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Diakon’s Erroneous Claims to Medicare Cost Hospice $10.56M—12/02/11

Diakon Hospice Saint John, which operates hospice care facilities in Pennsylvania, has agreed to pay $10.56 million in a false claims settlement. According to the U.S. Attorney’s Office for the Middle District of Pennsylvania and the HHS’ Office of the Inspector General, Diakon erroneously submitted claims to Medicare for hospice care provided to individuals who […]

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Fake Doctor Sentenced to Over Five years in Prison—12/02/11

Matthew Paul Brown, who posed as a fake doctor for two years in Atlanta, Georgia, was sentenced to five years and ten months in prison. He was charged for health care fraud and wrongful disclosure of patients’ health information. United States Attorney Sally Quillian Yates said, “[u]nlike most fraud cases, which endanger the bank accounts […]

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Genentech to Pay $20M in Rituxan Whistleblower Lawsuit– 12/02/11

Genentech, the San Francisco-based U.S. subsidiary of Swiss pharmaceutical giant Roche, will pay $20 million to settle a whistleblower lawsuit brought in 2003. The suit claims that from 2000 to at least 2002, Genentech “encouraged oncologists and other physicians and medical providers to bill Medicare and other government reimbursement programs for Rituxan for off-label uses.” […]

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PwC Survey Finds Whistleblowers Hesitant to Report Company Wrongdoings—11/30/11

According to the Sixth PwC global economic survey, whistleblowers are less likely to report wrongdoings taking place in the workplace because of the fear of retaliation. The survey notes that companies could improve whistle-blowing mechanisms by making employees more confident in the systems, assuring them that all channels are available to report crime. PwC forensic […]

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U.S. Files Suit Against Allied for Over $800 Million in Fraudulent Claims

The U.S. has filed a civil mortgage fraud lawsuit against Allied Home Mortgage Capital Corporation, its affiliate, Allied Home Mortgage Corporation, Allied President and CEO Jim Hodge, and Executive Vice President Jeanne Stell. Under the False Claims Act and the Financial Institutions Reform, Recovery, and Enforcement Act of 1989 (FIRREA), the U.S. Government seeks damages […]

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Medicare Fraud Scheme Traded Spa Treatments, Other Goodies for Personal Info—11/02/11

Seventeen arrests were made on November 2nd in clinics based in Brooklyn and Queens. These health clinics allegedly defrauded the Government of $95 million in Medicare dollars. The fraud scheme namely involved trading free spa treatments, dance lessons, and other freebies for personal information provided by Medicare beneficiaries. In addition, the clinics never performed procedures […]

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50-Year Prison Sentence for Florida Exec Running $205M Medicare Fraud Scheme – 11/01/11

A federal judge has imposed a 50-year prison sentence on a Florida executive, Lawrence Duran, for targeting patients with dementia in a $205 million Medicare fraud scheme. According to the Department of Justice, Duran’s sentence is the longest Medicare Fraud Strike Force sentence ever given. Assistant Attorney General Lanny A. Breuer of the Criminal Division […]

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New York To Pay $70 M for Medicare False Claims– 11/01/11

New York City has agreed on a $70 million settlement with the Department of Justice for overbilling Medicaid’s Personal-Care Services Program. The program provides basic essentials for selected Medicaid patients, such as cleaning, shopping, and medical aid. The settlement acknowledges that for almost a decade, the city’s personal-care services allowed people to receive the 24-hour […]

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Feds Arrest 16 People for $18M Medicare Scam—10/28/11

During a raid conducted by federal authorities, sixteen people within the Los Angeles area were arrested for an $18 million Medicare fraud scheme. One of the doctors arrested worked at Manor Medical Imaging Clinic of Glendale, where he wrote prescriptions for anti-psychotic drugs that were billed to Medicare and Medi-Cal, but never sent to patients. […]

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