Prosecutors, investigators and fraud enforcement officials specialized in uncovering the art of fakery this week, targeting schemes that included deceased patients, a nurse imposter, forged prescriptions and falsified time sheets.
A busted fraud scheme that billed Medicare for patients in Nicaragua and the Dominican Republic offers an inside look at how criminals manage to steal millions from the government program by using fake United States addresses, adding to a growing concern about fraud that takes place outside of U.S. borders.
If you had any doubt that federal prosecutors are serious about bringing the hammer down on healthcare executives who oversee fraud schemes, look no further than the sentences handed down to three administrators at Riverside General Hospital over the last month.
Less than a month after the former assistant administrator of Riverside General Hospital was sentenced to 40 years in prison for his role in a $116 million fraud scheme, the president of the hospital has received 45 years for billing Medicare $158 million for mental health care that was never provided, according to a Department of Justice release.
Two years after federal agents arrested David and Scott Nicoll, owners of Biodiagnostic Laboratory Services Inc. in New Jersey, for orchestrating a 37-person, $200 million fraud scheme, CNBC is pulling back the curtain on how that scheme evolved.
The former owner and two high-level executives at the now-defunct Sacred Heart Hospital in Chicago were convicted of orchestrating a referral kickback scheme following a trial that took nearly two months, according to a release from the U.S Attorney's Office in the Northern District of Illinois.
For years, Alejandra Collazo posed as a licensed physician or a nurse practitioner, using the stolen identities of real physicians to forge prescriptions in a scam that prosecutors estimate cost Medicare more than $8 million. Now she'll spend 17 years in prison for her part in the scheme.
A rash of fraud cases involving chiropractic practices over the past month have highlighted vulnerabilities within an industry that has previously been identified as problematic.
Ambulance services contribute to as much as $350 million in fraudulent Medicare billing every year, often transporting healthy patients or double billing for two patients at one time, according to ABC News.
The FBI has raided the medical supply company Med-Care Diabetes & Medical Supplies Inc.--a firm that garnered national attention because of ties to an infamous fraudster who helped inspire the blockbuster movie "The Wolf of Wall Street."