Category Archives: Medicaid

Mother, Son Face Prison Time for Pharmacy Fraud

A mother and son based in Miami were sentenced today to 120 months and 30 months in prison, respectively, for their roles in spearheading a $9.5 million health care fraud conspiracy that targeted Medicare Part D. Assistant Attorney General Leslie … Continue reading

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Senators Demand Mylan Repay $50M to the Pentagon for EpiPen

A group of senators wants to know if Mylan Pharmaceuticals will refund $50 million for charging the Department of Defense “exorbitant rates” at retail pharmacies for the EpiPen emergency allergy device. Their demand followed a Reuters report last week that Pentagon spending … Continue reading

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2017 Trial for Alleged Leader in $1B Health Care Fraud

A fall 2017 trial date is set for a South Florida businessman accused of orchestrating a $1 billion Medicare and Medicaid fraud scheme. Court records show a Miami federal judge on Wednesday scheduled 48-year-old Philip Esformes’ trial for Sept. 18. … Continue reading

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Former American Senior Communities Executives Indicted

United States Attorney Josh J. Minkler announced the indictment of four individuals for their roles in a vast fraud, kickback, and money laundering scheme involving Indiana nursing home chain American Senior Communities (ASC).  Those charged include James Burkhart, 51, of Carmel, … Continue reading

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Ambulance Company Owner Sentenced to Prison

Bassem Kuran, 23, of Philadelphia, PA, was sentenced today to ten months in prison for making false statements to Medicare through VIP Ambulance, Inc., an ambulance company that Kuran owned and which he served as President. The Honorable Gerald J. … Continue reading

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Former Tuomey Healthcare CEO Pays $1M Fine

The former CEO of the Sumter-based Tuomey Healthcare Systems, Ralph “Jay” Cox III, paid a $1 million fine and is banned from administering or managing any federal health care programs for four years, the Justice Department announced Tuesday. Cox, who … Continue reading

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Medicaid Anti-Fraud Skilled Nursing Home Recoveries

Federal authorities recovered roughly $25 million from skilled nursing facilities during criminal and civil investigations in fiscal year 2015, a new report from the Department of Health & Human Services Office of Inspector General shows. The OIG’s Medicaid Fraud Control … Continue reading

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Pharmacist Sentenced to Jail for Medicare Fraud

Earlier today, Andrew Barrett, a New York pharmacist who operated pharmacies in Bronx, Queens, and Rockland counties, was sentenced to 43 months’ imprisonment to be followed by three years of supervised release.  As part of the sentence, he was ordered … Continue reading

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CMS Finalizes Emergency Preparedness Requirements

The CMS on Thursday finalized a rule that requires providers who participate in Medicare and Medicaid to have adequate emergency preparedness plans. Some changes were made to the rule as originally proposed, including some flexibility in annual testing and removing … Continue reading

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Taxpayers Foot 70% of California’s Health Care Tab, Study Finds

This year, taxpayers will cover about 70 percent of what is spent on health care in California, according to a new analysis released Wednesday by the UCLA Center for Health Policy Research. Many people assume that the U.S. health care … Continue reading

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