New York Doctor Imprisoned For $30M Scheme
Dr. Ewald Antoine pleaded guilty to healthcare fraud, as well as several other crimes. According to the indictment, Dr. Antoine posed as the owner of two clinics in Brooklyn, falsely [...]
Northwest ENT Associates, P.C. to pay approximately $1.2 million to resolve False Claims Act allegations
Northwest ENT Associates, P.C. (“Northwest ENT”), a Marietta, Georgia based professional corporation, has agreed to pay $1,195,361 to resolve allegations that it violated the False Claims Act by submitting claims [...]
California Physician and Practice Settle False and Fraudulent Claims Case
On June 11, 2018, James S. Dunn, Jr., MD, d/b/a Auburn Urogynecology and Women's Health (collectively, "Dr. Dunn"), Auburn, California, entered into a $419,578 settlement agreement with OIG. The settlement [...]
Providence Health Sued Over Alleged $188 Million Medicare Upcoding Scheme
Providence Health and Services has been hit with a lawsuit alleging the health system violated the False Claims Act by purposely upcoding Medicare to increase reimbursement. The lawsuit, filed late last [...]
Whistleblower Sharing in Settlement from Prime Healthcare
A San Diego whistleblower will receive $17. 2 mil with the settlement of a 7-year-old false statements|lawsuit against Prime Healthcare Care regarding overbilling for Medicare services at California hospitals. Read [...]
Prime Healthcare Services To Settle False Claims Act Allegations
Prime care Services, Inc., Prime care Foundation, Inc., and Prime care Management, Inc. (collectively Prime), and Prime’s Founder and Chief exective officer, Dr. Prem Reddy, have united to pay the u. s. $65 million to settle allegations that fourteen Prime hospitals in Calif. wittingly submitted false [...]
Proposed 2019 E&M Overhaul Impact Analysis
You don’t have to be a coder to realize what the financial impact of proposed changes from the Centers for Medicare & Medicaid Services (CMS) will be, or to see [...]
Owner of Ambulance Company Pleads Guilty To Health Care Fraud
The owner and managers of Arrow-Med Ambulance, Inc. plead guilty in connection with claims of fraud to Medicare and Medicaid. The accusation was of them using ambulances for medically unnecessary [...]
eClinicalWorks Fined For Failing To Comply With DOJ Settlement Agreement
The Inspector General of the Department of Health and Human Services fined eClinicalWorks $132K for violating a 2017 agreement which had required them to report patient safety issues with its EHR [...]
OIG Estimates Medicare Improper Payments at $3.7 million
The Office of Inspector General (OIG) reviewed 191,118 Medicare paid distant-site telehealth claims, totaling $13.8 million, that lacked corresponding originating-site claims. The watchdog agency then reviewed provider supporting documentation of these claims to determine if the services met Medicare’s [...]