Medicare

Skin Cancer Testing Company To Pay $5,038,011 to Resolve Allegations of False Claims to Medicare for Unreliable Cancer Tests

By the Constantine LLP Whistleblower Team On August 26, the U.S. Department of Justice’s Office of Public Affairs announced that a skin cancer testing company (formerly known as DermTech Inc.) agreed to settle allegations it violated the False Claims Act by knowingly submitting false claims for unreliable skin cancer tests to Medicare.[1] After filing for Chapter 11 bankruptcy in the District of Delaware in...

Oglethorpe and Three Executives Agree to Pay $32 Million to Settle FCA Case

By the Constantine Cannon Whistleblower Team According to a recent DOJ press release, Oglethorpe, Inc., a company that operates psychiatric hospitals, and three of its executives have agreed to pay $32 million to settle a False Claims Act case alleging a failure to return Medicare overpayments in connection with patient admissions at Oglethorpe facilities.[1]  The DOJ partially intervened in the case prior to the...

Health Care Practice and Doctor Agree to Pay Over $6.73 Million to Settle False Claims Act Case

By the Constantine Cannon Whistleblower Team The United States Department of Justice (DOJ) recently announced that a California-based health care practice and a doctor have agreed to pay $6.73 million to settle allegations of violating the False Claims Act.[1]  The DOJ alleged that the practice, called Feliciano Serrano, M.D., Inc. d/b/a Serrano Kidney & Vascular Access Center, and Dr. Serrano submitted or caused...

Government Seizes $2M+ from California Wound Care Clinic Over Alleged Medicare Skin Graft Fraud

By the Constantine Cannon Whistleblower Team On April 28, a federal court granted the government’s request to seize over $2 million from a California clinic, Expert Wound Care, which allegedly defrauded Medicare by billing for skin grafts and skin graft substitutes that patients never received. United States Magistrate Judge Alicia G. Rosenberg authorized the seizure of roughly $2,039,792 from a bank account...

Owner of Telemedicine and DME Companies Pleads Guilty for Role in $46.2 Million Fraud Scheme

By the Constantine Cannon Whistleblower Team On March 27, Christopher Harwood, the owner of telemedicine company TelevisitMD and a number of durable medical equipment (DME) supply companies, pleaded guilty to conspiracy to commit healthcare fraud and wire fraud for his role in a $46.2 million scheme.[1]

Harwood’s Businesses

Harwood was the owner and operator of TelevisitMD, a telemedicine company.[2]...

Texas Fugitive Caught and Sentenced to 12+ Years in Prison for $61M Telemarketing Fraud Scheme Targeting Medicare Beneficiaries

By the Constantine Cannon Whistleblower Team  On March 25, a federal court sentenced Texas resident Robert “Bobby” Leon Smith III to 150 months in prison and two years of supervised release for allegedly orchestrating a $61.5 million healthcare fraud and wire fraud scheme. The scheme relied on deceptive telemarketing tactics that targeted thousands of Medicare beneficiaries and resulted in shipments of...

Physical Therapy Company to Pay Millions to Resolve False Claims Act Allegations

By the Constantine Cannon Whistleblower Team On March 25, Jerome F. Gorgon Jr., the U.S. Attorney for the Eastern District of Michigan, announced that Team Rehabilitation Services, LLC (“Team Rehab”), a company operating around 140 physical therapy clinics in various states, agreed to pay $4,969,494 to settle allegations it violated the False Claims Act by submitting false claims for payment to federal...

Former NFL Player Turned Lab Owner Convicted in $328 Million Genetic Testing Fraud Scheme

By the Constantine Cannon Whistleblower Team  In February, a federal jury in Texas convicted lab owner Keith J. Gray, a former NFL player, for his role in a $328 million genetic testing fraud scheme involving two clinical labs he owned and operated: Axis Professional Labs LLC (Axis) and Kingdom Health Laboratory LLC (Kingdom).[1] The jury found Gray guilty of (1) conspiracy to defraud the United States and to...

Whistleblower-Initiated Case: DOJ Files FCA Complaint Against Priority Hospital Group and Three LTCHs

By the Constantine Cannon Whistleblower Team On January 16, the government filed a False Claims Act complaint against Priority Hospital Group LLC (PHG), a Louisiana-based hospital management company, three PHG-managed long term care hospitals, and a doctor alleging they submitted false claims for medically unnecessary care and engaged in improper patient referrals in violation of the Anti-Kickback and Stark Law.

Healthcare Employees Sentenced to Prison for Multimillion Dollar Adult Daycare Fraud Scheme

By the Constantine Cannon Whistleblower Team A Texas physician and a clinic employee have been sentenced to prison for their roles in a multimillion dollar healthcare fraud and kickback scheme involving unnecessary lab tests and prescriptions. Dr. Osama Nahas, owner and physician at Crosspoint Medical Clinic, and medical assistant Isabel Pruneda were convicted on March 1, 2024 by a federal jury of conspiracy to...