Seven Individuals Charged in Florida Healthcare Fraud Schemes

Fraud and Compliance Update

10/4/2019 (AHLA)U.S. Attorney for the Middle District of Florida Maria Chapa Lopez announced charges against seven individuals for their alleged involvement in schemes to defraud Medicare, Medicaid, and other federal health care benefit programs, and in conspiracies to illicitly obtain and distribute oxycodone and other controlled substances.

According to a press release, Marcus Anderson was charged in a 13-count indictment with health care fraud and aggravated identity theft for stealing providers’ identities to submit more than $1.2 million in false and fraudulent claims to Medicaid.

Teresa Johnson, who owned and operated Tri-County Medical Billing, was charged with conspiracy to commit health care fraud for allegedly submitting fraudulent claims to Medicare, Medicaid, Tricare, and ChampVA, on behalf of a medical doctor who owned several clinics in Florida.

In addition, Hong Truong, Jessica Evans, Lucretia Mullan, Robin Lloyd, and Patrice Jackson were charged in separate indictments with conspiracy to unlawfully distribute and dispense Schedule II controlled substances, among other charges.

Charges contained in the indictments are allegations only; all defendants are presumed innocent until proven guilty in court.

Coordinated Enforcement Action Ensnares 48 Defendants Across Northeast

Fraud and Compliance Update

10/4/2019 (AHLA)

The Department of Justice (DOJ) announced that coordinated health care fraud enforcement action across seven federal districts in the Northeastern United States, involving more than $800 million in loss and the distribution of over 3.25 million opioids through “pill mill” clinics, resulted in new charges against 48 defendants.
Defendants include 15 doctors or medical professionals and 24 who were charged for their roles in diverting opioids, DOJ said.
According to DOJ, the enforcement action also includes the guilty pleas of three previously charged corporate executives, including the Vice President of Marketing of numerous telemedicine companies and two owners of approximately 25 durable medical equipment companies, for their roles in causing the submission of over $600 million in fraudulent claims to Medicare. 
The charges and guilty pleas reflect targeted enforcement of corporate health care fraud involving fraudulent telemedicine companies; the solicitation of illegal kickbacks and bribes from health care suppliers in exchange for the referral of Medicare beneficiaries for medically unnecessary durable medical equipment and other testing; and of individuals contributing to the opioid epidemic, including medical professionals involved in the unlawful distribution of opioids and other prescription narcotics, DOJ said.
Charges contained in indictments are allegations only; all defendants are presumed innocent until proven guilty.

Midwest Strike Force Action Nets Charges Against 53 for Alleged $250 Million in Medicare, Medicaid Fraud

Fraud and Compliance Update

10/4/2019 (AHLA)
Health care fraud and enforcement efforts in Detroit, Chicago, and Minnesota resulted in charges against 53 individuals for their alleged roles in schemes to defraud Medicare and Medicaid by billing for procedures that were medically unnecessary or not provided and for prescription medications that were never purchased or distributed, the Department of Justice (DOJ) announced September 27.

In the Eastern District of Michigan, 20 individuals are facing charges for their alleged involvement in schemes that resulted in $144.8 million in fraudulent Medicare billings, prosecutors said in a press release. In the Northern District of Illinois, 12 individuals were charged in alleged bids to defraud Medicare of more than $103 billion. Seven of the those charged in the two federal districts were doctors or medical professionals.

Also, in Minnesota, 21 defendants, including two medical professionals, were charged with defrauding Medicaid of nearly $3 million.

“Today’s action in the Midwest are further proof of the Department’s steadfast commitment to investigating and prosecuting those who put their personal greed above the public good,” said Assistant Attorney General Brian A. Benczkowski of DOJ’s Criminal Division.

The indictments include allegations only. Defendants are presumed innocent until proven guilty in court.

Maine Ambulance Company Settles Allegations of Fraudulent Billing for Nonemergency Transports

Fraud and Compliance Update

10/4/2019 (AHLA)
U.S. Attorney for the District of Maine Halsey B. Frank announced that Meridian Mobile Health, LLC, doing business as Capital Ambulance, agreed to pay $138,285 to resolve allegation it violated the False Claims Act by billing for medically unnecessary nonemergency ambulance transportation.

According to a press release, the government alleged that from October 2016 through February 2018, Capital improperly billed Medicare for transporting patients discharged from Eastern Maine Medical Center (EMMC) who were not “bed-confined” and did not otherwise medically require ambulance transport.

The government also alleged the medical center provided Capital with certification statements containing incomplete or incorrect information about medical necessity, which the company used to bill Medicare.

Capital identified instances of billing and receiving Medicare payment for medically unnecessary nonemergency ambulance transports originating at EMMC and voluntarily disclosed this information to the government, the release said. The company also cooperated with the government’s investigation and implemented enhanced compliance and remedial measures, the release said.

A settlement is not an admission of liability.