Medicare fraud

Wikimedia Commons

Nine Jacksonville-area hospitals and an ambulance service have agreed to pay the federal government about $7.5 million related to charges it improperly billed Medicare for transporting patients in non-emergency situations, the Florida Times-Union reports.

 

  A hospital and nursing home in Hollywood may be on the auction block soon as its owner and former CEO is in federal prison for Medicare fraud, the South Florida Business Journal reports. 

A Florida doctor charged with corruption alongside New Jersey Sen. Robert Menendez was sent back to jail for a second night Wednesday while his lawyers try to negotiate his bond over allegations of Medicare fraud.

A Jacksonville dermatology clinic accused of billing Medicare for cosmetic procedures that were not medically necessary has reached a settlement with federal investigators, the Florida Times-Union reports. 

The younger brother of a man accused of laundering $238 million in Medicare dollars from Florida to Cuba's banking system was sentenced to 3 1/2 years in federal prison on Wednesday, the Miami Herald reports.

Eduardo Perez de Morales was barely an adult when his brother recruited him into the scheme, but he admitted he continued with the partnership even after realizing it was illegal, the Herald reports. 

The Florida Bulldog says questions are being raised about the sale of a non-profit Miami-Dade nursing home undergoing a federal whistleblower investigation.

While the publication claims that last year’s sale of the 104-bed Plaza Health Network facility and adjoining properties netted $3 million for its owner and board chairman, the company disputes the 'misleading' allegations.

Wikimedia Commons

  Federal jurors continue to deliberate the fate of a South Florida psychiatrist  who prosecutors say defrauded Medicare by signing off on thousands of bogus medical treatments, the Miami Herald reports. 

Barry Kaplowitz approved fraudulent services for the Hollywood Pavilion outpatient facility even when he was out of the country, the Herald reports. The result was $6.5 million in false claims to Medicare.

Wikimedia Commons

A case of mistaken identity has forced a West Palm Beach doctor to temporarily close his doors.

Dr. Andre Celestin tells WPBF he has the same name as a dead New York surgeon who was convicted of Medicare fraud. The mix-up led some pharmacies to stop filling the doctor's prescriptions. Patients were told his license was suspended even though it's clear and active.

One of the pharmacies, CVS, said a third-party claims processor apparently confused the names in its system and is working to fix the error.

Wikimedia Commons

 A Pembroke Pines resident was sentenced Thursday to 17 years in prison stealing the identities of physicians and filing false claims to Medicare, the South Florida Business Journal reports.

The. U.S. Attorney’s Office in Miami said Alejandra Collazo forged prescriptions for services not ordered by physicians and accepted payments through her clinic, Vortex Medical Center & Management Services of Hialeah.

U.S. Department of Justice

A doctor who ran clinics in Boynton Beach and Delray Beach has been indicted on eight counts of fraud, the Palm Beach Post reports. 

Dr. Isaac Kojo Anakwah Thompson defrauded Medicare when he submitted fraudulent diagnoses to the Humana HMO network for Medicare Advantage beneficiaries and received $2.1 million in excess fees as a result of the scheme, according to the Post.

Wikimedia Commons

Some physicians are starting to warn their patients who winter in Florida that physicians may be ordering tests they don’t need, the New York Times reports. 

Medicare data show that some doctors in Florida have been ordering tests at twice the rate of doctors in Massachusetts, according to analysis by the Times

Broward Health

A prominent Fort Lauderdale cardiologist under investigation for Medicaid and Medicare fraud signed a new contract with Broward Health featuring a pay cut and a new agreement to treat poor patients, the Florida Bulldog reports. 

Med-Care Diabetic and Medical Supplies

 The Federal Bureau of Investigation raided a Boca Raton medical-supply company early Wednesday, the South Florida Sun Sentinel reports. 

The company, Med-Care Diabetes and Medical Supplies, Inc., was the subject of a 2013 U.S. Senate subcommittee hearing for possible Medicare fraud and has ties to Daniel Porush, a man who helped inspire a character depicted in the movie “The Wolf of Wall Street”.

One of the top Medicare billers in the country, Central Florida cardiologist Asad Qamar, is the target of two lawsuits accusing him of systematic Medicare fraud, including padding bills and performing unnecessary procedures.

The U.S. Department of Justice’s civil division has joined in the whistleblowers' cases on behalf of Medicare and Medicaid taxpayers.  The lawsuits, filed in 2011 and 2014, were kept secret while the DOJ investigated and debated whether to join them. 

The veteran business executive hired by Florida Healthcare Plus is trying to repair the image of the firm after six former employees were indicted for their role in an international, $25 million Medicare and Medicaid scam, the Miami Herald reports.

In an interview, Susan Rawlings Molina says no one else at the company knew about the fraud, except for the ex-employees who are now facing charges. Only the former workers, not the company, are accused of wrongdoing.

A Tampa man has been sentenced to 11 years in prison for his part in a $28.3 Medicare fraud scheme, the Tampa Bay Business Journal reports.  In his guilty plea, Luis Duluc admitted to using physical therapy clinics and other businesses to submit false claims to Medicare. He was also ordered to pay $14.4 million in restitution, according to the Business Journal. 

A whistleblower’s lawsuit by an ex-Plaza Health Network executive alleges that false claims were submitted to Medicare and Medicaid to the tune of $130 million, the Broward Bulldog reports.

Florida's insurance officials are recommending a state takeover and liquidation of Florida Healthcare Plus, a Medicare Advantage plan accused of submitting $25.2 million in phony bills to Medicare and Florida Medicaid.

 A former top executive at a South Florida health care company has pleaded guilty for his role in a nine-year, $67 million Medicare fraud scheme.

Christopher Gabel of Davie, former chief operating officer at Hollywood Pavilion LLC, pleaded guilty Tuesday to health care fraud conspiracy and conspiracy to defraud the U.S. government.

The director of a Miami home health care agency will serve 57 months in prison for his role in a $7 million Medicare fraud scheme, the Miami Herald reports.  A federal judge sentenced Armando Buchillon of Hialeah for fraudulently billing Medicare for procedures such as physical therapy that never were performed at his company, Anna Nursing Services Corp., the Herald reports.

tampalawfirm.com

WellCare Health Plans, which paid more than $400 million to settle past accusations of health-care fraud, is once again being sued under the False Claims Act.

The whistleblowers in this case are a half-dozen former WellCare staff members, including the former Vice President of Care Management Dr. Kirk Cianciolo. All are represented by Tampa attorney Kevin Darken, from the same firm that handled the previous whistleblower case against the Tampa-based WellCare.

University of Miami Miller School of Medicine

Behind the scenes at the University of Miami’s Bascom Palmer Eye Institute, two top physicians feuded so badly over just about everything that a "personality coach" was hired to try to soothe tensions. 

But as the Miami Herald reports, the two stars couldn’t coexist; and after one of the doctors left Bascom Palmer, he turned in the other over allegations of Medicare fraud.

Call it drugs for the departed: A quirky bureaucratic rule led Medicare's prescription drug program to pay for costly medications even after the patients were dead.

That head-scratching policy is now getting a second look.

A report released Friday by the Health and Human Services Department's inspector general said the Medicare rule allows payment for prescriptions filled up to 32 days after a patient's death — at odds with the program's basic principles, not to mention common sense.

A Lake Worth man has pleaded guilty for his role in making more than $12 million in fraudulent Medicare claims,  according to the Tampa Bay Business Journal

Gregory J. Sylvestri, the former principal of Bioscan, will be sentenced at a later date for the claims made between June of 2010 and April 2014.

College students studying whistleblower law heard a first-hand account from the woman who accused Halifax Health of Medicare fraud, the Daytona Beach-News Journal reports. 

For the first time, Elin Baklid-Kunz spoke publicly to Stetson University students about the whistleblower lawsuit that was settled earlier this year for $86 million, and earned $20.8 million for Baklid-Kunz and her attorneys.

Gov. Rick Scott’s leadership of the Columbia/HCA hospital chain is well known, as is the company’s record $1.7 billion fine for filing false claims for Medicare and other federal health programs.

But as he faces re-election, stories about a simultaneous investigation in the 1990s are emerging involving Scott and attempts to buy the then-publicly owned Tampa General Hospital, The Tampa Tribune reports.

The U.S. Department of Justice claims a company with a Florida connection paid spinal surgeons kickback fees for using its devices, the Miami Herald reports (paywall alert).

The co-owner of a Miami home health agency was sentenced to 70 months in prison for fraudulently providing therapy to Medicare recipients.

Between 2008 and 2014, Annarella Garcia’s Professional Medical Home Health received approximately $6.25 million in fraudulent Medicare claims, the U.S. Department of Justice announced Wednesday.

The last of about 40 defendants linked to a sprawling Medicare scam have been convicted in federal court, the Miami Herald reports.

A jury took just a few hours to find Roger Bergman, 65, and Rodolfo Santaya, 55, guilty for their involvement in the American Therapeutic Corp. scam that was first discovered in 2010, according to the Herald.

Pages