Three sentenced to a combined 14 years in prison for ambulance fraud scheme; Wisconsin lab pays $8.5 million after billing Medicare for food sensitivity testing;

News From Around the Web

> A former owner, operator and manager of a Los Angeles ambulance company were sentenced to a combined 14 years in prison for a fraud scheme that led to $1.5 million in false claims paid by Medicare. Yaroslav Proshak, owner of ProMed Medical Transportation, was sentenced to nine years for providing non-emergency transportation to dialysis patients who did not need it. Emilia Zverev, who served as the billing manager for the company, and Sharetta Michelle Wallace, who supervised EMTs, were sentenced to three and two years respectively for their role in the scheme, according to the DOJ. Announcement

> A Wisconsin laboratory has agreed to pay $8.5 million to settle allegations that it billed Medicare for improper testing for nearly five years. Pharmasan Labs Inc., which billed Medicare through NeuroScience Inc., was founded by Gottfried and Mieke Kellermann. The Kellermanns knowingly billed Medicare for food sensitivity testing that was not covered, along with services referred by non-physician practitioners, according to the DOJ. Announcement

> A Savannah, Georgia woman was charged with eight counts of healthcare fraud, alleging that she submitted false claims to Medicaid for orthotic equipment. Prosecutors allege that Barbara J. Wallace, owner of MBA Diabetic Footwear Solutions, submitted the claims from 2010 through 2014, and they were neither authorized by a physician nor were they delivered to patients. Announcement

Health Payer News

> More competition within Affordable Care Act marketplaces means lower premiums for patients, according to several new studies. Researchers found that the addition of one insurer in a county led to 3.5 percent lower premium in benchmark plans, and 1.2 percent lower premiums in silver plans. Another study showed that CO-OP plans and Medicaid managed care plans had lower premium increases than commercial plans. Article

> A real-time cyberattack readiness simulation showed that payers are still vulnerable to hackers and cyber threats. Employees from 12 insurers participated in the exercise, but only two referenced incident report plans during the exercise. Additionally, many employees did not know who had the authority to take down the company's claims processing platform. Article

And finally… This dog is more excited for Star Wars than you are. Article

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