Report: Illinois’ home health care industry rife with fraud, tainted by unscrupulous physicians 

Aging at home

From the Chicago Tribune news report: …For adults hobbled by disability or disease who want to stay out of nursing homes or hospitals, home health care services can be a godsend. For criminals who want to tap into federal Medicare dollars, it can represent a loosely guarded bank vault. A Tribune investigation reveals that Illinois […]

U.S. — S.A. pharmaceutical rep indicted in $9.5 million health care fraud case 

Health by Pictures of Money 17124132409_1b446dcabd_k

From the San Antonio Express-News news article: …The use of compounded drugs by current and former servicemen and servicewomen has skyrocketed in the past decade, federal data show. In some cases, the Defense Department’s Tricare insurance and private insurers have faced bills of up to $30,000 for a month’s supply of the compounded cream, records […]

US — Owner of Home Health Agency Sentenced to 75 Years in Prison for Involvement in $13 Million Medicare Fraud Conspiracy 

Mom's pills by Robbie Sproule

From the Department of Justice media release: According to the evidence presented at trial, from February 2006 through June 2015, Neba and others conspired to defraud Medicare by submitting over $10 million in false and fraudulent claims for home health services to Medicare through Fiango Home Healthcare Inc., owned by Neba and her husband, Ebong […]

Canada — Hospital denies defaming former director accused in kickback scheme 

From the CBC News article: Marshall was one of two longtime Ottawa Hospital directors named in a statement of claim filed in January 2016 by the hospital, which alleged that they defrauded the institution in exchange for luxury vacations, free or inexpensive cars, and other family favours. Marshall responded to the allegations last week, claiming […]

US — Fla. health care admin charged in $1B Medicare fraud case 

Magnifying glass by John Lester

From the ABC News story: A Florida health care administrator accepted bribes in exchange for helping a nursing home owner accused of orchestrating a $1 billion Medicare and Medicaid fraud scheme keep his license, federal prosecutors said. Blanco made about $31,300 a year overseeing inspections at nursing facilities owned by 48-year-old Philip Esformes, an extremely […]

Canada — 10 TTC employees charged with fraud in alleged $5M insurance scheme 

Canadian money by Sara Long

From the national Post news item: To date, the TTC says 150 employees have been fired, retired or resigned to avoid dismissal as a result of the investigation, which started in 2014. All 10 people charged face one count of fraud over $5,000. Of the 10, one is an employee on medical leave. The allegations […]

Canada — More than 100 TTC workers dismissed or quit after multimillion-dollar benefits scam 

Canadian money by Sara Long

From the CBC news item: …It is alleged that receipts were provided to employees by Healthy Fit for claim reimbursement where no product or service was obtained, or where receipt amounts were inflated. It is also alleged that Healthy Fit and the employee making the claim would then share the money paid out by the TTC’s insurer at […]

U.S. –Pharmacy Owners Charged in $158 Million Health Care Fraud Scheme 

From the Department of Justice news article: …According to the DOJ, Noryian, Nourian, and Rydberg controlled 3 pharmacies: Ability Pharmacy, Industrial & Family Pharmacy, and Park Row Pharmacy. Allegedly, the defendants filed forms to transmit payments electronically from the Department of Labor-Office of Workers’ Compensation (DOL-OWCP) for pricey creams used to treat scars, wounds, and […]

U.S. — Doctor sentenced for taking bribes, including Bieber tickets 

From the NJ.com news item: …According to Assistant U.S. Attorney Joseph N. Minish, Ostrager was like the other doctors who admitted their guilt after the wide-ranging kickback arrangement was revealed in 2013. But unlike most of them, Ostrager wasn’t satisfied with the $3,300 he was receiving in monthly kickbacks, Minish said. Ostrager asked for, and […]

Valeant pays $54 million to settle U.S. kickback, fraud claims 

Drugs by Images Money

From the REUTERS news item: …Salix admitted and accepted responsibility for routinely paying doctors hundreds or thousands of dollars, or offering perks including lavish meals at restaurants such as Le Bernardin and Nobu, to attend some of its roughly 10,000 “speaker programs,” including many with little or no educational value. One doctor from Rochester, New […]