All articles tagged with #medicare fraud
Originally Published 5 months ago — by ABC News
UnitedHealth disclosed it is under criminal and civil investigation by the Department of Justice related to its Medicare practices, following media reports and ongoing probes, but maintains confidence in its compliance and practices amid a tumultuous year for the company.
Originally Published 6 months ago — by Rolling Stone
Senator Rick Scott, known for his company's past Medicare fraud settlements, is advocating for significant cuts to Medicaid, including an additional $313 billion, which could result in millions losing coverage. The article highlights Scott's history with HCA Healthcare, which settled large fraud claims related to Medicaid and Medicare billing practices, and criticizes his current stance on Medicaid reductions, framing it as targeting able-bodied adults and exploiting claims about undocumented immigrants. The piece underscores the irony of Scott's past with Medicaid fraud and his current efforts to cut funding.
Originally Published 1 year ago — by Department of Justice
The United States has filed a complaint against Regeneron Pharmaceuticals, alleging that the company fraudulently manipulated Medicare reimbursement for its drug, Eylea, by knowingly submitting false average sales price (ASP) reports to Medicare. The complaint alleges that Regeneron inflated Eylea’s ASP by paying credit card processing fees for the benefit of physician-customers purchasing Eylea, without properly reporting these payments as price concessions to ASP, resulting in hundreds of millions of dollars in inflated reimbursements by Medicare. The government's investigation was prompted by False Claims Act allegations brought in a whistleblower lawsuit, and if found liable, Regeneron could face significant financial penalties.
Originally Published 1 year ago — by The Washington Post
Former President Donald Trump, who recently vowed to reduce spending on Social Security and Medicare by targeting waste and fraud, granted clemency to several individuals convicted in major Medicare fraud cases during the closing months of his presidency. These individuals collectively filed nearly $1.6 billion in fraudulent claims through Medicare or Medicaid. Trump's actions have drawn criticism from experts and come in contrast to his recent statements about protecting entitlement programs.
Originally Published 1 year ago — by NBC 6 South Florida
South Florida call centers are linked to a multi-billion dollar Medicare fraud scheme, targeting Medicare recipients with unnecessary genetic testing. Telemarketers use illegally obtained personal data to convince beneficiaries to take the tests, which are then billed to Medicare for exorbitant amounts. The scheme involves call centers in South Florida, with one case involving over $67 million in false claims. Despite efforts by federal investigators, limited resources and funding hinder the crackdown on such fraudulent activities.
Originally Published 2 years ago — by CNBC
A Florida nurse practitioner, Elizabeth Hernandez, has been convicted of health-care conspiracy and other charges for her involvement in a scheme that defrauded Medicare of over $200 million. Hernandez participated in a broad scheme where telemarketing companies convinced Medicare patients to request unnecessary orthotic braces and genetic tests. She fraudulently billed Medicare for these services, even though she had never examined or treated many of the patients. Hernandez personally profited $1.6 million from the scheme, using the money for luxury purchases. She is scheduled to be sentenced on December 14 and faces a maximum possible sentence of 20 years in prison.
Originally Published 2 years ago — by WGME
Martin's Point Health Care, a healthcare provider based in Maine, has agreed to pay over $22 million to settle allegations of Medicare fraud. The settlement comes after an investigation into the company's billing practices, which allegedly involved fraudulent claims submitted to Medicare.
Originally Published 2 years ago — by Press Herald
Martin's Point Health Care has agreed to pay over $22 million to settle allegations of Medicare fraud. The company was accused of abusing the Medicare Advantage program by assigning additional diagnoses to patients in order to receive higher reimbursements. A former manager at Martin's Point filed a whistleblower complaint in 2018, alleging violations of the False Claims Act. The settlement agreement states that the company knowingly submitted unsupported and invalid diagnostic codes, resulting in payments to which it was not entitled. Martin's Point denies liability but decided to settle to avoid the costs and uncertainty of litigation. The settlement does not release the company from the possibility of criminal charges.
Originally Published 2 years ago — by POLITICO
Navy veteran Phil Ehr has officially entered the race for Senate in Florida, challenging incumbent GOP Sen. Rick Scott. Ehr criticized Scott's support for former President Trump and highlighted his oversight of a company fined $1.7 billion for Medicare fraud. Despite pressure from Democratic leaders to recruit former Rep. Debbie Mucarsel-Powell, Ehr launched his campaign, emphasizing his commitment to fighting for American values. Other potential challengers to Scott include state Rep. Fentrice Driskell, Brevard County School Board member Jennifer Jenkins, and former Rep. Alan Grayson.