professionals, in a series of alleged healthcare fraud schemes involving about $2 billion in fraudulent claims to government and commercial payers combined.
7. A Columbus, Ohio, physician and his clinic’s office manager pleaded guilty in a scheme that defrauded Medicaid of more than $1.6 million.
8. A New Orleans man was ordered to pay more than $7 million in restitution for his role in a genetic testing fraud scheme that billed Medicare more than $174 million.
9. Negril, a mental health and disability care company, and its owners agreed to a $1.8 million civil settlement over allegations of improperly billing Virginia Medicaid for mental health services.
10. A former New Hampshire physiatrist and onetime hospital chief medical officer was sentenced to 12 months and a day in federal prison for signing hundreds of medically unnecessary orders for braces without ever examining patients.
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