Category Archives: Medicare

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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Medicare Wastes Billions on Defective Medical Devices, Audit Finds

Medicare’s fiscal watchdog has documented $1.5 billion in spending on seven types of defective heart devices that doctors implanted in thousands of beneficiaries. In addition to the money Medicare paid to health care providers for services and procedures related to … 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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Billing Company Hit with First-Ever Penalty in Medicare Case

The owner and operator of a New Jersey billing company will pay a $100,000 penalty after submitting fraudulent Medicare claims for diagnostic tests that were never conducted, marking the first such penalty for a billing company from HHS’ Office of … Continue reading

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‘Extraordinary’ Generics Price Hikes Hit Medicare Part D

Generic drug prices in Medicare Part D decreased significantly in recent years, a new report from the U.S. Government Accountability Office (GAO) says. So why the worry about price hikes? Hundreds of products saw “extraordinary price increases,” that’s why. For … 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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