Tag Archives: Healthcare fraud

NICB Launched Online COVID-19 Resource Center Due to Surge in Insurance Fraud Schemes

The National Insurance Crime Bureau (NICB) has created a new page on its website called the “NICB COVID-19 Resource Center.” The page provides the latest information on emerging fraud schemes due to an influx of insurance fraud cases tied to the COVID-19 outbreak.

The Coalition Against Insurance Fraud (CAIF) recently sent out a statement regarding a surge of fake coronavirus health coverage schemes. It warned that robocalls, text messages, and email phishing attacks could fake insurance deals to consumers, asking them to pay for health or travel insurance premiums without delivering coverage.

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Boca Raton Doctor Charged with Insurance Fraud

A Boca Raton osteopathic physician Dr. Max Citrin has been charged with insurance fraud for allegedly copying and pasting false symptoms for his patients. Citrin was charged with three felonies for submitting fraudulent claims to Blue Cross Blue Shield, Cigna and Humana, totaling nearly 1 million dollars.

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Tallahassee Doctor Accused of Billing Insurers for Phony Medical Procedures

Dr. Moses D. Degraft-Johnson of the Heart and Vascular Institute of Northern Florida in Tallahassee is accused of taking $26 million from health insurance agencies for phony medical procedures. According to federal prosecutors, Dr. Degraft-Johnson allegedly went to hospitals, scheduled patients for unnecessary visits, and billed for the services that never occurred. In some cases, the doctor was traveling when he claims to have done procedures in his office.

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Man Arrested and Extradited to Florida for Posing as Doctor in Kissimmee

Ozioma Maduka was arrested and charged with allegedly diagnosing and treating patients as a health care professional with a license at Osceola Injury Center in Kissimmee. He is also accused of fraudulent billing for unlicensed medical treatments. Maduka’s medical license expired in 2017.

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Unlicensed Florida Doctor Arrested For Unlicensed Medical Treatments and Fraudulent Billing

Ozioma Maduka of Osceola Injury Center, LLC was arrested for allegedly practicing healthcare without an active, valid Florida medical doctor’s license as well as fraudulently billing unlicensed medical treatments. Maduka billed two insurance companies for more than $4,400 in claims for unlicensed treatment of auto accident victims.

Maduka could face up to 5 years in prison if convicted.

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Filed under Fraud, Healthcare

Three South Floridians Arrested in Sober Home Health Care Fraud Scheme

Peter Port, 64, of Boca Raton; Brian Dublynn, 62, of Fort Lauderdale; and Jennifer Sanford, 57, Hollywood were arrested for allegedly billing health-insurance companies for services that were not performed or medically necessary. Port, Dublynn and Sanford made about $13 million in the scam through Safe Haven Recovery, a substance abuse treatment facility in Miami.

The trio was charged with conspiracy to commit health care fraud and wire fraud, health care fraud, conspiracy to commit money laundering and money laundering. They could face at least 20 years in prison if convicted.

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Filed under Fraud, Healthcare

Former Medical Clinic Bookkeeper Charged with Insurance Fraud

Teresa Johnson of Lecanto has been charged with insurance fraud for allegedly defrauding Medicare and Medicaid while working as a bookkeeper for the now-closed Christ Medical Center. According to Johnson’s plea statement, she knowingly billed Medicaid and Medicare for services the now deceased clinic owner did not perform. She also ordered tests she knew were not medically necessary.

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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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Filed under Fraud, Healthcare