fraud

Adventist Health System has turned itself in for violating federal laws involving doctor referrals, the Orlando Business Journal reports.

The Altamonte Springs-based health care chain told the Department of Justice it violated the federal Stark Law that prohibits physician referrals to hospitals where there is already a financial relationship, according to bondholder documents obtained by the Business Journal.

A Marion County woman accused of defrauding Medicaid said in an affidavit she was caught up in living well and "got greedy," the Ocala Star-Banner reports.

Attorneys for WellCare Health Plans want the company’s convicted executives to pay $365 million in restitution, according to the Tampa Bay Times.

The documents, filed in federal court on April 16, say WellCare’s 2011 Medicaid fraud indictment was the result of the actions of a few company executives, and they should pay the penalty.

A Broward County man who paid HIV patients to help defraud Medicare has entered a plea deal in Tampa’s federal court, the Tampa Bay Times reports.

Halifax Health could be on the hook for $116 million to resolve part of a whistleblower lawsuit, the Daytona Beach News Journal reports.

(Update late Monday) Jurors prepared to be questioned in a Medicare fraud whistle-blower case Monday learned that Halifax Health has reached a partial settlement with the U.S. Department of Justice, the Daytona Beach News-Journal reports (paywall alert).

Federal officials are lengthening a temporary moratorium on new home health care agencies in Miami-Dade and Monroe counties, and have also included Broward County in the ban. As the Miami Herald reports, the six-month ban that starts today is an attempt to deter Medicare and Medicaid fraud. Federal health officials say Miami-Dade has the highest ratio of home health agencies to Medicare beneficiaries and has the biggest payments.

Ten retired members of the New York City Police and Fire Departments who now call South Florida home are charged with defrauding the Social Security system of tens of thousands of dollars.

The owner of a South Florida clinic has pleaded guilty to defrauding Medicare to the tune of almost $20 million, the Associated Press reports. Isabel Medina could face 10 years in prison for her role in several health schemes.

 

In a column in the Orlando Sentinel, Scott Maxwell shares his outrage over questionable profits in hospice care, especially since he has helped promote it over the years.

A Miami Beach doctor will stay in a federal detention center while he awaits trial for Medicare fraud, the Miami Herald reports. Dr. Christopher Gregory Wayne, known for his punk rock style and nicknamed the “Rock Doc” by patients, is charged with a dozen counts of Medicare fraud totaling $230. But the indictment alleges systematic abuse: he’s accused of billing for, on average, 500 physical therapy sessions a day in 2008. 

Dr. Christopher Gregory Wayne, called the “Rock Doc" and known by a signature punk-rock hairstyle, has been charged with 12 counts of Medicare fraud, The Miami Herald reports (paywall alert).

 

A Pembroke Pines chiropractor who was allowed to keep practicing after pleading guilty in the 1980s to defrauding insurance companies is in trouble again, the South Florida Sun-Sentinel reports. This time, David Hirschenson is accused of illegally chasing down accident victims to offer them medical services.

WSVN-TV/7 News

It doesn't pay to be too good at your job if you're an investigator for the state Department of Health, according to a report on WSVN-TV/7 News in Miami. An investigator and his supervisor, both of whom were said by outsiders to be good at finding illegal activity in the health professions, are no longer employed at DOH.

Federal health officials will enact strict moratoriums on certain types of Medicare and Medicaid providers in the Miami area, Medical Daily reports. The stronger bans start Tuesday, and will affect new home health providers looking to join the programs.

Tampa Bay Times

Jurors in the health-fraud trial of four WellCare executives are getting an unusual 10-day reprieve from deliberations, the Tampa Bay Times reports. The trial, heavy with insurance jargon, has gone on for almost three months; a couple of jurors have been moved to alternate status after they nodded off or were seen with their eyes closed.  

U.S. Attorney's Office

The latest haul of 33 arrests brings the total so far to 92 charged in Operation Sledgehammer, a joint state and federal investigation of staged car accidents that brought in $20 million, the South Florida Sun-Sentinel reports. 

El Nuevo Herald

The Medicare Fraud Strike Force arrested 34 people in Florida as part of a nationwide sweep.  

The Florida Department of Health has revoked the license of a 118-bed assisted living facility in Boynton Beach accused of numerous shortcomings, The Palm Beach Post reports.

The facility allegedly lost track of a resident who wandered away, failed to prevent a rape of one resident by another and had an office employee who committed Medicare fraud.

Ellen Weinstein / Broward Palm Beach New Times

Some of the Medicare fraud stories that come out of South Florida are pretty unbelievable, as the Broward Palm Beach New Times reports. There are plenty of people who exploit the Medicare system for quick, easy cash. Prosecutors are overwhelmed, and many guilty of Medicare fraud get little more than a slap on the wrist.  

 

Police say bus drivers were involved in a health-insurance scheme to defraud Miami-Dade County, the Miami Herald reports. The county employees let a pain clinic bill for 758 bogus treatments and 135 visits, police say.  

 

Scammers Find Fertile Ground In Health Law

Apr 22, 2013

One recent morning, Evelyne Lois Such was sitting at her kitchen table in Denver when the phone rang. Such, who's 86, didn't recognize the phone number or the deep voice on the other end of the line.

"He asked, 'Are you a senior?' and I said yes, and he said, 'Well, we are sending out all new Medicare cards, and I want to make sure I have all your statistics just correct,' " Such recalls.

Miami Herald

It may seem as though it’s always health-care-fraud week in Miami, but this week’s a lollapalooza. And all the alleged crimes involved mental-health clinics.

As the Miami Herald reports, the FBI captured Kathryn Abbate, who used to run the Miami Beach Community Health Center until auditors found $6.8 million in taxpayers’ money had been siphoned off.

Nearly a decade ago Dr. Alan Freedman of Tampa reported a kickback scheme involving a Venice dermatologist and a Tampa pathology lab; now his payday has come. As the U.S. Department of Justice says in a press release, Freedman’s share of the recovery adds up to $4 million.

The dermatologist, Steven J. Wasserman, settled the case with federal authorities by agreeing to pay more than $26 million.

Palm Beach Sheriff's Office

A judge added years to a mother’s prison sentence because she brought her five children with her when she was involved in staging auto accidents, the South Florida Sun-Sentinel reports. Prosecutors said the 43-year-old woman made the children lie to insurance companies and get medical care they didn’t need, according to the Sun-Sentinel.

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