Tag Archives: Healthcare fraud

Five People Charged in Mail-order Prescriptions Patient-Brokering Kickbacks

Five people have been charged with patient brokering, insurance fraud, money laundering, and racketeering in connection with a scam that raked in hundreds of thousands of dollars in kickbacks. Authorities allege that hundreds of prescriptions, many of them fraudulent, were sent to Express Care Pharmacy with prices ranging from $646 to $5,614. Many of the prescriptions were forged, unnecessary, or submitted without the patients or treating physician’s consent, according to the police report.

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Medical Biller Sentenced to 4 Years for Healthcare Fraud Scheme

Sabrinea Brooks of Port St. Lucie was sentenced to four years in federal prison after pleading guilty to wire fraud, access device fraud and forgery. Brooks used her four jobs in healthcare billing from June 2014 through April 2015 to simultaneously work her fraud scheme rerouting over $873,000 to bank accounts that she controlled.

 

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Land o’ Lakes Medical Marketing Company Owner Found Guilty in $2M Medicare Fraud Scheme

David Brock Lovelace, the owner of the medical marketing company DBL Management LLC, was found guilty of Medicare fraud. After a four-day trial, Lovelace was found guilty of conspiracy to pay health care kickbacks and structuring currency transactions to avoid the reporting requirement.

Lovelace paid cash kickback and bribes in exchange for the referral of Medicare beneficiaries’ DNA swabs. He was then paid a percentage of the reimbursements from the $2.2 million in claims submitted by a clinical lab.

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South Florida Pain Clinic Owner Sentenced in Health Care Fraud Case

Scott Novick, owner of pain clinics in Palm Beach, Broward and Miami, was sentenced to six and a half years in prison and forfeit almost $1.4 to Medicare. Novick pled guilty to conspiracy to commit health-care fraud resulting in Medicare losses in the amount of $2.2 million. He was sentenced to six and a half years in prison and ordered to forfeit $1.4 million to Medicare.

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Tampa Bay Residents Charged in $200M Health Care Fraud Scheme

Jessica Linton of Clearwater and Juan Rodriguez of Tampa are two of 10 people who were charged in an indictment alleging over $200 million in insurance fraud. Linton is facing 24 charges in the indictment while Rodriguez is facing 6 charges including health care fraud, mail fraud and aggravated identity theft. The scheme included altering prescriptions to add non-prescribed drugs including Tramadol and ketamine.

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Stuart OB/GYN Found Guilty in Health Insurance Fraud Scheme

A federal court jury found Dr. Sheetal Kanar Kumar, former Stuart obstetrician and gynecologist, guilty of 23 counts of health insurance fraud. Kumar faces up to 10 years in prison and fines of $250,000 for each charge as a result of her fraudulent claims to Medicare, Medicaid and Blue Cross Blue Shield. Kumar’s claims involved charges for patient office visits involving complex cystometrogram, anorectal manometry, uroflowmetry and voiding pressure studies.

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Physical Assistant Pleaded Guilty for Role in $1B Medicare Fraud Scheme

Arnaldo Carmouze, a former physician assistant, is facing up to 10 years in prison time for his role in a Medicare fraud scheme. Carmouze was one of three defendants who pleaded guilty to conspiracy to commit healthcare fraud while working for a network of skilled nursing homes and assisted living facilities. The scheme involved admitting Medicare and Medicaid patients to these homes and facilities even if they did not qualify for placement and giving them unnecessary medical care as well as referring patients to certain healthcare providers for kickbacks. In addition to prison time, Carmouze is also facing a fine up to $250,000 and three years of supervised release for his role in the $1 billion Medicare fraud scheme.

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Miami Home Health Care Worker Sentenced in Health Care Fraud Scam

Margarita Palomino of Homestead, Florida pleaded guilty to conspiracy to commit health care fraud and wire fraud. Palomino who worked for three home health agencies where she allegedly accepted kickbacks for the referral of Medicare beneficiaries, even ones that did not qualify for home health services and changed claims coding to increase reimbursement by Medicare. Palomino also admitted that she performed home health care nursing visits and prepared related medical records although she does not have a license to do so in the United States.

Medicare made payments of at least $4.65 million as a result of false and fraudulent claims submitted as part of this conspiracy. Palomino was sentenced to over six years in prison to be followed by three years of supervised release for her role in the health care fraud scheme.

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Brothers Sentenced In Smart Labs Healthcare Fraud Scheme

H. Hamilton Wayne (CEO) and Justin Wayne (COO) of Smart Labs of Palm Beach have been sentenced to prison for healthcare fraud charges they pleaded guilty to back in August. They were also ordered to pay more than $9.6 million in restitution. H. Wayne was sentenced to 63 months in prison, three years of supervised release and a $50,000 fine. His brother Justin received 46 months in prison, three years of supervised release and a fine of $20,000. Justin was a Florida Marlins pitcher from 2002 to 2004.

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Telemedicine Business Owner Pleads Guilty to Fraud

Scott Gregory Roix, owner of the telemedicine company HealthRight, pleaded guilty to conspiracy to commit health care and wire fraud. Roix and his four alleged conspirators, Florida and Texas pharmacists and pharmacy owners are accused of submitting fraudulent insurance claims for more than $930 million.

Healthright made a lot of money illegally selling suspect, inexpensive drugs like weight-loss pills, skin creams and testosterone supplements at inflated prices. Roix’s company also obstructed doctor-patient relationships with telemarketers posing as “medical personnel.” HealthRight hid drug sales to the partner pharmacies by accounting for the payments as “marketing services.”

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