Those who are under investigation for health care fraud may face years in federal prison if they are found guilty, or they ay face civil charges that result in much less severe penalties. It is up to the discretion of the federal prosecutor to determine if the case will be…
Even though the Anti-Kickback Statute is a federal criminal statute that results in serious penalties when violated, it is also one that physicians and healthcare professionals violate on a regular basis. If you believe you were referred to a physician or other healthcare provider as part of a monetary or…
It is illegal in California to commit health care fraud, yet with the confusing payment bureaucracy for health care in the United States, health care fraud occurs more frequently than most people think. Health care fraud, also known as medical insurance billing fraud, health insurance fraud, Medicare fraud, Medi-Cal fraud,…
The False Claims Act (FCA), which prohibits entities that conduct business with the government from defrauding the government, goes all the way back to the time of the Civil War. It is sometimes called the Lincoln Law because of the president who was in office when the law went into…
California lawmakers are concerned with health care providers who may be taking advantage of patients by unnecessarily enrolling them into commercial health care plans in order to maximize the provider’s reimbursement rates. Lawmakers believe some providers are encouraging sick individuals to enroll in commercial health care plans, which the providers…
The U.S. Department of Justice (DOJ) announced mid-March that a dentist based in Los Angeles has been charged with conducting an identity theft and health care fraud scheme. Benjamin Rosenberg, D.D.S., 58, faces six counts of health care fraud and two counts of aggravated identity theft. According to the unsealed…
In February, Julian Omidi, 49, a former physician, and Dr. Mirali Zarrabi, 55, were charged with multiple counts of fraud in regard to a scheme surrounding their business, 1-800-GET-THIN. Two corporations, partly controlled by Omidi, were also named in the 37-count federal indictment, Surgery Center Management, LLC (SCM) and Independent…
In January 2018, the California Division of Workers’ Compensation (DWC) suspended 18 medical providers. These providers, many of whom are physicians, can no longer work in the state’s workers’ compensation system due to the loss of their medical license, criminal conduct, or fraud. DWC Require to Suspend Certain Providers AB…
Jimmy and Ashley Collins, a married couple from Tennessee, have been charged with operating a health care fraud scheme that unlawfully caused TRICARE to reimburse more than $65 million in funds. TRICARE is the federal health care program for U.S. military members, veterans, and their dependents. The Collins conspired with…
Kmart Corporation, a subsidiary of Sears Holding Corporation, will pay the federal government $32.3 million to settle allegations of violations of the False Claims Act. A whistleblower alleged that Kmart stores did not report discounted prescription drug prices to Medicare Part D, Medicaid, and TRICARE, thereby receiving larger reimbursements than…