Medicare fraud

Group Health Cooperative in Seattle, one of the United States' oldest and most respected nonprofit health insurance plans, is accused of bilking Medicare out of millions of dollars in a federal whistleblower case.

Dean Ernest had been living in a nursing home about a year when his son, John, got a call last winter asking if his father was experiencing back pain and would like a free orthotic brace.

The caller said he was with Medicare. John Ernest didn't believe him, said "no" to the brace and hung up. He didn't give out his father's Medicare number.

And yet, not just one, but 13 braces addressed to Dean arrived soon afterward at the younger Ernest's house in central Pennsylvania — none of which Dean Ernest wanted or needed.

Telemedicine scams on the rise

orthopedic back brace
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Federal authorities said Tuesday they've broken up a $1.2 billion Medicare scam that peddled unneeded orthopedic braces to hundreds of thousands of seniors via foreign call centers.

Opening Statements Set In $1B Florida Medicare Fraud Case

Feb 12, 2019
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Opening statements are set in the trial of a Florida health care executive accused of defrauding Medicare out of $1 billion, one of the biggest such cases in U.S. history. 

A prominent Florida eye doctor once accused of bribing Democratic Sen. Bob Menendez of New Jersey received a 17-year sentence Thursday for stealing $73 million from Medicare by persuading elderly patients to undergo excruciating tests and treatments they didn't need for diseases they didn't have.

New Jersey Senate

The federal corruption trial of U.S. Sen. Bob Menendez will begin as scheduled next month after a judge said he'd wait to rule on the Democrat's motion to dismiss the charges based on a 2016 Supreme Court ruling.

No Verdict Yet In Eye Doctor's Medicare Fraud Case

Apr 27, 2017
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A jury has failed to reach a verdict on the first day of deliberations in the Medicare fraud trial of a prominent Florida eye doctor who is accused separately of bribing a U.S. senator.

A company that runs pain clinics in northeast Florida will pay the federal government $7.4 million after an investigation found that it was fraudulently billing Medicare for unneeded patient drug tests.

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The trial on health care fraud charges has been delayed until spring for a prominent Florida eye doctor also linked to a corruption case against New Jersey Sen. Bob Menendez.

WMFE

A businessman accused of orchestrating a $1 billion Medicare and Medicaid fraud scheme in South Florida will be staying in jail until his trial.

The Justice Department calls it the largest criminal health care fraud case ever brought against individual suspects: Three people are accused of orchestrating a massive fraud involving a number of Miami-based health care providers.

The three facing charges are all from Florida's Miami-Dade County; they include Philip Esformes, 47, owner of more than 30 Miami-area nursing and assisted living facilities; hospital administrator Odette Barcha, 49; and physician assistant Arnaldo Carmouze, 56, the Justice Department says.

More than a year after being hit with multiple lawsuits alleging Medicare fraud, Ocala-based cardiologist Dr. Asad Qamar has filed for Chapter 11 bankruptcy, the Ocala Star-Banner reports.

Miami Doctor Gets 9 Years' Prison For $30M Medicare Fraud

Apr 21, 2016
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A Miami doctor has been sentenced to nine years in federal prison for his role in a $30 million Medicare fraud scheme.

Miami Medicare Fugitive Caught In Nicaragua

Apr 4, 2016
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A fugitive from Miami who has been on the run for almost 20 years is back in federal custody after he was arrested in Nicaragua.

Doctor Faces 10 years In Prison For Medicare Fraud

Mar 7, 2016
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A South Florida doctor accused of falsely diagnosing hundreds of patients as part of a Medicare fraud scheme has pleaded guilty.

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As a nationwide investigation of hundreds of hospitals by the U.S. Department of Justice wraps up, two more South Florida hospitals are among those settling False Claims Act charges.

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The former operator of three Miami home health care agencies is facing up to 25 years behind bars for a fraud scheme that sought to bilk Medicare out of $57 million.

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Federal prosecutors say the nation's largest nursing home rehabilitation therapy provider has agreed to pay $125 million to resolve a lawsuit that alleged it knowingly had nursing homes submit false Medicare claims.

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Seven hospitals in Florida have agreed to pay the federal government about $9 million to settle allegations they submitted false claims to Medicare for a minimally-invasive procedure commonly used to treat spinal fractures from osteoporosis, a news release from the U.S. Department of Justice says.

A Fort Myers-based integrated cancer care services provider accused of billing for tests that were not needed will pay nearly $20 million to the federal government to settle allegations from a whistleblower that it violated the False Claims Act, according to a news release from the U.S. Department of Justice.

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A Miami doctor is facing two federal fraud conspiracy charges for his alleged role in a $20 million Medicare fraud scheme run by a health care company.

New Jersey Senate

U.S. Sen. Bob Menendez has renewed his attack on the federal government's corruption case against him and a Florida eye doctor in court filings that accuse prosecutors of ginning up the 22-count indictment out of a "fixation on sex and salacious headlines."

Doctor In Menendez Case Seeks Bail Changes

Aug 25, 2015

A Florida eye doctor linked to New Jersey Sen. Bob Menendez in a corruption case is seeking changes in his bond conditions in an unrelated Medicare fraud prosecution.

Broward Health

North Broward Hospital District's Broward Health has offered nearly $70 million to settle allegations the taxpayer-supported health district committed Medicare and Medicaid fraud, the Florida Bulldog reports.

Psssst — Need a phony ID? A fraudulent tax refund? Insurance money from a sham car crash? Florida may have just what you're looking for.

Since the first settlers hacked their way into the mangrove tangles and drained much of the swampland, sunny South Florida has been virtually synonymous with shady deals and scams.

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Under a plea deal with the U.S. Department of Justice, a Miami pharmacist has pleaded guilty to one count of health care fraud for his role in submitting more than $1.8 million in false claims to Medicare, according to a news release from the DOJ. Evelio Fernandez Penaranda, the owner of  Naranja Pharmacy Inc., admitted to submitting claims for Medicare beneficiaries and doctors without their consent.

Fraud and abuse continue to dog Medicare's popular prescription drug program, despite a bevy of initiatives launched to prevent them, according to two new reports by the inspector general of Health and Human Services.

Their release follows the arrests of 44 pharmacy owners, doctors and others, who last week were accused of bilking the program, known as Part D.

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Covenant Hospice Inc., a non-profit hospice care provider in Southern Alabama and Northwest Florida, will pay more than $10.1 million to the government for overbilling of Medicare, Tricare and Medicaid for hospice services, the Northwest Florida Daily News reports.

Every health care provider at the Ocala cardiology practice run by Dr. Asad Qamar is unable to receive payments from Medicare as federal officials continue their fraud investigation, according to court documents reviewed by the Ocala Star-Banner.

Qamar -- the second-highest doctor paid by the federal program in 2012 -- was sued by the federal government in January for fraud charges including overbilling and performing uneccessary procedures.

 

FL Doc Tied to Senator Could Be Released

Jun 8, 2015

A Florida doctor charged with corruption alongside New Jersey Sen. Bob Menendez appears to be nearing release from prison.

Dr. Salomon Melgen is due to appear before a federal judge Monday afternoon in West Palm Beach for a bond hearing. He's been behind bars for seven weeks.

Though a judge sided with prosecutors last month in keeping Melgen held, a second judge ruled Friday he could be released pending trial.

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