Archive
Fraud & Abuse
Houston physician sentenced to prison for $17M billing fraud
Yolanda Hamilton, MD, was found guilty by a federal jury of participating in a Medicare scheme that involved signing false “plans of care” and other medical…
California Doctor Pleads Guilty to EKRA Violations
On September 15, 2020, Doctor Akikur R. Mohammad, a California resident and drug treatment facility owner, pled guilty before the U.S. District Court of New Jersey…
San Antonio ER hospital sued for alleged overbilling
A former patient has sued Baptist Emergency Hospital in San Antonio and its owner alleging they fraudulently overcharged for lab work to generate higher reimbursements. This…
OIG Semiannual Report to Congress
OIG issued its Semiannual Report to Congress summarizing the activities of the Department of Health and Human Services (HHS), Office of Inspector General (OIG), for the…
Justice Department accuses Anthem of Medicare fraud
Yet another allegation of Medicare Advantange risk adjustment fraud, this time by Anthem. I wrote about the government’s case against Cigna here. The case alleges that…
DOJ sues Cigna, alleging $1.4B in Medicare Advantage fraud
Cigna falsified the health conditions of its Medicare Advantage plan members to coax CMS into making larger payments to the insurer on behalf of beneficiaries, a…
Two charged in prescription and kickback scheme
An 11-count indictment unsealed on Friday charges former Kindred Home Health employee Amber Price, 37, and Christopher Cruz, 46, owner of a medical marketing business, CP…
Medical Device Maker to Pay $18 Million to Settle Allegations of Improper Payments to Physicians
This is not a Texas company, but it is a good example of how some manufacturers try to cloak improper payments under the veil of legitimate…