LexisNexis® Legal Newsroom
Home Health Agency Manager Pleads Guilty in Connection with Detroit Fraud Scheme

From the US Department of Justice : WASHINGTON - Detroit-area resident Hassan Akhtar pleaded guilty yesterday for his role in managing a home health care fraud scheme, the Departments of Justice and Health and Human Services (HHS) announced. Akhtar, 26, pleaded guilty before U.S...

Medicare Fraud: Los Angeles Medical Equipment Supplier Sentenced to Prison / New Orleans Doctor and Owner of Equipment Company Plead Guilty to Health Care Fraud Scheme

From the US Department of Justice : Los Angeles Medical Equipment Supplier Sentenced to 46 Months in Prison for Role in Power Wheelchair Scheme to Defraud Medicare WASHINGTON - The owner and operator of a Los Angeles durable medical equipment (DME) company was sentenced to 46 months in prison...

Owner of Two Houston Health Care Companies Pleads Guilty in Connection with Schemes to Defraud Medicare of $6.3 Million

From the US Department of Justice : WASHINGTON - An owner of two Houston health care companies pleaded guilty Tuesday in connection with schemes to defraud Medicare of $6.3 million, announced the Departments of Justice and Health and Human Services (HHS). Princewill Njoku, 51, pleaded...

73 Members and Associates of Organized Crime Enterprise, Others Indicted for Health Care Fraud Crimes Involving More Than $163 Million

From the US Department of Justice : Indictments in Five States - California, Georgia, New Mexico, New York and Ohio WASHINGTON - Seventy-three defendants, including a number of alleged members and associates of an Armenian-American organized crime enterprise, were charged in indictments...

California Claims Drug Giant Bribed Doctors To Prescribe

LOS ANGELES - (AP) California has joined a whistleblower lawsuit that claims Bristol-Myers Squibb Co. bribed doctors to prescribe its drugs, costing insurers perhaps millions of dollars in the largest alleged health care fraud case ever handled by the state, Insurance Commissioner Dave Jones announced...

Workers' Comp Fraud Blotter (7/7/2011) – Pill Mill Doctor Prescribed Unneeded Narcotics and Improperly Billed Workers’ Compensation

Each week we'll be surveying what the media, state agencies, insurance companies, and others report in terms of workers' comp fraud. Just like a police blotter, our workers' comp fraud blotter lists recent arrests, charges, convictions and investigations. Workers' Comp Fraud...

Workers' Comp Fraud Blotter (4/12/2012) – “The Noodle” Fights On MMA Circuit While Seeking Workers’ Compensation For Day Job As Firefighter

Each week we'll be surveying what the media, state agencies, insurance companies, and others report in terms of workers' comp fraud. Just like a police blotter, our workers' comp fraud blotter lists recent arrests, charges, convictions and investigations. Workers' Comp Fraud Blotter...

Workers' Comp Fraud Blotter (5/24/2012) – Newly Retired Police Officer Charged With Mail Fraud and Health Care Fraud

Each week we'll be surveying what the media, state agencies, insurance companies, and others report in terms of workers' comp fraud. Just like a police blotter, our workers' comp fraud blotter lists recent arrests, charges, convictions and investigations. Workers' Comp Fraud Blotter...

Workers' Comp Fraud Blotter (5/31/2012) – AIG Fined; Largest Fine in Pennsylvania Insurance Department’s History Levied

Each week we'll be surveying what the media, state agencies, insurance companies, and others report in terms of workers' comp fraud. Just like a police blotter, our workers' comp fraud blotter lists recent arrests, charges, convictions and investigations. Workers' Comp Fraud Blotter...

LexisNexis Acquires EDIWatch, Provider of Leading Health Care Fraud Waste and Abuse Workflow Solutions

Company strengthens its advanced analytics, health care offering with end-to-end solution LexisNexis® Risk Solutions on Sept. 5 announced it has acquired EDIWatch, Inc., a privately-held leading provider of fraud, waste and abuse (FWA) technology solutions exclusively for the health care payer...

49 Russian Diplomats and Spouses Charged with Medicaid Fraud, But Diplomatic Immunity Bars Their Arrest

A total of 49 current or former Russian diplomats and their spouses have been charged by U.S. prosecutors with participating in a widespread health care fraud scheme from 2004 to August 2013 to illegally obtain nearly half a million dollars in Medicaid benefits. Not one of the people charged was arrested...

“Skid Row” Health Care Fraud: Doctor Guilty for Recruiting Homeless to Defraud Medicare and Medi-Cal

In the first case filed in relation to the second major investigation into the illegal recruitment of “Skid Row” homeless people in Los Angeles for unnecessary medical procedures, a La Mirada, California, doctor has pleaded guilty to federal tax charges and admitted participating in a large...

#1 in Financial Fraud Law: US Attorney Preet Bharara

When we here at the Financial Fraud Law Blog think about financial fraud law, it does not take long before we think about the U.S. Attorney for the Southern District of New York, Preet Bharara. In a little over four years as U.S. Attorney – following his unanimous confirmation by the Senate –...

Williams Mullen Health Care Fraud and Abuse Alert: What CMS’s New Billing Requirement For ‘Incident To” Services Means For Medicare Providers

By Brian C. Vick In the final Medicare Physician Fee Schedule for 2014 (“2014 PFS”), CMS implemented a new condition of payment for “incident to” services that has significant fraud and abuse implications for any Medicare provider who relies on reimbursement revenue from these...

$8 Billion Collected by Justice Department in Civil and Criminal Cases in Fiscal Year 2013

The Justice Department collected a lot of money in civil and criminal cases during the last fiscal year. Attorney General Eric Holder totaled it up, and came to at least $8 billion. “The department’s enforcement actions not only help to ensure justice is served, but also deliver a valuable...

New York City Settles Whistleblower Suit Over Medicaid Claims for Psychological Services for Special Education Students

The federal government and the City of New York have settled the case of Ohlmeyer ex rel. United States of America v. City of New York , a whistleblower action brought pursuant to the qui tam provisions of the federal False Claims Act. In its civil complaint, the federal government alleged that the...

Website Operator Tricked Consumers with Phony Information about Obamacare, FTC Alleges

The Federal Trade Commission is taking action against a website operator that allegedly tricked consumers – in advance of the roll-out of the Affordable Care Act (ACA) – with spam emails that falsely claimed that consumers would be violating the ACA if they did not immediately click a link...

Health Care Fraud Prosecutions Set Record in 2013

The U.S. Justice Department’s Medicare Fraud Strike Force set record numbers for health care prosecutions in Fiscal Year 2013. “These record results underscore our determination to hold accountable those who take advantage of vulnerable populations, commit fraud on federal health care...

Bennington School’s Former President Sentenced to 18 Months in Federal Prison for Tax and Health Care Fraud

Matthew Merritt Jr., 82, of West Stockbridge, Massachusetts, has been sentenced to 18 months in federal prison after his guilty plea to charges that he engaged in a scheme to defraud a health care program and commit tax fraud. U.S. District Judge William K. Sessions, III, sitting in Burlington, also...

Disability Doctor Peter J. Lesniewski Sentenced to 8 Years in Prison for His Role in Long Island Railroad Fraud

Peter J. Lesniewski, a Board-certified orthopedist, has been sentenced in Manhattan federal court to eight years in prison for his role in the alleged massive fraud scheme in which Long Island Railroad (LIRR) workers claimed to be disabled upon early retirement so that they could receive disability benefits...

Health Care Fraud Recoveries Hit Record $4.3 Billion Last Year, DOJ Reports

For every dollar federal prosecutors spent on health care-related fraud and abuse investigations under the Health Care Fraud and Abuse Control (HCFAC) Program and other programs over the last three years, the government recovered $8.10. This is the highest three-year average return on investment in the...

A Doctor, a Pharmacist, and a Marketer Found Guilty in Health Care Fraud Scheme

A doctor, a pharmacist, and a marketer have been convicted in federal court in Detroit for health care fraud and controlled substance distribution. A jury returned guilty verdicts against Dr. Carl Fowler, M.D., of West Bloomfield, Michigan, pharmacist Mukesh Khunt, of Toronto, Ontario, Canada, and...

Pharmacy Preyed On HIV Patients While Fraudulently Billing Medicaid for Millions, Prosecutors Assert

Three men have been arrested on charges that they defrauded government-funded health care programs by buying back prescriptions and billing Medicaid as if the medication had been dispensed. The two owners of 184th Street Pharmacy in the Bronx, along with the supervising pharmacist, targeted financially...

7 for 7: Jury Convicts All Defendants in $97 Million Medicare Fraud

A federal jury in Houston has convicted two owners of a former Houston mental health care company, Spectrum Care P.A., several of its employees, and the owners of certain Houston group care homes for their participation in a $97 million Medicare fraud. Physicians Mansour Sanjar and Cyrus Sajadi, the...

Warner Chilcott Pleads Guilty, Pays $125M In Criminal, Civil Fines For Fraud

BOSTON — (Mealey’s) Pharmaceutical company Warner Chilcott on Oct. 23 pleaded guilty to health care fraud, and its former president was arrested for conspiracy to pay kickbacks to physicians, the U.S. Attorney for the District of Massachusetts announced Oct. 29 ( United States of America...