Corporate Compliance Articles by Topic: Medicare Fraud
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Compliance Monitor, Issue 24, June 13, 2012
Victor Jayasundera, 59, of Detroit, faces 30 months in prison for his role in a scheme that...
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Compliance Monitor, Issue 24, June 13, 2012
A jury convicted David James Garrison, 50, of Los Angeles, of conspiracy, healthcare fraud and...
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Compliance Monitor, Issue 28, July 13, 2011
A former chief financial officer who pleaded guilty to bilking about $200,000 from hospitals in...
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Compliance Monitor, Issue 28, July 13, 2011
Leonard Langman, MD, a neurologist who owned and operated a Brooklyn, NY, medical clinic, pleaded...
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Compliance Monitor, Issue 22, June 1, 2011
Marion Beverly Metoyer, a patient recruiter for a Houston durable medical equipment (DME) company...
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Compliance Monitor, Issue 21, May 25, 2011
Doris Vinitski, a Houston-area resident and owner of Onward Medical Supply, was sentenced to serve...
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Compliance Monitor, Issue 19, May 11, 2011
Martin and Joaquin Tasis, owners of a Detroit-area medical clinic, and co-conspirator Leoncio...
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Compliance Monitor, Issue 19, May 11, 2011
Pharmaceutical manufacturer Serono Laboratories Inc. will pay $44.3 million to resolve False Claims...
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Compliance Monitor, Issue 19, May 11, 2011
American Therapeutic Corporation (ATC) and Medlink Professional Management Group Inc., pleaded...
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Compliance Monitor, Issue 17, April 27, 2011
Two Miami-area medical assistants and a physician assistant will serve time in prison for their...
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Compliance Monitor, Issue 16, April 20, 2011
Dallas-based Tenet Healthcare Corp. filed a Medicare fraud lawsuit that accuses Community Health...
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Compliance Monitor, Issue 16, April 20, 2011
Two Miami-area residents and owners of a mental healthcare corporation pleaded guilty to submitting...
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Compliance Monitor, Issue 16, April 20, 2011
A jury convicted Miami physician Rene De Los Rios of five felony counts for his role in a $23...
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Compliance Monitor, Issue 14, April 6, 2011
Fred Dweck, a Miami-area doctor, will serve 24 months in prison for his role in a Medicare fraud...
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Compliance Monitor, Issue 14, April 6, 2011
Carolyn Ann Vasquez of Los Angeles pleaded guilty to using fraudulent medical clinics and the...
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Compliance Monitor, Issue 13, March 30, 2011
Joseph Raymond, 39, of Orchard Park, NY, admitted to stealing medical supplies and equipment from a...
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Compliance Monitor, Issue 13, March 30, 2011
The Greater Palm Beach Health Care Fraud Task Force arrested Selwyn Carrington, MD, 57, of Miami...
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Compliance Monitor, Issue 12, March 23, 2011
Since May 2009, the Department of Justice (DOJ) and HHS have charged 120 Detroit-area defendants...
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Compliance Monitor, Issue 11, March 16, 2011
Jerry A. Spiegel, MD, of Boynton Beach, FL, will serve 41 months in prison followed by three years...
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Compliance Monitor, Issue 11, March 16, 2011
A federal jury convicted Sunny Robinson, 42, owner of Houston-area durable medical equipment (DME...
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Compliance Monitor, Issue 10, March 9, 2011
Senator Chuck Grassley introduced legislation to build on key reforms to fight fraud in Medicare...
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Compliance Monitor, Issue 10, March 9, 2011
An owner and a physician associated with a Detroit-area infusion therapy clinic will serve 120...
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Compliance Monitor, Issue 10, March 9, 2011
One crucial element of a good compliance program is having a supportive board and senior management.
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Compliance Monitor, Issue 8, February 23, 2011
The Medicare Fraud Strike Force charged 111 defendants in nine cities for their alleged...
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Compliance Monitor, Issue 8, February 23, 2011
Twenty southern Florida residents were indicted for various healthcare fraud, kickback, and money...
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Compliance Monitor, Issue 8, February 23, 2011
The office manager of a Los Angeles durable medical equipment (DME) company pleaded guilty today to...
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Compliance Monitor, Issue 7, February 16, 2011
Guy Ross, 51, a Detroit-area medical assistant, will serve 36 months in prison and pay $472,000 in...
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Compliance Monitor, Issue 6, February 9, 2011
The Office of Inspector General (OIG) of the Department of Health & Human Services launched the...
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Compliance Monitor, Issue 4, January 26, 2011
The government’s healthcare fraud and abuse efforts netted more than $4 billion in fiscal...
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Compliance Monitor, Issue 3, January 19, 2011
Renier Vicente Rodriguez Fleitas, 60, of Miami-Dade County, will serve 37 months after pleading...
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Compliance Monitor, Issue 3, January 19, 2011
Edward Birts, 51, will serve more than five years in federal prison without parole and pay more...
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Compliance Monitor, Issue 2, January 12, 2011
Dahlia V. Kirkpatrick, MD, and Emmanuel M. Komandu, the owner and operator of Alpha Medical...
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Compliance Monitor, Issue 1, January 5, 2011
Seven hospitals agreed to pay the United States a total of more than $6.3 million to settle...
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Compliance Monitor, Issue 48, December 22, 2010
CMS is looking to acquire new state-of-the-art fraud fighting tools to prevent wasteful and...
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Compliance Monitor, Issue 48, December 22, 2010
Bernice Brown, 56, the owner of a Detroit-area physical therapy clinic, and Daniel Smorynski, 63...
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Compliance Monitor, Issue 48, December 22, 2010
Alan Silber, MD, will serve 36 months in prison for participating in a scheme to defraud the...
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Medicare Insider, Issue 51, December 21, 2010
Last week, it was announced that critical access hospitals (CAHs) will be able to add a little...
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Compliance Monitor, Issue 47, December 15, 2010
Ken B. Beverly, former CEO of Thomasville, GA–based Archbold Memorial Hospital, was convicted...
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Compliance Monitor, Issue 47, December 15, 2010
Kos Pharmaceuticals agreed to pay more than $41 million to resolve claims that it offered illegal...
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Compliance Monitor, Issue 46, December 8, 2010
Oliver Nkuku and Callistus Edozie were sentenced to 120 months in prison and 41 months in prison...
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Compliance Monitor, Issue 46, December 8, 2010
St. John’s Mercy Health System and St. John’s Health System, Inc., agreed to pay $2.2...
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Compliance Monitor, Issue 46, December 8, 2010
Q: What is fraud?
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Compliance Monitor, Issue 45, December 1, 2010
The Department of Justice (DOJ) recovered $2.5 billion in healthcare fraud recoveries for fiscal...
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Compliance Monitor, Issue 45, December 1, 2010
Walter Janke, MD, his wife, Lalita Janke, and Medical Resources LLC agreed to pay $22.6 million to...
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Compliance Monitor, Issue 44, November 24, 2010
U.S. District Judge Adalberto Jordan sentenced Jose Garcia, 55, to 57 months in prison for...
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Compliance Monitor, Issue 44, November 24, 2010
Ameritox, Ltd., a laboratory based in Midland, TX, agreed to pay the U.S. government $16.3 million...
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Compliance Monitor, Issue 43, November 17, 2010
St. Joseph Medical Center agreed to pay $22 million to settle allegations that the hospital paid...
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Compliance Monitor, Issue 42, November 10, 2010
Simi Valley (CA) Hospital paid the United States $5.1 million to resolve allegations that its...
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Compliance Monitor, Issue 42, November 10, 2010
The majority of providers that CMS suspended in 2007 and 2008 exhibited characteristics that...
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Compliance Monitor, Issue 42, November 10, 2010
Q: Can a recovery audit contractor (RAC) review a claim more than once?
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Compliance Monitor, Issue 41, November 3, 2010
James Roland Fuquay, 49, will serve 21 months in prison and pay $557,000 for his participation in a...
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Compliance Monitor, Issue 32, August 18, 2010
Authorities charged nine New Yorkers with participation in a Manhattan-based drug ring that...
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Medicare Insider, Issue 33, August 17, 2010
On August 10, CMS issued a special edition MLN Matters article on medical record retention and...
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Compliance Monitor, Issue 28, July 21, 2010
Two Detroit citizens pleaded guilty in U.S. District Court for their roles in a Medicare home...
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Medicare Insider, Issue 21, May 25, 2010
The recently enacted Patient Protection and Affordable Care Act (and companion Health Care and...
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Medicare Insider, Issue 19, May 11, 2010
On May 7, the OIG issued two audit reports on the program safeguard contractors (PSC). The OIG...
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Medicare Insider, Issue 18, May 4, 2010
We have received a denial stating: Fraud alert dosage exceeds 90mg. This patient has been...
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Strategies for Health Care Compliance, Issue 1, January 1, 2010
In this issue, we examine outpatient coding challenges that facilities are still facing. We explain...
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Compliance Monitor, Issue 51, December 23, 2009
Three Detroit residents pleaded guilty to a $4.2 million Medicare fraud scheme according to a...
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Medicare Insider, Issue 42, October 13, 2009
On September 29, the OIG issued an audit report on the Comprehensive Error Rate Testing (CERT...
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Medicare Insider, Issue 42, October 13, 2009
In last week’s note, we looked at the OIG Work Plan for Fiscal Year 2010. There were many...
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Compliance Monitor, Issue 38, September 23, 2009
Authorities arrested an adult family care home owner for concealing an unregistered family...
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Compliance Monitor, Issue 35, September 2, 2009
Covenant Medical Center in Waterloo, IA, agreed to pay $4.5 million to settle claims that it had...
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Compliance Monitor, Issue 34, August 26, 2009
On August 18, Jose and Arnaldo Rosario pleaded guilty to participating in a conspiracy to defraud...
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Compliance Monitor, Issue 34, August 26, 2009
On August 19, Kevin Watson and Jaqueline Jackson pleaded guilty to soliciting and paying kickbacks...
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Compliance Monitor, Issue 32, August 12, 2009
A federal judge sentenced Miami physician Keith Russell and physician’s assistant Jorge Luis...
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Compliance Monitor, Issue 31, August 5, 2009
Continuing the trend of increased fraud enforcement, the Medicare Fraud Strike Force arrested 32...
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Compliance Monitor, Issue 30, July 29, 2009
Federal prosecutors allege Simon Levich MD billed Medicare for services he never provided, billed...
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Compliance Monitor, Issue 29, July 22, 2009
On July 13, a New Jersey grand jury indicted Khashayar Salartash M.D., his office manager, Farah...
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Compliance Monitor, Issue 29, July 22, 2009
Endoscopic Technologies Inc., a medical device manufacturer, agreed to pay the United States $1.4...
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Compliance Monitor, Issue 29, July 22, 2009
Gabriel DeCandido MD agreed to pay the United States $1.7 million to settle charges that the...
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Compliance Monitor, Issue 27, July 8, 2009
The Louisiana State University Health Sciences Center-Shreveport (LSUHSC) will pay $706,000 to...
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Compliance Monitor, Issue 27, July 8, 2009
Jose Luis Perez, of Golden Beach, FL, and Reinaldo Guerra, of Miami, FL, will face charges of...
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Compliance Monitor, Issue 27, July 8, 2009
A report published by the George Washington University Medical Center, Health Insurance Fraud: An...
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Compliance Monitor, Issue 26, July 1, 2009
On June 24, the Medicare Fraud Strike Force in Detroit arrested 53 people on Medicare fraud...
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Compliance Monitor, Issue 26, July 1, 2009
The Medicare Fraud Strike Force in Florida arrested eight Miami-Dade County, FL residents June 26...
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Compliance Monitor, Issue 25, June 24, 2009
On June 18, many providers received an alert message from CMS informing them that scammers are...
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Compliance Monitor, Issue 25, June 24, 2009
Judge Robert G. James sentenced Janice Davis, former owner of Aging Care Home Health Care (ACHHC...
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Compliance Monitor, Issue 18, May 6, 2009
A federal grand jury indicted Karen Stone, former business manager of Kentucky-based...
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Compliance Monitor, Issue 17, April 29, 2009
A Huston jury convicted Houston area residents, Rhonda Fleming, Bose Ebhamen, and King Arthur, of...
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Compliance Monitor, Issue 17, April 29, 2009
On April 28 the Senate approved the Fraud Enforcement and Recovery Act of 2009, a bill designed to...
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Healthcare Auditing Weekly, Issue 16, April 28, 2009
Office of Inspector General Chief Counsel Lewis Morris stressed to the Senate Finance Committee...
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Compliance Monitor, Issue 16, April 22, 2009
Former and current personal care attendants at First Thessalonians Community Programs were arrested...
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Compliance Monitor, Issue 15, April 15, 2009
On April 7, Chaunsay Beckwith, owner and operator of International Alternative Medicine Inc...
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Healthcare Auditing Weekly, Issue 14, April 14, 2009
On April 7, U.S. Attorney for the Southern District of Florida R. Alexander Acosta unsealed an...
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Healthcare Auditing Weekly, Issue 13, April 7, 2009
In a March 30 press release, the U.S. Government Accountability Office (GAO) urged private citizens...
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Healthcare Auditing Weekly, Issue 11, March 24, 2009
On March 17, a federal jury convicted two physicians and two medical assistants in Miami in...
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Compliance Monitor, Issue 10, March 11, 2009
U.S. District Judge Steven D. Merryday sentenced Yosdan Castellanos to 63 months in prison for...
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Compliance Monitor, Issue 7, February 18, 2009
The Department of Justice (DOJ) has charged six Miami-area healthcare workers with defrauding...
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Compliance Monitor, Issue 7, February 18, 2009
Police arrested Sanjay Patel and his wife, Leena Bharat Kumar Patel, in Connecticut on Feburary 13...
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Compliance Monitor, Issue 5, February 4, 2009
A federal indictment named two more individuals in an alleged Medicare fraud scheme that recruited...
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Compliance Monitor, Issue 5, February 4, 2009
Federal authorities recently charged four Chicago-area individuals, including two physicians, in...
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Compliance Monitor, Issue 4, January 28, 2009
On January 22, the U.S. Government Accountability Office (GAO) released its biennial list of...
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Compliance Monitor, Issue 4, January 28, 2009
The owners and operators of two Miami-area HIV infusion clinics along with a phlebotomist employed...
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Compliance Monitor, Issue 3, January 21, 2009
Alfredo F. Lopez was sentenced to 10 years in prison for healthcare fraud, according to a...
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Healthcare Auditing Weekly, Issue 2, January 13, 2009
Quality of care, Medicaid and the State Children’s Health Insurance Program (SCHIP), as well...
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Healthcare Auditing Weekly, Issue 2, January 13, 2009
The sagging economy is causing concern for healthcare compliance and ethics professionals...
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Compliance Monitor, Issue 1, January 7, 2009
Wylene Simmons, a midwife from Lauderhill, FL, allegedly defrauded the state Medicaid program for...
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Compliance Monitor, Issue 1, January 7, 2009
On December 30, 2008, a federal jury convicted Dr. Mehmood Patel, of Lafayette, LA, on 51 counts of...
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Compliance Monitor, Issue 92, December 31, 2008
Frederic Feit, owner Modern Pain Therapy in Freehold, NJ, pleaded guilty to charges of third-degree...
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Compliance Monitor, Issue 92, December 31, 2008
A federal grand jury in Detroit indicted eight owners and employees of several Michigan home...
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Compliance Monitor, Issue 91, December 24, 2008
Ana Alvarez-Jacinto and Sandra Mateos were sentenced to 30 years in prison for their involvement in...
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Compliance Monitor, Issue 91, December 24, 2008
Paul Lessler, a former physician in Newport Beach, CA, agreed to pay $2.2 million to settle civil...
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Compliance Monitor, Issue 90, December 17, 2008
Marie Weller King, registered nurse and owner of King and Associates, will serve 18 months in...
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Health Care Auditing Strategies, Issue 1, December 12, 2008
With the focus on enforcement increasing in many areas of healthcare compliance, auditors need to...
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Compliance Monitor, Issue 87, November 26, 2008
On November 24, Carlos Contreras and Ramon Pichardo were sentenced to 37 months and 48 months in...
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Compliance Monitor, Issue 86, November 19, 2008
Even more fraud in South Florida
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Compliance Monitor, Issue 86, November 19, 2008
Another Miami HIV infusion clinic owner sentenced for Medicare fraud
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Compliance Monitor, Issue 85, November 12, 2008
Miami physician and clinic administrator sentenced for roles in Medicare fraud scheme
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Compliance Monitor, Issue 84, November 5, 2008
Louisiana trio indicted for Medicare fraud
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Compliance Monitor, Issue 83, October 29, 2008
Delaware doctor indicted for Medicare fraud
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Compliance Monitor, Issue 82, October 22, 2008
Six Nevada doctors pay to settle Medicare fraud claims
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Compliance Monitor, Issue 82, October 22, 2008
Louisiana Hospital pays $3.3 million to resolve Medicare fraud charges
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Compliance Monitor, Issue 80, October 15, 2008
Peoria podiatrist sentenced to year in prison for Medicare fraud
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Compliance Monitor, Issue 80, October 15, 2008
Eight indicted in South Florida AIDS/HIV infusion scheme
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Compliance Monitor, Issue 78, October 8, 2008
CMS cracks down on fraud
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Compliance Monitor, Issue 72, September 17, 2008
Two Miami physicians admit to participation in HIV infusion scheme
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Compliance Monitor, Issue 72, September 17, 2008
Staten Island University Hospital to pay $89 million to settle fraud claims
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Compliance Monitor, Issue 68, September 3, 2008
Skid Row recruiter will plead guilty to healthcare fraud conspiracy
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Compliance Monitor, Issue 68, September 3, 2008
Whistleblowers help the government recoup $9.3 billion
