In court in Central Islip, Hal Abrahamson, a foot doctor with offices in Plainview, Long Island, and Rego Park, Queens, was sentenced by US District judge Denis R. Hurley to at least one year and a day in jail for his role during a health care fraud scheme. The Court additionally ordered Abrahamson to pay [...]
Separately asking routine evaluation and management (E/M) services provided on a similar day as another procedure is usually denied by Medicare. Care providers might typically individually bill E/M services if they meet certain criteria and append modifier 25 vital, on an individual basis specifiable analysis and management service by a similar MD or different qualified [...]
An indictment unsealed July ten charges Vasso Godiali, MD, with orchestrating a $60 million care fraud scheme and lavation payoff from the scheme, per the Department of Justice. Dr. Godiali, a vascular physician, allegedly submitted false claims to Medicaid, Medicare and Blue Cross of Michigan for services that weren't provided and exploited Modifier fifty nine [...]
The United States DOJ is initiating direct legal proceedings against Hospitals, Health Care systems, and Medical Technology Corporations for submitting an exhaustive number of false claims to both Medicare and Medicaid. This action is in concordance with the Electronic Health Records (EHR) incentive program, per the National Law Review. Click Here to Read the Full [...]
A United States Federal Jury found Dr. Robert Glazer guilty on June 7th for his primary role during a 33 million dollar fraud scheme concerning requests of Medicare for care services that were not actually provided. Following a seven-day trial, Dr. Glazer was found guilty of a single count of Conspiracy to Commit Fraud and [...]
Joseph P. Galichia MD, the previous owner of the Wichita-based Galichia Medical, after quite some time, reached Fraud Claim Act settlements with the Feds in 2000 and 2009 amounting to nearly 6 Million Dollars. This was his third time settling with the US Federal Government for such behavior. Click Here to Read the Full Story!
A West Los Angeles dental practitioner was sentenced last week to forty months in federal jail for a health-care insurance fraud scheme during which he submitted phony billings for crowns and fillings that were not ever really provided to patients. Benjamin Rosenberg, 59, pleaded guilty in January to one federal count of health care fraud, [...]
Jaime L. Sepulveda, MD, LLC (d/b/a Miami Urogynecology Center), Jaime L. Sepulveda, M.D., and Sujata Yavagal, M.D. (collectively, "Miami Urogynecology Center"), South Miami, Florida, entered into a $173,768.08 settlement agreement with OIG. The settlement agreement resolves allegations that Miami Urogynecology Center submitted claims to Medicare for items or services that it knew or should have [...]
On November 19, 2018, Southern Connecticut Vascular Center, LLC (SCVC), Stratford, Connecticut, entered into a $792,076.76 settlement agreement with OIG. The settlement agreement resolves allegations that SCVC submitted claims for Healthcare Common Procedure Coding System (HCPCS) code 96965 when those claims were for a procedure that was already included as a component of the duplex ultrasound [...]
On April 12, 2019, Complete Women Care, Inc., and Miriam Mackovic-Basic, M.D. (collectively, "CWC"), with multiple locations in Los Angeles County, California, entered into a $258,045 settlement agreement with OIG. The settlement agreement resolves allegations that CWC submitted claims to Medicare for items or services that it knew or should have known were not provided as [...]
