The New York Attorney General's Office recovered more than $335 million last year from companies and individuals who engaged in Medicaid fraud and abuse. New York has one of the most aggressive Medicaid Fraud Control Units (MFCU), with a staff of more than 315 people across the state. They work closely with the Medicaid Inspector General in the NYS Health Department to detect and prevent Medicaid fraud. The most common forms of Medicaid fraud in New York last year included:
The largest Medicaid fraud recoveries came from pharmaceutical companies. Abbott Labs, Boehringer-Ingelheim, Dava Pharmaceuticals, GlaxoSmithKline, K-V Pharmaceutical, McKesson, Merck, and other pharmaceutical companies paid more than $250 million to settle allegations that they submitted false price reports to Medicaid and/or promoted their products for uses not approved by the federal Food and Drug Administration (off-label marketing). Other significant recoveries involved pharmacists, hospitals, and dental clinics. Pharmacy Fraud: Four pharmacists and a pharmacy owner agreed to pay $9.9 million in restitution after pleading guilty to billing Medicaid for drugs that they never dispensed to their patients. Stark Law Violations: Cayuga Medical Center paid $3.1 million to settle a whistleblower or qui tam lawsuit alleging that the hospital billed Medicaid and Medicare for patients referred by physicians who had financial relationships with the hospital. The Stark Act prohibits a physician from referring patients to a hospital if the physician has a financial relationship with the hospital, unless an exception applies. The whistleblower in this case, a physician at the hospital, received 18% of the settlement (approximately $560,000) as his whistleblower reward. Dental Fraud: Kaleida Health repaid $1.6 million to Medicaid after an internal audit revealed that it had billed Medicaid for patients who received teeth cleanings more often than once in six months, which violated Medicaid reimbursement rules. The audit also revealed that the dental clinic had billed Medicaid for multiple visits to complete exams, x-rays, and cleanings. Medicaid regulations require dental clinics to perform and bill these tasks in one office visit. If you are under investigation or have been charged with Medicaid fraud, then you should consult with an experienced Medicaid fraud attorney immediately, before you speak with government investigators. Anything you say to the investigators can and will be used against you. To arrange a free and confidential consultation, call John Howley, Esq. at (212) 601-2728 or click here to reach our office via email. You should also consult with an experienced Medicaid and Medicare fraud lawyer if you know that your employer is submitting false claims to the government. You may be entitled to a substantial whistleblower reward and legal protections if you help the government recover money paid on false and fraudulent claims. Call our office today to schedule a free and confidential consultation. John Howley, Esq. The information you obtain at this site is not, nor is it intended to be, legal advice. You should consult an attorney for advice regarding your individual situation. I invite you to contact our law offices and welcome your calls, letters and electronic mail. Contacting us does not create an attorney-client relationship. Please do not send any confidential information to us until such time as an attorney-client relationship has been established. I practice law and offer legal services only in jurisdictions where I am properly authorized to do so. I do not seek to represent anyone in any jurisdiction where this web site does not comply with applicable laws and bar rules.
0 Comments
The owner of a medical transportation company has been indicted on seven counts of health care fraud. The government alleges that he defrauded Medicaid of $406,000 by filing false claims on behalf of his ambulette company. This is the latest in a growing number of ambulance fraud investigations and criminal prosecutions. Rolando Sepulveda owned and operated Med Transportation, a company that provided ambulette transportation services for Medicaid beneficiaries. An ambulette is a specially equipped van designed to transport passengers in wheelchairs. Medicaid pays ambulette companies to transport Medicaid patients to and from Medicaid-covered appointments. To qualify for ambulette transportation reimbursement, the following criteria must be met:
Sepulveda is accused of filing false claims with Medicaid for transporting patients who did not need or use wheelchairs. He is also accused of fraudulently billing Medicaid for ambulette attendants, when his company did not provide attendants on the ambulettes. Submitting claims to Medicaid for services that were not medically necessary or were not provided violates the federal False Claims Act and other state and federal laws. The government’s press release notes that the defendant “is currently believed to be residing in Puerto Rico.” This absence may explain why the government sought an indictment on seven felony charges, which could result in a long prison sentence. When you are facing a Medicaid fraud investigation, it is important to get advice from an experienced Medicaid fraud attorney immediately, before you talk to anyone fro, the government. Your lawyer may be able to negotiate a financial settlement that avoids an indictment. But if the government cannot find you, then they will charge you with the most serious crimes. Employees also need advice from a Medicaid fraud attorney if they are aware that their employer is submitting false claims to Medicare or Medicaid. When the government suspects that a company is engaged in Medicare and Medicaid fraud, it investigates everyone connected with the company. You could be at risk even though you are not personally benefiting from the fraud. If you are aware of false or fraudulent claims submitted to Medicare or Medicaid, you should consult with an experienced Medicaid and Medicare fraud lawyer immediately to protect yourself. You may be entitled to legal protections and a substantial whistleblower reward under the federal False Claims Act. To arrange a free and confidential consultation with an experienced Medicaid and Medicare fraud lawyer, call John Howley, Esq. at (212) 601-2728 or click here to reach our office via email. John Howley, Esq. The information you obtain at this site is not, nor is it intended to be, legal advice. You should consult an attorney for advice regarding your individual situation. I invite you to contact our law offices and welcome your calls, letters and electronic mail. Contacting us does not create an attorney-client relationship. Please do not send any confidential information to us until such time as an attorney-client relationship has been established. I practice law and offer legal services only in jurisdictions where I am properly authorized to do so. I do not seek to represent anyone in any jurisdiction where this web site does not comply with applicable laws and bar rules. A podiatrist was sentenced to more than four years in prison after pleading guilty to one count of conspiracy to commit health care fraud. He was accused of diagnosing patients with foot and toe infections that did not actually exist, and then billing Medicare for treatments that were not provided. Richard Alan Behnan, D.P.M., was a “traveling podiatrist” who treated elderly patients at senior centers and assisted living facilities. According to the government, he provided toenail trimming and other routine foot care that is not covered by Medicare, but then claimed reimbursement for a procedure known as nail avulsion that is covered by Medicare. A nail avulsion involves surgically removing all or part of the nail from the nail bed. It is an outpatient procedure that is often performed with either a local anesthetic or no anesthetic at all. The government uncovered the fraud by analyzing the doctor’s Medicare and private health insurance claims. When the claims data raised a red flag, they went out and spoke with the patients. Medicare Fraud Data Analysis The government constantly analyzes Medicare claims data for unusual patterns. This includes looking at the total value of an individual physician's claims, as well as comparing the individual physician's claims with averages for the types of procedures and the communities in which the physician practices. In this case, the traveling podiatrist was paid more than $1.6 million, with $1.4 million coming from Medicare and the rest from a private insurer. The large amount of money paid for a relatively simple procedure, and the large numbers of procedures involved, caused the government to suspect that something was not right. Medicare Audits and Investigations Once the government sees an unusual pattern, it can send in auditors and/or investigators to review medical records and speak with patients, current and former employees, and anyone else who might have useful information. In this case, the investigators learned that patients had never received the nail avulsion procedures that the traveling podiatrist had claimed. The government also looks at other records to find possible inconsistencies. This can range from simple steps such as looking at diaries and calendars, to more complex data analyses such as comparing Medicare claims data with claims data from private insurance companies. In this case, the investigators found that the traveling podiatrist submitted claims for nail avulsion procedures that allegedly were performed on dates when he was traveling outside the United States. Medicare Fraud Whistleblowers Whistleblowers provide another major source for government fraud investigations. Under the federal False Claims Act, an individual who has knowledge of false claims may file a lawsuit on behalf of the government. The lawsuit is filed “under seal” (in secret) and the evidence is presented to the government before the defendant knows they are suspected of wrongdoing. If the government ultimately recovers money from the defendant, then the whistleblower is entitled to a reward of up to 30% of the amount recovered. While there was no whistleblower in the traveling podiatrist case, if there had been, the reward could have been as much as $350,000. Whistleblowers can be patients, current or former employees, competitors, consultants, or anyone else who has information that can help the government prove that false claims were submitted to Medicare or Medicaid. The whistleblower does not need to know all the facts. It is enough if they have helpful information that is not available to the government. Protecting Your Rights If you are under investigation or have been charged with a crime, then you are facing government investigators and prosecutors who have access to tremendous resources. You should not try to handle this on your own. Get an experienced Medicaid and Medicare fraud lawyer on your side immediately, before you speak with anyone from the government. If you have knowledge that your employer or someone else is submitting false claims to Medicare or Medicaid, then you may be entitled to legal protections and a substantial whistleblower reward. You should consult with an experienced Medicare and Medicaid fraud attorney immediately, because only the first whistleblower is entitled to the reward. To arrange a free and confidential consultation, call John Howley, Esq. at (212) 601-2728 or click here to reach our office via email. John Howley, Esq. The information you obtain at this site is not, nor is it intended to be, legal advice. You should consult an attorney for advice regarding your individual situation. I invite you to contact our law offices and welcome your calls, letters and electronic mail. Contacting us does not create an attorney-client relationship. Please do not send any confidential information to us until such time as an attorney-client relationship has been established. I practice law and offer legal services only in jurisdictions where I am properly authorized to do so. I do not seek to represent anyone in any jurisdiction where this web site does not comply with applicable laws and bar rules. A government study has found that approximately half of Community Mental Health Centers (CMHCs) exhibited questionable Medicare billing in 2010. During that time frame, Medicare paid almost $220 million to more than 200 community mental health centers for providing Partial Hospitalization Program (PHP) services to Medicare beneficiaries. PHPs provide outpatient services to patients who have been discharged from inpatient psychiatric care. The objective is to provide ongoing outpatient care in a community setting at a lower cost than inpatient care. To qualify for reimbursement from Medicare, patients who participate in PHPs must have mental disorders that severely interfere with multiple areas of their daily lives, including social, vocational, and/or educational functioning. The PHP services must be:
The Office of Inspector General (OIG) at the Department of Health and Human Services (HHS) has identified nine questionable billing characteristics or red flags based on its analysis of Medicare fraud cases and data from the Centers for Medicare & Medicaid Services (CMS). OIG determined that Partial Hospitalization billing fraud occurs with greater frequency when PHP patients:
Using Medicare claims history, the OIG identified community mental health centers that had unusually high billing for at least one of the nine questionable billing characteristics and the metropolitan areas where these CMHCs were located. Approximately half of community mental health centers met or exceeded thresholds that indicated unusually high billing for at least one of nine questionable billing characteristics. Approximately one-third of these community mental health centers had at least two of the characteristics. OIG also determined that 90 percent of the centers with questionable billing were located in States that do not require community mental health centers to be licensed or certified. The government aggressively investigates and prosecutes mental health fraud cases. False claims for PHP services costs Medicare millions of dollars and endangers patients who do not receive appropriate mental health services and treatment. If you are under investigation or have been charged with Medicare fraud, then you should consult with an experienced Medicaid and Medicare fraud lawyer immediately, before you speak with an investigator. If you are aware of false claims being submitted by your employer, you also need legal advice right away. You may be at risk of criminal prosecution because the government goes after everyone who was involved. On the other hand, you may be entitled to legal protections and a substantial whistleblower reward if you help the government uncover the fraud and recover money. To arrange a free and confidential consultation with an experienced Medicare and Medicaid fraud attorney, call John Howley, Esq. at (212) 601-2728 or click here to reach our office via email. John Howley, Esq. The information you obtain at this site is not, nor is it intended to be, legal advice. You should consult an attorney for advice regarding your individual situation. I invite you to contact our law offices and welcome your calls, letters and electronic mail. Contacting us does not create an attorney-client relationship. Please do not send any confidential information to us until such time as an attorney-client relationship has been established. I practice law and offer legal services only in jurisdictions where I am properly authorized to do so. I do not seek to represent anyone in any jurisdiction where this web site does not comply with applicable laws and bar rules. A licensed professional counselor has avoided prison after pleading guilty to felony Medicaid fraud. The counselor was charged with “phantom billing,” or billing for services not provided. The court imposed but then suspended a five-year prison sentence. The counselor must complete five years of supervised probation, 200 hours of community service, and pay restitution to Medicaid. Terome Knight, the licensed professional counselor, allegedly offered his services to recently released prison inmateshomeless people who lived in shelters. These individuals were eligible for benefits under the Medicaid program, which provides basic healthcare services to individuals and families at or near the poverty level. The mental health fraud charges resulted because Knight billed Medicaid for services that were never provided to these patients. According to the government, the patients themselves reported that they never received any mental health services or treatment. Billing for services not rendered is a serious form of Medicaid fraud and abuse. It often results in criminal charges and a long prison sentence, especially when the fraud involves multiple patients. The government may seek a felony indictment for each patient involved, and for each false claim submitted to Medicaid. A conviction could result in a sentence of up to five years in prison on each count and other Medicaid fraud penalties. In this case, several factors appear to have influenced the court’s decision to suspend the prison sentence and impose a sentence of probation, community service, and restitution. One factor in the professional counselor’s favor was the amount of money involved. The court ordered restitution of less than $20,000. Compared with the hundreds of thousands of dollars and sometimes millions of dollars involved in many Medicaid fraud cases, this was a relatively small case. The other significant factor was the professional counselor’s decision to negotiate a plea agreement with the government. Judges often credit a defendant’s acceptance of responsibility when imposing sentence, and prosecutors often will agree to recommend or support a specific sentence to the judge as part of a pleas agreement. Every case is different. In some cases, you must prepare an aggressive defense and fight the charges to protect your rights. In other cases, cooperation and a negotiated settlement or plea agreement can avoid more serious consequences. You need an experienced Medicare and Medicaid fraud attorney on your side to make these types of decisions. If you are under investigation or have been charged with a crime, then you should consult with an experienced Medicaid and Medicare fraud lawyer immediately, before you speak with anyone else. To arrange a free and confidential consultation, call John Howley, Esq. at (212) 601-2728 or click here to reach our office via email. John Howley, Esq. The information you obtain at this site is not, nor is it intended to be, legal advice. You should consult an attorney for advice regarding your individual situation. I invite you to contact our law offices and welcome your calls, letters and electronic mail. Contacting us does not create an attorney-client relationship. Please do not send any confidential information to us until such time as an attorney-client relationship has been established. I practice law and offer legal services only in jurisdictions where I am properly authorized to do so. I do not seek to represent anyone in any jurisdiction where this web site does not comply with applicable laws and bar rules. When Orthofix, Inc. pleaded guilty to Medicare fraud, felony charges were filed against several its employees. And a former healthcare consultant turned whistleblower walked away with a $9 million reward. Jeffrey Bierman, the former healthcare consultant, brought a whistleblower lawsuit alleging that Orthofix violated the federal False Claims Act by:
Orthofix agreed to settle the lawsuit by paying the government more than $42 million. Under the qui tam provisions of the False Claims Act, Mr. Bierman received more than $9 million from the settlement as his reward. Other employees are facing a much different future. A physician’s assistant was sentenced to six months in prison, six months in home confinement, and two years of supervised release for taking kickbacks. A former regional manager pleaded guilty to making a false declaration to a federal grand jury. He was sentenced to three months home confinement, one year probation, and a $2,000 fine. A former vice president pleaded guilty to paying kickbacks, and three former territory managers pleaded guilty to creating false medical records used to support Medicare claims. This is a wake-up call. You are personally at risk of criminal prosecution if you know that your employer is falsifying medical records, paying kickbacks, or submitting false claims to Medicare or Medicaid. The government investigates everyone who had knowledge of the false claims, including those who did not personally sign false medical records or participate actively in the fraud. You may be able to protect yourself from criminal charges and earn a substantial reward if you help the government as a whistleblower. An experienced False Claims Act attorney will review your case at no charge. If your claims are viable, your lawyer will file a complaint under seal (in secret) and present your evidence to the local prosecutor. If the case is pursued and the government recovers money, you will be entitled to a reward of between 15% and 30% of the amount the government recovers. If you are already under investigation or have been charged with a crime, you can no longer be a whistleblower, but you still have options. An experienced Medicare fraud lawyer can explain those options and help you prepare your defense. Your lawyer may also be able to negotiate with the government to avoid or reduce the possible charges. Do not go to prison for your employer’s fraud. Get an experienced Medicare and Medicaid fraud attorney on your side. For a free and confidential consultation, call John Howley, Esq. (212) 601-2728 or click here to reach our office via email. John Howley, Esq. The information you obtain at this site is not, nor is it intended to be, legal advice. You should consult an attorney for advice regarding your individual situation. I invite you to contact our law offices and welcome your calls, letters and electronic mail. Contacting us does not create an attorney-client relationship. Please do not send any confidential information to us until such time as an attorney-client relationship has been established. I practice law and offer legal services only in jurisdictions where I am properly authorized to do so. I do not seek to represent anyone in any jurisdiction where this web site does not comply with applicable laws and bar rules. The government conducts healthcare fraud investigations literally every day. In many cases, an experienced attorney can help you negotiate a financial settlement to resolve allegations of questionable or false claims. In more serious cases, the government may insist on a guilty plea but will agree to a sentence of probation. Sometimes, however, the government pursues criminal charges and a sentence of five or ten years in prison. Why does the government settle some health care fraud cases and prosecute others? A key factor is the nature of the false or fraudulent claims. Conduct that is obviously intentional, that involves numerous false claims over a long period of time, or that has put patient safety at risk is more likely to result in criminal charges. Another critical factor is how you respond to the audit or investigation. The owners of a home health care business in Virginia recently demonstrated what you should not do when Medicare or Medicaid investigators start asking questions. Irvine Johnston King and Aisha Rashidatu King owned and operated Bright Beginnings Healthcare Services. They provided in-home personal and respite care and private duty nursing services to Medicaid patients. Bright Beginnings was audited by the government for allegedly submitting false claims to Medicaid. The government ultimately found evidence of “phantom billing” or billing Medicaid for services not provided. During the audit, however, the owners of Bright Beginnings compounded their problems. According to the government, the owners created false medical records in response to the audit and instructed an employee to lie to Medicaid about the false claims. They also instructed an employee to convince a patient’s mother to lie to Medicaid in order to cover up the false claims. Once the government discovered that the owners were obstructing their audit, all hopes of avoiding criminal prosecution were lost. Ultimately, this case was referred to prosecutors who obtained a conviction on 22 counts of healthcare fraud. Each of the owners now faces up to 10 years in prison on each count. How should you respond to government auditors and investigators? You should consult with an experienced Medicare and Medicaid fraud attorney immediately, before you say anything to investigators. You have very important legal rights during an investigation. You have the right to consult with a lawyer. You have the right to have your lawyer present during any meetings or interviews with investigators. You have the right to remain silent and to refuse to answer the investigators’ questions. An experienced Medicaid and Medicare fraud lawyer can help you understand the possible charges and consequences, develop a strong and aggressive defense, and negotiate with the government to avoid or reduce the charges and penalties. If you are under investigation or have been charged with a crime, consult with an experienced Medicare and Medicaid fraud lawyer immediately. To arrange a free and confidential consultation, call John Howley, Esq. at (212) 601-2728 or click here to reach our office via email. John Howley, Esq. The information you obtain at this site is not, nor is it intended to be, legal advice. You should consult an attorney for advice regarding your individual situation. I invite you to contact our law offices and welcome your calls, letters and electronic mail. Contacting us does not create an attorney-client relationship. Please do not send any confidential information to us until such time as an attorney-client relationship has been established. I practice law and offer legal services only in jurisdictions where I am properly authorized to do so. I do not seek to represent anyone in any jurisdiction where this web site does not comply with applicable laws and bar rules. Pfizer Inc. and Endo Pharmaceuticals agreed to resolve Medicaid fraud allegations by paying the State of Texas a total of $36.34 million. Both pharmaceutical companies were accused of filing false price reports with Medicaid. The false price reports allegedly misstated the prices charged for their pharmaceutical products. Under state and federal law, drug companies must file price reports setting forth the prices they charge pharmacies, wholesalers and distributors for their products. The price reports are used to establish Medicaid reimbursement rates. The difference between the Medicaid reimbursement amount and the actual market price is referred to as the “spread.” The government alleged that Pfizer and Endo filed the false price reports in order to increase the spread and thereby induce pharmacies and other providers to purchase their products. The improper price reports were first identified by Ven-A-Care of the Florida Keys Inc., a pharmacy that filed a qui tam or whistleblower lawsuit on behalf of the government. Individual citizens who have knowledge of false claims can file these types of lawsuits on behalf of the government and share in any recovery. Under state and federal False Claims Acts, the whistleblower’s share or reward is usually between 15% and 30% of the amount recovered by the government. The qui tam lawsuit was initially filed “under seal” (in secret) so the government could conduct an investigation before the defendants knew that they were under investigation. No one other than the government and the court knew about the lawsuit until the government completed its investigation. In this case, the State of Texas conducted an investigation and decided to intervene in the case to recover overpayments made by Medicaid to pharmacies based on the false price reports. The pharmacy that brought the suit will therefore receive a share of the overall recovery as its whistleblower reward. Pfizer and Endo will also pay the whistleblower’s attorney’s fees. If you are aware that false price reports are being submitted to the government – or that other types of false claims are being submitted to Medicare or Medicaid – then you should consult with an experienced Medicare and Medicaid fraud attorney immediately. You may be entitled to legal protections and a substantial reward as a whistleblower. To arrange a free and confidential consultation, call John Howley, Esq. directly at (917) 652-6504 or click here to reach our office via email. No attorney’s fees will be charged unless you win, in which case the attorney’s fees will be paid out of the total amount recovered. John Howley, Esq. The information you obtain at this site is not, nor is it intended to be, legal advice. You should consult an attorney for advice regarding your individual situation. I invite you to contact our law offices and welcome your calls, letters and electronic mail. Contacting us does not create an attorney-client relationship. Please do not send any confidential information to us until such time as an attorney-client relationship has been established. I practice law and offer legal services only in jurisdictions where I am properly authorized to do so. I do not seek to represent anyone in any jurisdiction where this web site does not comply with applicable laws and bar rules. The owners and operators of two home health agencies pleaded guilty to participating in a $48 million home health Medicare fraud scheme. Rogelio Rodriguez and Raymond Aday operated Caring Nurse Home Health Corp. and Good Quality Home Health Inc. in Miami, Florida. According to the government, the two defendants submitted claims to Medicare for home health care and therapy services that were not medically necessary. They also engaged in phantom billing or billing for services not provided. The fraudulent scheme involved paying kickbacks to patient recruiters who supplied the home health care agencies with patients, prescriptions, plans of care, and certifications for therapy and home health services. The owners used these documents to submit false claims to Medicare. In addition, nurses and office staff at the home health agencies created false medical records to make it appear that Medicare beneficiaries qualified for home health care and therapy services when, in fact, the beneficiaries did not qualify for and did not receive such services. Between 2006 and 2011, the two home health care agencies submitted approximately $48 million in claims for home health services that were not medically necessary and/or not provided. The two defendants each pleaded guilty to one count of conspiracy to commit health care fraud. They each face up to 10 years in prison and exclusion from Medicare in the future. Home healthcare fraud is a top priority for government investigators and prosecutors. They are constantly monitoring Medicare and Medicaid claims data to identify suspicious billing patterns. And when government investigators find evidence of Medicare or Medicaid fraud, they go after everyone involved – not just the owners and managers, but every single employee who was aware of the fraud or signed false medical records. Do not go to prison for your employer’s fraud. Consult with a Medicare and Medicaid fraud attorney to protect yourself before the FBI shows up at your door. An experienced defense lawyer can help you avoid prosecution or minimize the charges. You may even be entitled to legal protections and a substantial reward as a whistleblower by bringing a qui tam case under the False Claims Act. You should also consult with a Medicaid and Medicare fraud lawyer immediately if you are under investigation or have been charged with a crime. You may have options and defenses, but only an experienced defense lawyer can help you assert them. To arrange a free and confidential consultation, call John Howley, Esq. at (917) 652-6504 or click here to reach our offices via email. John Howley, Esq. The information you obtain at this site is not, nor is it intended to be, legal advice. You should consult an attorney for advice regarding your individual situation. I invite you to contact our law offices and welcome your calls, letters and electronic mail. Contacting us does not create an attorney-client relationship. Please do not send any confidential information to us until such time as an attorney-client relationship has been established. I practice law and offer legal services only in jurisdictions where I am properly authorized to do so. I do not seek to represent anyone in any jurisdiction where this web site does not comply with applicable laws and bar rules. The owner of adult day care centers pleaded guilty to submitting false claims to Medicare for psychotherapy services that were not provided. He faces a possible sentence of 60 years in prison, a $1.5 million fine, and mandatory exclusion from Medicare and other government healthcare programs. Marcus Jenkins owned and operated two adult day care centers and several adult foster care homes (AFCs) that housed severely mentally-disabled Medicare recipients. The government alleges that Jenkins and his wife used the Medicare identification information of more than 100 residents to bill Medicare for individual and group psychotherapy services that were never provided. The government alleged that Jenkins and others submitted more than 185,000 false Medicare claims totaling more than $13.2 million for group and individual psychotherapy sessions that were not provided. The phantom billing scheme allegedly included billing for services provided to a patient who was deceased on the dates of claimed service. Jenkins admitted that he and others conspired to defraud Medicare by billing for services not rendered. He pleaded guilty to one count of conspiracy to commit health care fraud and five counts of health care fraud. The government aggressively investigates and prosecutes allegations healthcare providers billing for services not provided. If you are under investigation or have been charged with a crime, then you should consult with an experienced Medicaid and Medicare fraud lawyer immediately. Do not try to handle this on your own. The government also goes after everyone connected with the fraud. In this case, Jenkins’ wife and a physician who worked for their companies are also facing criminal prosecution. If you are aware that your employer is submitting false claims to Medicare or Medicaid, then you are at serious risk of criminal prosecution. You need to consult with an experienced Medicare and Medicaid fraud attorney immediately to protect yourself. To arrange a free and confidential consultation, call John Howley, Esq. at (917) 652-6504 or click here to contact our office via email. John Howley, Esq. The information you obtain at this site is not, nor is it intended to be, legal advice. You should consult an attorney for advice regarding your individual situation. I invite you to contact our law offices and welcome your calls, letters and electronic mail. Contacting us does not create an attorney-client relationship. Please do not send any confidential information to us until such time as an attorney-client relationship has been established. I practice law and offer legal services only in jurisdictions where I am properly authorized to do so. I do not seek to represent anyone in any jurisdiction where this web site does not comply with applicable laws and bar rules. |
John Howley, Esq.
350 Fifth Avenue 59FL New York, NY 10118 (212) 601-2728 |