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Ammed Direct Llc to Pay $18 Million to United States and Tennessee to Resolve False Claims Allegations

AmMed Direct LLC has agreed to pay the United States and the state of Tennessee $18 million plus interest to settle allegations that it submitted false claims to Medicare and Tennessee Medicaid (TennCare), the Justice Department announced today. Under the agreement, AmMed will pay $17,560,997 to the United States and $439,003 to Tennessee.



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Detroit-Area Patient Recruiter Pleads Guilty to Medicare Fraud

Daron Elder, 28, of Southfield, Mich., pleaded guilty before U.S. District Judge Arthur J. Tarnow in the Eastern District of Michigan to one count of conspiracy to commit health care fraud.



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Medicare Fraud Strike Force Charges 107 Individuals for Approximately $452 Million in False Billing

Attorney General Eric Holder and Health and Human Services (HHS) Secretary Kathleen Sebelius announced today that a nationwide takedown by Medicare Fraud Strike Force operations in seven cities has resulted in charges against 107 individuals, including doctors, nurses and other licensed medical professionals, for their alleged participation in Medicare fraud schemes involving approximately $452 million in false billing.



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Leaders of Multi-million Dollar Fraud Ring That Used Stolen Information of Medicaid Recipients Each Sentenced to Over 25 Years in Prison

Veronica Dale and Alchico Grant, who jointly ran a stolen identity refund fraud ring that attempted to defraud the United States of millions of dollars over several years, were sentenced to federal prison today, the Justice Department and Internal Revenue Service (IRS) announced. Veronica Dale, of Montgomery, Ala., was sentenced to 334 months and Alchico Grant of Lowndes County, Ala., was sentenced to 310 months in prison. In addition, Dale and Grant were both ordered to pay over $2.8 million in restitution to the IRS.



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Nineteen-Year Police Veteran Convicted in Puerto Rico for Role in Providing Armed Security for Drug Transaction

Yamil Navedo Ramirez, 39, was convicted of one count of attempting to possess with the intent to distribute more than five kilograms of cocaine and one count of possession of a firearm in furtherance of a drug transaction.



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Houston-Area Nurse Sentenced to 97 Months in Prison for Role in $5.2 Million Medicare Fraud Scheme

Ezinne Ubani, the former director of nursing at Family Healthcare Group, a Houston home health care company, was sentenced by U.S. District Judge Nancy Atlas in the Southern District of Texas to 97 months in prison, followed by three years supervised release.



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Owner of Houston Health Care Company Convicted of Defrauding Medicare

An owner of a Houston health care company was convicted yesterday by a jury in the Southern District of Texas in connection with a $750,000 Medicare fraud scheme.



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Co-Owner of Detroit-Area Physical Therapy Company Sentenced to 48 Months for Medicare Fraud Scheme

The co-owner of a Detroit-area physical therapy company was sentenced today to 48 months in prison for her leading role in a more than $1.9 million Medicare fraud scheme, announced the Department of Justice, the FBI and the Department of Health and Human Services (HHS).



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Self-proclaimed “Governor” of Alabama Sentenced to Ten Years in Federal Prison for Tax Fraud

Monty Ervin and Patricia Ervin, owners of Southern Realty in Dothan, Ala., were sentenced today to federal prison for conspiring to defraud the United States and tax evasion, the Justice Department and Internal Revenue Service (IRS) announced. After a two-week trial that began Oct. 25, 2011, a federal jury in Montgomery, Ala., convicted the Ervins of one count of conspiracy and three counts of tax evasion. The jury also convicted Patricia Ervin of one count of structuring transactions to avoid bank reporting requirements. Monty Ervin was sentenced to 120 months in prison; Patricia Ervin was sentenced to five years of probation, with the condition that she spend 40 consecutive weekends in jail. In sentencing the Ervins, the court found that Monty Ervin was the leader and organizer of the conspiracy and exercised control over Patricia Ervin.



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Minnesota-based St. Jude Medical Pays U.S. $3.65 Million to Settle Claims That It Overcharged for Implantable Cardiac Devices

St. Jude Medical Inc. has agreed to pay the United States $3.65 million to resolve civil allegations under the False Claims Act that the company inflated the cost of replacement pacemakers and defibrillators purchased by the Departments of Defense and Veterans Affairs, the Justice Department announced today. St. Paul, Minn.-based St. Jude Medical develops, manufactures and distributes cardiovascular and implantable neurostimulation medical devices.



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Doctors, Therapist and Recruiters from Miami-Area Mental Health Care Corporation Convicted for Participating in $205 Million Medicare Fraud Scheme

A federal jury today convicted two Miami-area doctors, one Miami-area therapist and two others for their participation in a Medicare fraud scheme involving more than $205 million in fraudulent billings by American Therapeutic Corporation (ATC), a mental health care corporation.



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Los Angeles Physician Assistant Found Guilty for Role in $18.9 Million Medicare Fraud Scheme

On June 1, 2012, after a two-week trial in federal court in Los Angeles, a jury found David James Garrison, 50, guilty of one count of conspiracy to commit health care fraud, six counts of health care fraud and one count of aggravated identity theft.



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Texas-based Medical Device Manufacturer Pays U.S. $34 Million to Settle False Claims Act Allegations

Orthofix Inc., a Texas-based manufacturer of medical devices, has agreed to pay the United States $34,234,263 to settle allegations under the civil False Claims Act relating to the company’s sale of bone growth stimulator devices, the Justice Department announced today. The company has also agreed to plead guilty to a felony of obstruction of a federal audit, and to pay a $7,765,737 criminal fine.



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Miami-Area Resident Sentenced to 46 Months in Prison for Participating in Medicare Fraud Scheme

Leyanes Placeres, 32, was sentenced by U.S. District Judge Patricia A. Seitz in the Southern District of Florida.



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Co-Owner of Houston-Area Home Health Care Agency Sentenced to 108 Months in Prison for Role in $5.2 Million Medicare Fraud

Clifford Ubani, a former co-owner and chief financial officer at Family Healthcare Group, was sentenced by U.S. District Judge Nancy Atlas in the Southern District of Texas.



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Owner and Operator of Halfway House Company Pleads Guilty for Role in Medicare Fraud Scheme

Hassan Collins, 41, pleaded guilty to one count of conspiracy to receive and pay health care fraud kickbacks before U.S. Magistrate Judge Edwin G. Torres.



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Brooklyn Doctor Convicted for Role in Medicare and Private Insurance Fraud Scheme

A Brooklyn board-certified colorectal surgeon, who owned and operated a New York medical clinic, was convicted for his role in a fraud scheme that billed Medicare and numerous private insurance companies for surgeries and other complex medical procedures that were never performed.



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Owner and Employee of Miami Home Health Company Sentenced to Prison in $22 Million Medicare Fraud Scheme

U.S. District Judge Patricia A. Seitz in Miami sentenced Marietha Morales, 38, to 108 months in prison and Eduardo Saborit-Dominguez, 48, to 46 months in prison.



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Owner of Miami-Area Assisted Living Facility Sentenced to 37 Months in Prison for Role in Medicare Fraud Scheme

Billy Denica, 50, was sentenced by U.S. District Judge Joan A. Lenard in Miami.



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US Settles Complaint Against Wisconsin Livestock Company for Improper Medication Practices

The United States has filed suit in the U.S. District Court for the Eastern District of Wisconsin against Dan Nolan Livestock LLC. and its owner Daniel W. Nolan to block them from violating the Food, Drug and Cosmetic Act (FDCA) in connection with their alleged unlawful use of new animal drugs in cows slaughtered for food. The Justice Department filed the suit on behalf of the Food and Drug Administration (FDA).



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Miami-Area Resident Pleads Guilty to Participating in $63 Million Medicare Fraud Scheme

Sarah Da Silva Keller, 27, pleaded guilty before U.S. District Judge Marcia G. Cooke in Miami to one count of conspiracy to commit health care fraud.



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Miami-Area Patient Recruiters Sentenced to Prison for Roles in $200 Million Medicare Fraud Scheme

James Edwards was sentenced today to 84 months in prison and three years of supervised release and Nelson Fernandez was sentenced yesterday to 63 months in prison and three years of supervised release.



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Second Owner of Houston-area Home Health Care Agency Sentenced to 108 Months in Prison for Role in $5.2 Million Medicare Fraud

The former co-owner of a Houston-area home health care company was sentenced in Houston to 108 months in prison for his participation in a $5.2 million Medicare fraud scheme, announced the Department of Justice, the FBI and the Department of Health and Human Services (HHS).



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Asheville, North Carolina, Resident Pleads Guilty to Participating in $63 Million Medicare Fraud Scheme

Serena Joslin, 31, a Licensed Psychological Associate, pleaded guilty before U.S. District Judge Cecilia M. Altonaga in Miami to one count of conspiracy to commit health care fraud.



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Michigan Man Pleads Guilty in Connection with Detroit-Area Medicare Fraud Scheme

Nabeel Shaikh, 30, of Wixom, Mich., pleaded guilty today to one count of conspiracy to commit health care fraud before U.S. District Judge Gerald E. Rosen of the Eastern District of Michigan.



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Co-Owners of Houston-Area Durable Medical Equipment Company Sentenced to Prison for Role in $1.18 Million Medicare Fraud

Clifford Ubani, 54, and Princewill Njoku, 53, the former co-owners of Family Healthcare Services, were sentenced by U.S. District Judge Gray H. Miller in the Southern District of Texas in Houston.



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City of Woodlake, Calif., Settles with Justice Department Over Practice of Unlawful Pre-employment Medical Examinations

The Justice Department announced today that it has reached a settlement with the city of Woodlake, Calif., to resolve allegations that the city engaged in a pattern or practice of discrimination against people with disabilities by requiring applicants for job vacancies to undergo unlawful pre-employment medical examinations before receiving an offer of employment, in violation of the Americans with Disabilities Act (ADA).



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United States Joins Lawsuit Against San Francisco Area’s North East Medical Services

The United States has joined a whistleblower action pending in the Northern District of California against the federally-qualified health center (FQHC), North East Medical Services (NEMS), alleging that the center under-reported income it received from a managed care organization in order to artificially inflate reimbursements it received from the California Medicaid program, the Justice Department announced today. North East serves the San Francisco Bay area.



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Miami-Area Patient Broker Sentenced to 18 Months in Prison for Role in $200 Million Medicare Fraud Scheme

Jean-Luc Veraguas, 51, of Plantation, Fla., was sentenced by U.S. District Judge Frederico A. Moreno in the Southern District of Florida.



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Florida Assisted Living Facility Owner Sentenced to 30 Months in Prison for Medicare Fraud Scheme

Bobby Ramnarine, 36, was sentenced by U.S. District Judge Donald M. Middlebrooks in the Southern District of Florida.



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Medical Equipment Company Owner Sentenced in Louisiana to 180 Months in Prison for Medicare Fraud Scheme

Henry Lamont Jones, 37, of Prairieville, La., was sentenced by U.S. District Judge James J. Brady of the Middle District of Louisiana.



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Detroit-Area Resident Pleads Guilty to Participating in $3.1 Million Medicare Fraud Scheme

Gregory Lawrence, 54, of Detroit, pleaded guilty yesterday before U.S. District Court Judge Victoria A. Roberts in the Eastern District of Michigan to one count of conspiracy to commit health care fraud.



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Settlement Requires Boston Water and Sewer Commission to Remedy Sewer and Stormwater Discharges

Under the terms of a consent decree lodged in federal court today, the Boston Water and Sewer Commission (BWSC) will implement extensive remedial measures to minimize the discharge of sewage and other pollutants into the water bodies in and around Boston.



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Eight Individuals and a Corporation Convicted at Trial in Florida in $50 Million Medicare Fraud

Eight individuals and a Miami-based corporation were convicted by a federal jury for their participation in a Medicare fraud scheme involving the submission of more than $50 million in fraudulent billings to Medicare.



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Louisiana Resident Sentenced to 18 Months in Prison for Role in Medicare Fraud Scheme

Karen T. Rayburn, 47, was sentenced today by U.S. District Judge James J. Brady of the Middle District of Louisiana.



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Four Individuals Charged in Detroit for Alleged Roles in Medicare Fraud Scheme

Four individuals were charged in court documents unsealed today in the Eastern District of Michigan for their participation in a Medicare fraud scheme involving home health services.



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Self-Proclaimed “President” of Sovereign Citizen Group Indicted for Tax Crimes

A federal grand jury in Montgomery, Ala., charged James Timothy Turner, also known as Tim Turner, with conspiracy to defraud the United States, attempting to pay taxes with fictitious financial instruments, attempting to obstruct and impede the Internal Revenue Service, failing to file a 2009 federal income tax return and falsely testifying under oath in a bankruptcy proceeding.



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Los Angeles Physician Assistant Sentenced to 72 Months in Prison for Role in $18.9 Million Medicare Fraud Scheme

David James Garrison, 50, was sentenced by U.S. District Judge Consuelo B. Marshall in the Central District of California.



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Five Individuals Charged in Detroit for Alleged Roles in $24.7 Million Medicare Fraud Scheme

Five individuals were charged in court documents unsealed today in the Eastern District of Michigan for their participation in a Medicare fraud scheme involving purported home health and psychotherapy services.



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Detroit-Area Doctor Charged for Role in Alleged $40 Million Medicare Fraud Scheme

According to a criminal complaint unsealed today in U.S. District Court in Detroit, Dr. Hicham Elhorr, 45, masterminded a $40 million scheme involving the submission of fraudulent claims submitted to Medicare for services that were medically unnecessary and/or never provided through House Calls Physicians (HCP), a physician home visiting service he owned and operated.



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Two Miami-Area Doctors Sentenced to 10 Years in Prison for Participating in $205 Million Medicare Fraud Scheme

Miami-area residents Dr. Mark Willner and Dr. Alberto Ayala, former medical directors at the mental health care company American Therapeutic Corporation (ATC), were each sentenced today to 10 years in prison for participating in a $205 million Medicare fraud scheme.



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Medicare Fraud Strike Force Charges 91 Individuals for Approximately $430 Million in False Billing

Medicare Fraud Strike Force operations in seven cities have led to charges against 91 individuals – including doctors, nurses and other licensed medical professionals – for their alleged participation in Medicare fraud schemes involving approximately $429.2 million in false billing.



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Los Angeles Medical Equipment Supplier Sentenced to 30 Months in Prison for Medicare Fraud Scheme

A Los Angeles medical equipment supplier, who submitted almost $1 million in false claims to Medicare for expensive, high-end power wheelchairs, was sentenced today to serve 30 months in prison.



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Former Owners of Los Angeles DME Wholesale Company Arrested and Charged with Participating in $16.6 Million Medicare Fraud Scheme

The former owners of a durable medical equipment (DME) wholesale company located in Ontario, Calif., were arrested late yesterday at Los Angeles International Airport in connection with a DME fraud scheme that resulted in the submission of over $16.6 million in false claims to Medicare and are expected to appear this afternoon in Los Angeles federal court.



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Miami-Area Therapist Sentenced to 108 Months in Prison for Participating in $205 Million Medicare Fraud Scheme

Miami-area resident Vanja Abreu (Ph.D), former program director at the mental health care company American Therapeutic Corporation (ATC), was sentenced today to 108 months in prison for participating in a $205 million Medicare fraud scheme.



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CVS Subsidiary, RxAmerica, Reaches $5 Million Settlement with US for Allegedly Submitting False Pricing Relating to the Company’s Medicare Part D Plan

In one of the first False Claims Act settlements involving Medicare’s Prescription Drug Program, known as Part D, RxAmerica LLC. has entered into a civil settlement agreement with the United States in which it has agreed to pay the government $5.25 million to resolve allegations that it made false submissions to the Centers for Medicare & Medicaid Services (CMS), the Justice Department announced today. RxAmerica, a wholly-owned subsidiary of CVS Caremark Corporation, provides prescription drug benefits to Medicare beneficiaries pursuant to a prescription drug plan.



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Owner and Operator of Florida Halfway House Company Sentenced to 51 Months in Prison for Role in Medicare Fraud Scheme

Hassan Collins, 41, was sentenced by U.S. District Judge Kevin Michael Moore in the Southern District of Florida.



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Detroit Area Physician, Home Health Agency Owner and Patient Recruiter Convicted in $14.5 Million Medicare Fraud Scheme

A federal jury in Detroit today convicted a physician, a home health agency owner and a patient recruiter for their participation in a $14.5 million Medicare fraud scheme.



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Orthofix Subsidiary, Blackstone Medical, Pays U.S. $30 Million to Settle False Claims Act Allegations

Orthofix International NV, has agreed to pay the United States $30 million to settle allegations that an Orthofix subsidiary, Blackstone Medical Inc., paid illegal kickbacks to physicians in order to induce use of the company’s products, the Justice Department announced today. Orthofix, which manufactures spinal implants and other spinal surgery products, is a publicly traded company headquartered in Curacao.



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Owner of Miami Assisted Living Facility Sentenced to 15 Months in Prison for Role in Medicare Fraud Conspiracy

Alba Serrano, 66, of Miami, was sentenced today by U.S. District Judge Patricia A. Seitz in the Southern District of Florida.



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