Michael Mirando, 40, previously a resident of Aliso Viejo, CA, was found guilty in May of 2017 on 15 counts of health care fraud. It took a federal jury less than half an hour to reach a verdict following the trial. At the end of October, Mirando was sentenced to…
Articles Posted in Healthcare Fraud
Two Fresno Health Care Fraud Cases Resolved in October
The Department of Justice (DOJ) for the Eastern District of California announced in October that two individuals pleaded guilty to health care fraud charges. These announcements continue to prove that the DOJ is focused on prosecuting all forms of health care fraud throughout the state and federal levels. If you…
California Workers’ Comp Suspends 11 Medical Providers in October
The California Division of Workers’ Compensation (DWC) announced new suspensions twice in October. It suspended eight medical providers from participating in the state’s workers’ compensation system in early October and then three more shortly after. The total suspensions for 2017 are now up to 49. These suspensions are part of…
California Judge Dismisses FCA Case Against UnitedHealth Group
In early October, a California federal judge dismissed without prejudice a False Claims Act (FCA) lawsuit against UnitedHealth Group Inc. (UHG). The suit, U.S. ex rel. Swoben v. Secure Horizons, et al., alleged UHG ignored questionable diagnoses that led to higher reimbursements through the Medicare Advantage program. This is significant…
Drug Maker Aegerion to Pay $35 Million Settlement
On Sept. 22, the U.S. Department of Justice announced that drug manufacturer, Aegerion Pharmaceuticals Inc., a subsidiary of Novelion Therapeutics Inc., has agreed to plead guilty to criminal charges and pay a multi-million settlement of to resolve allegations of civil false claims. The Criminal Charges The criminal charges against Aegerion…
The DOJ Prosecutes All Levels of Healthcare Fraud
There is a misconception that the U.S. Department of Justice (DOJ) is mainly interested in health care fraud and violations of the False Claim Act (FCA) from large corporations like major insurers or pharmaceutical manufacturers. However, this is not true. The DOJ is on a mission to uncover health care…
DOJ Continues to Fight Opioid Epidemic
In early September, the U.S. Department of Justice announced that Galena (Galena) Biopharma Inc. will pay more than $7.55 million in a False Claims Act (FCA) settlement. The U.S. alleges that Galena paid various types of kickbacks to encourage physicians to prescribe Abstral, which is a fentanyl-based drug, also known…
Novo Nordisk to Pay $58 Million Settlement
In early September, the U.S. Department of Justice (DOJ) announced pharmaceutical manufacturer Novo Nordisk Inc. has agreed to pay $58.65 million for failing to comply with a Food and Drug Administration (FDA) mandated Risk Evaluation and Mitigation Strategy (REMS) program. The REMS was for Novo Nordisk’s Type II diabetes medication…
CHRISTUS Health Care Companies to Pay $12.24 Million in FCA Settlement
CHRISTUS St. Vincent Regional Medical Center, located in Santa Fe, New Mexico, and CHRISTUS Health, located in Irving, Texas, have agreed with the U.S. Department of Justice to resolve allegations of violating the federal False Claims Act (FCA) with a settlement of $12.24 million plus interest. A Qui Tam Suit…
Owner of Texas Home Health Agencies Sentenced to Prison for Conspiracy to Defraud Medicare
The U.S. Department of Justice (DOJ) announced August 18 that the owner and operator of five home health agencies located in the Houston area, Godwin Oriakhi, 61, was sentenced to 480 months in prison for conspiring to defraud Medicare and the Texas’ Medicaid programs: Home and Community-Based Service (HCBS) and…