Healthcare fraud news from FierceHealthcare

Ah, you've gotta love the guys who just won't give up. After years of being knee-deep in an operation riddled with bad behavior, the war still goes on for former administrator and co-owner Peter Read more...

HHS has launched a new pilot program hoping to catch dishonest medical equipment suppliers in the Los Angeles area and South Florida. If the pilot is successful, CMS plans to role out the program across the United States. The two-year effort, designed to ferret out Medicare fraud, will search for falsified bills and overcharges from suppliers of prosthetics, orthotics, diabetic supplies …

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Despite its having engaged in a massive Medicare scam costing the federal government at least $630 million, St. Barnabas Health Care System did not prevent other hospitals from getting fair reimbursement.

That's the conclusion of a federal judge, who ruled that despite the fraud, St. Barnabas had not engaged in racketeering. Two small hospitals in Maine and Colorado filed the suit, alleging St. Barnabas' over billing was so extreme it distorted CMS's Medicare reimbursement …

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A group of Tuscaloosa, AL-based physicians are suing HealthSouth to stop the pending sale of one of its outpatient surgery centers. The physician group, Surgery Center Partners, contends that when it agreed to sell its outpatient surgical facilities, HealthSouth didn't honor the terms of the partnership contract with their regional surgery center, HealthSouth Surgical Center of Tuscaloosa. HealthSouth has agreed to sell its 139 surgery centers and three surgical hospitals to Texas Pacific …

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The University of Medicine and Dentistry of New Jersey (UMDNJ) has seen another top administrator leave in the wake of ongoing questions over alleged financial fraud. A week before he was due to retire, associate dean for academic and student affairs Paul Mehne has been relieved of his duties and placed on paid administrative leave amidst yet another investigation into the school's purported financial misdealings. Early last year, New Jersey Governor Jon Corzine dismissed the school's …

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Scottsdale, AZ-based ambulance firm Rural/Metro has settled with the U.S. Department of Justice over a pair of whistleblower suits alleging that it had offered kickbacks in exchange for Medicare and Medicaid business. Rural/Metro has agreed to pay $2.5 million to settle the 2000 and 2001 suits, which asserted that the company had offered discounts to Texas hospitals in return for contracts to provide services billable to the state and federal entities. (Competitor American Medical …

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A group of six men have been indicted on federal charges that they rigged bids for a $79 million IT project. The group, which includes contractors, a military officer, the officer's son and a prominent healthcare consultant, is accused of steering IT contracts for roughly 20 Army hospitals to companies with which they were affiliated or companies they controlled. In some cases, the contracts were designed such that only a specific company could get them, and in others, the bidding process …

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A group of Chicago-area MRI centers have been named in a broad-based state investigation, which concluded that they'd agreed to pay doctors over $130,000 a year to refer patients. The state attorney general's office contends that the MRI centers, largely operated by Virginia's MIDI, trained salespeople to lure physicians into bogus lease deals by dangling kickbacks, as much as $277 per MRI scan. Phantom lease deals made it look like doctors were managing the MRI equipment and providing …

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Federal officials have arrested 38 individuals in South Florida--a world capital of DME fraud--accusing them of defrauding the Medicare program of more than $142 million. Working with state and local authorities, the feds investigated the individuals for two months, relying in part on real-time computer data to track the progress of their activities. The officials concluded that the defendants paid Medicare enrollees to use the enrollees' card numbers. Prosecutors say that the accused …

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The U.S. Department of Justice has joined a group of suits filed against HealthEssentials Solutions, a provider of geriatric services to nursing homes, assisted living facilities and home-based patients, has been charged with making false Medicare claims. The suits accuse HealthEssentials of upcoding Medicare billings and charging Medicare for needless services. Specifically, the charges say that HES not only upcoded care charges, but also billed for assisted living care for services …

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