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Justice Department Announces Americans with Disabilities Act Barrier-free Health Care Initiative by Us Attorney’s Offices Nationwide

U.S. Attorney’s offices across the nation are partnering with the Civil Rights Division to target their enforcement efforts on a critical area for individuals with disabilities through a new Barrier-Free Health Care Initiative, the Justice Department announced today. The announcement comes on the 22nd anniversary of the Americans with Disabilities Act (ADA), which was passed on July 26, 1990. Assistant Attorney General Thomas E. Perez announced the new initiative today at an event celebrating the anniversary of the ADA in Washington, D.C.



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Tennessee-Based Home Health Care Provider & Related Entities Agree to Pay More Than $9 M to Resolve False Claims Act Lawsuit

James W. Carell, CareAll Management LLC (formerly known as Diversified Health Management Inc.), CareAll Inc., the James W. Carell Family Trust, VIP Home Nursing and Rehabilitation Services LLC, Professional Home Health Care LLC, University Home Health, LLC and Elizabeth Vining (as representative of the Estate of Robert Vining) have agreed to pay $9.375 million to the federal government. This payment is to resolve the lawsuit that the United States filed in 2009 alleging that they violated the False Claims Act, caused Medicare to pay out money through mistake of fact, and were unjustly enriched by falsely concealing the home health agencies’ relationship with their management company, the Justice Department announced today.



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Owner of Miami Home Health Company Pleads Guilty in $60 Million Health Care Fraud Scheme

Rodolfo Nieto Jr., 40, of Miami, pleaded guilty before U.S. District Judge Cecilia M. Altonaga in the Southern District of Florida to one count of conspiracy to defraud the United States and to receive health care kickbacks.



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Justice Department Obtains Comprehensive Agreement Regarding North Carolina Mental Health System

The Justice Department announced today that it has entered into an agreement with the state of North Carolina to ensure the state is in compliance with the Americans with Disabilities Act (ADA) and the Rehabilitation Act. The agreement will transform the state’s system for serving people with mental illness. Under the settlement agreement, over the next eight years, North Carolina’s system will expand community-based services and supported housing that promote inclusion and independence and enable people with mental illness to participate fully in community life.



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Pacific Health Corporation and Related Entities Agree to Pay $16.5 Million for Allegedly Engaging in an Illegal Kickback Scheme in Los Angeles

The United States has entered into a settlement agreement with Pacific Health Corporation (PHC) and related entities in which they agreed to pay the government and the state of California $16.5 million for allegedly engaging in an illegal kickback scheme in Los Angeles, the Justice Department announced today.



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Detroit-Area Resident Pleads Guilty in $13.8 Million Health Care Fraud Scheme

Jawad Ahmad, 42, pleaded guilty today before U.S. District Judge Gerald E. Rosen in Detroit to one count of conspiracy to commit health care fraud.



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Statement on the Final Rule by the National Institute for Occupational Safety and Health to Include Certain Cancers into the World Trade Center Health Program

Sheila Birnbaum, Special Master of the September 11th Victim Compensation Fund (VCF), released the following statement on the final rule by the National Institute for Occupational Safety and Health (NIOSH) to include certain cancers into the World Trade Center Health Program.



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Assistant Attorney General Lanny A. Breuer Speaks at the Health Care Fraud Takedown Press Conference

"We have made it one of our missions at the Department of Justice to hold accountable those who abuse the Medicare program for personal profit. And there are Medicare fraudsters in prisons across the country – some who will be there for decades – who can attest to our determination and our effectiveness," said Assistant Attorney General Breuer.




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Attorney General Eric Holder Speaks at the Health Care Fraud Takedown Press Conference

"Over the last 24 hours, Medicare Fraud Strike Force operations in seven different cities have conducted one of the largest health care fraud takedowns on record. Through a series of coordinated, nationwide law enforcement actions, charges have been brought against 91 individuals – including doctors, nurses, and other licensed medical professionals – for their alleged participation in fraud schemes involving nearly $430 million in false billings," said Attorney General Holder.




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Owner of Texas Home Health Services Company Pleads Guilty, Admits Role in $374 Million Fraud Scheme

A Dallas-area home health services company owner today admitted his role in a $374 million home health fraud scheme in which he and others conspired to bill Medicare for unnecessary services that were never performed.



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Owner of Miami Home Health Company Sentenced to 120 Months in Prison for $42 Million Health Care Fraud Scheme

Eulises Escalona, 44, of Monroe County, Fla., was sentenced today by U.S. District Judge Joan A. Lenard in the Southern District of Florida.



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Department of Health and Human Services Employee Sentenced in North Carolina to Prison for Theft of Government Funds

Jihan S. Cover, 34, of Arden, N.C., was sentenced today by U.S. District Judge Martin Reidinger in the Western District of North Carolina.



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

Program director Lydia Ward, 47, and therapist Nichole Eckert, 35, were each found guilty of one count of conspiracy to commit health care fraud.



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Detroit-Area Nurse Sentenced to 30 Months in Prison for Role in $13.8 Million Home Health Care Fraud Scheme

Anthony Parkman, 41, of Southfield, Mich., was sentenced today by U.S. District Judge Gerald E. Rosen in the Eastern District of Michigan.



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Two Plead Guilty in Miami for Roles in $63 Million Mental Health Care Fraud Scheme

–A registered nurse pleaded guilty today and a former program coordinator pleaded guilty yesterday in connection with a health care fraud scheme involving defunct health provider Health Care Solutions Network Inc.



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Pharmacy Owner Pleads Guilty in Miami for Role in $23 Million Health Care Fraud Scheme

A co-owner and operator of three Miami discount pharmacies pleaded guilty today in connection with a $23 million health care fraud scheme.



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Owner of Louisiana-Based Health Care Company Convicted in Texas for Role in $6.7 Million Medicare Fraud Scheme

The owner and operator of a Louisiana-based durable medical equipment (DME) company was convicted today by a federal jury in Houston for his role in a $6.7 million Medicare fraud scheme.



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Leader of $63 Million Mental Health Fraud Scheme Pleads Guilty in Miami

The owner of a string of community mental health centers pleaded guilty today in connection with a health care fraud and money laundering scheme involving defunct health care provider Health Care Solutions Network Inc. (HCSN).



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Owners of Two Miami Home Health Companies Plead Guilty in $48 Million Health Care Fraud Scheme

The owners and operators of two Miami health care agencies pleaded guilty today for their participation in a $48 million home health Medicare fraud scheme.



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Clinical Director for Miami-based Health Care Clinic Sentenced to Prison for Role in $50 Million Medicare Fraud Scheme

A former clinical director for Biscayne Milieu, a Miami-based mental-health clinic, was sentenced today to 100 months in prison for his participation in a Medicare fraud scheme involving the submission of more than $50 million in fraudulent billings to Medicare.



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Justice Department Settles Lawsuit Alleging Interference with Persons Exercising Right to Seek or Provide Reproductive Health Care

The Department of Justice today settled a civil complaint against Richard A. Retta, of Rockville, Md, in the U.S. District Court for the District of Columbia, for violations of the Freedom of Access to Clinic Entrances (FACE) Act.



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Seven Arrested, Charged with $22 Million Detroit-area Home Health Care Fraud Scheme

Six Detroit-area residents and one Chicago-area resident were arrested today by federal agents on charges arising from the ongoing investigation into an alleged $22 million home health care fraud scheme. The indictment was announced by Assistant Attorney General Lanny A. Breuer of the Justice Department’s Criminal Division; U.S. Attorney Barbara L. McQuade of the Eastern District of Michigan; Special Agent in Charge Robert D. Foley III of the FBI’s Detroit Field Office; Special Agent in Charge Lamont Pugh III of the Health and Human Services Office of Inspector General (HHS-OIG) Chicago Regional Office; and Special Agent in Charge Erick Martinez of the Internal Revenue Service Criminal Investigation (IRS-CI) Detroit Field Office.



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Four Sentenced to Prison in Florida Community Mental Health Center Case

The owners of three Miami-area assisted living facilities and an affiliated psychologist were sentenced to prison today in connection with a health care fraud scheme, involving now-defunct Miami-area health provider Health Care Solutions Network Inc. (HCSN), in which Medicare was billed for mental health treatments that were unnecessary or not provided.



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Former Program Director and Marketers Sentenced to Prison in Florida in $205 Million Community Mental Health Fraud Scheme

The former program director and two former marketers for Miami-based mental health care company American Therapeutic Corporation (ATC) have been sentenced to prison for their roles in a $205 million Medicare fraud and kickback scheme in which patients were forced to attend inappropriate treatment programs.



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Miami-Area Therapist Sentenced to Prison in Florida in $205 Million Community Mental Health Fraud Scheme

Miami-area resident Nichole Eckert, former therapist at the mental health care company American Therapeutic Corporation (ATC), was sentenced today to serve 48 months in prison for participating in a $205 million Medicare fraud scheme.



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Former Registered Nurse Sentenced in Miami to 111 Months in Prison in Connection with $63 Million Mental Health Care Fraud Scheme

A former registered nurse was sentenced today to serve 111 months in prison for his role in a health care fraud scheme involving defunct health provider Health Care Solutions Network Inc. (HCSN).



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Illegal Marketer of Medicare Information Admits Role in Detroit-area Home Health Care Fraud Scheme

A health care worker who sold Medicare beneficiary information to Detroit-area home health agency operators as part of a $24.7 million home health care fraud conspiracy pleaded guilty today for his role in the scheme, which sought to profit by billing for home healthcare services that were medically unnecessary and not provided.



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Miami Pharmacy Owner Sentenced to 14 Years in Prison in $23 Million Health Care Fraud Scheme

A co-owner and operator of three Miami discount pharmacies was sentenced today to 168 months in prison for his role in a health care fraud scheme that submitted more than $23 million in false claims to Medicare.



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Owner of Mental Health Facilities Sentenced to 168 Months in Prison in Connection with $63 Million Health Care Fraud Scheme

A former owner of mental health facilities in Florida and North Carolina was sentenced today to serve 168 months in prison for his leadership role in a health care fraud scheme involving defunct health provider Health Care Solutions Network Inc. (HCSN.



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Owners of Miami Home Health Companies Sentenced to Prison in $48 Million Health Care Fraud Scheme

The owners and operators of two Miami health care agencies were sentenced to nine years and more than four years in prison today, respectively, and ordered to pay millions in restitution for their participation in a $48 million home health Medicare fraud scheme that billed for unnecessary home health care and therapy services.



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Health Care Clinic Director Pleads Guilty in Miami for Role in $63 Million Health Care Fraud Scheme

A former health care clinic director and licensed therapist pleaded guilty today in connection with a health care fraud scheme involving defunct health provider Health Care Solutions Network Inc. (HCSN).



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Former Department of Health and Human Services Employee Pleads Guilty in Washington to Wire Fraud Charge in Retention Bonus Scheme

An employee of the Department of Health and Human Services’ Office of the Assistant Secretary for Preparedness and Response (HHS-ASPR) pleaded guilty today in Washington, D.C., to defrauding the United States by submitting fraudulent employment offers in order to claim retention bonuses totaling $138,8875.



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Medical Director for Miami-Based Health Care Clinic Sentenced to 144 Months in Prison for Role in $50 Million Medicare Fraud Scheme

A former medical director for Biscayne Milieu, a Miami-based mental-health clinic, was sentenced today to serve 144 months in prison for his role in a fraud scheme involving the submission of more than $50 million in fraudulent billings to Medicare.



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Justice Department Files Motion to Dismiss Antitrust Lawsuit Against Blue Cross Blue Shield of Michigan After Michigan Passes Law to Prohibit Health Insurers from Using Most Favored Nation Clauses in Provider Contracts

The Department of Justice today filed a motion to dismiss its antitrust lawsuit against Blue Cross Blue Shield of Michigan after the state of Michigan passed a law that prohibits health insurers from using most favored nation clauses in contracts with health care providers.



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Patient Recruiter for Miami Home Health Company Sentenced to 36 Months in $20 Million Health Care Fraud Scheme

A patient recruiter for a Miami health care company was sentenced today to serve 36 months in prison for his participation in a $20 million home health Medicare fraud scheme.



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Operators of Louisiana Home Health Company Convicted in $17.1 Million Health Care Fraud Scheme

The owner and the director of nursing of a Louisiana home health agency were each convicted late Friday for conspiring to defraud Medicare of $17.1 million.



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Detroit-Area Home Health Agency Owner and Physical Therapist Convicted in $2.3 Million Medicare Fraud Scheme

A federal jury in Detroit today convicted a home health agency owner and a physical therapist for their participation in a $2.3 million Medicare fraud scheme.



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Intermountain Health Care Inc. Pays U.S. $25.5 Million to Settle False Claims Act Allegations

Intermountain Health Care Inc. has agreed to pay the United States $25.5 million to settle claims that it violated the Stark Statute and the False Claims Act by engaging in improper financial relationships with referring physicians.



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Justice Department Reaches Multiple Settlements with Health Care Providers to Stop Discrimination Against Persons with Hearing Disabilities

The Justice Department announced today that, as part of its Barrier-Free Health Care Initiative, over the past year it has reached seven settlements with eight health care providers from across the United States to ensure that they are providing effective communication to people who are deaf or have hearing disabilities.



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Miami-Based Health Care Clinic and Its Owners and Operators Sentenced for $50 Million Fraud Scheme

The owners and operators of Biscayne Milieu, a Miami-based mental-health clinic, and the clinic itself were sentenced today 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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Detroit-Area Home Health Agency Office Manager Convicted in $5.8 Million Medicare Fraud Scheme

A federal jury in Detroit today convicted the office manager of a home health agency for her participation in a $5.8 million Medicare fraud scheme.



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Detroit Home Health Company Employee Pleads Guilty for Role in Medicare Fraud Scheme

An employee of Detroit medical service companies that fabricated patient visit notes and other documents as part of a $24 million home health care fraud scheme pleaded guilty today for her role in the conspiracy.



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Supervisor of $63 Million Health Care Fraud Scheme Convicted

A federal jury today convicted a Miami-area supervisor of a mental health care company, Health Care Solutions Network (HCSN), for helping to orchestrate a fraud scheme that crossed state lines and that resulted in the submission of more than $63 million in fraudulent claims to Medicare and Florida Medicaid.



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Justice Department Expands Its Barrier-Free Health Care Initiative with Settlement with Burke Health and Rehabilitation Center in Burke, Virginia

The Justice Department announced today that, as part of its Barrier-Free Health Care Initiative, it has reached a settlement agreement with another health care provider, Medical Facilities of America XXIX Limited Partnership, t/a Burke Health and Rehabilitation Center in Burke, Va., to ensure that they provide effective communication to people who are deaf or have hearing loss.



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Adventist Health Pays United States and State of California $14.1 Million to Resolve False Claims Act Allegations

Adventist Health System/West, dba Adventist Health, and its affiliated hospital White Memorial Medical Center have agreed to pay the United States and the state of California $14.1 million to settle claims that they violated the False Claims Act.



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Patient Recruiter of Miami Home Health Company Sentenced to 37 Months in Prison for Role in $20 Million Health Care Fraud Scheme

A patient recruiter for a Miami health care company was sentenced today to serve 37 months in prison for his participation in a $20 million Medicare fraud scheme.



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Health Care Clinic Director Pleads Guilty in Miami for Role in $63 Million Fraud Scheme

A former health care clinic director and licensed clinical psychologist pleaded guilty today in connection with a health care fraud scheme involving defunct health provider Health Care Solutions Network Inc. (HCSN).



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Detroit Area Home Health Agency Owner Sentenced to 60 Months for Role in $13 Million Health Care Fraud Scheme

A Detroit-area home health care agency owner was sentenced today to 60 months in prison for causing the submission of over $1 million in false and fraudulent billing to Medicare as part of a $13.8 million health care fraud conspiracy.



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Detroit-Area Clinic Owner Sentenced to 40 Months in Prison for Role in $19 Million Health Care Fraud Scheme

A Detroit-area adult day care center owner was sentenced today to serve 40 months in prison for billing for unnecessary psychotherapy services, or services that were not provided, as part of a health care fraud conspiracy which led to more than $19 million in fraudulent Medicare billings.



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