top of page
Search
National Home Healthcare and Hospice Provider Agrees to Pay $3.85M to Settle False Claims Act Allegations
Intrepid U.S.A. Inc. and various wholly-owned subsidiaries agreed to pay $3.85M to settle allegations that Intrepid violated the False...

James A. Gustino
Aug 23, 20241 min read
19 views
0 comments
Eleventh Circuit reverses dismissal of a whistleblower action alleging that the new owners of a construction firm fraudulently secured orders under a program for disadvantaged small businesses
The case, Gose, et al. v. Native American Services Corporation, et al., Case No. 23-10600, determined that the failure to disclose the...

James A. Gustino
Jul 29, 20241 min read
22 views
0 comments
DaVita Agrees to Pay $34M+ to Settle Illegal Kickback Claims
DaVita was alleged to have violated the False Claims Act by paying kickbacks to induce referrals to a subsidiary which had provided...

James A. Gustino
Jul 29, 20241 min read
12 views
0 comments
Placing Financial Gain Above the Interest of the Patient
Paying financial compensation in exchange for the recommendation of specific providers or services distorts the integrity of the...

James A. Gustino
Jul 25, 20241 min read
1 view
0 comments
Taking advantage of our weakest and frailest... hospice fraud is the worst.
$19.428M settlement of False Claims Act claims in the books. //The settlement resolves allegations made by the United States and the...

James A. Gustino
Jul 19, 20241 min read
0 views
0 comments
$59M Judgment Entered Against Pharmaceutical Marketing Agent
The temptation of making "easy money" drives many of these fraudulent schemes. //A Texas pharmaceutical marketer was sentenced today to...

James A. Gustino
Jul 15, 20241 min read
9 views
0 comments
Clermont Labs Settle Fraudulent Billing Case for $2.45M
The labs were accused of using their own manipulated diagnosis codes in lieu of codes furnished by their patients' physicians to bill...

James A. Gustino
Jul 12, 20241 min read
7 views
0 comments
Most fraudulent schemes targeting governmental programs involve the healthcare and defense industries
Here a $70M settlement was reached to resolve False Claims Act allegations of unlawful markups on spare parts for Navy trainer aircraft....

James A. Gustino
Jul 9, 20241 min read
5 views
0 comments
$1M Settlement in Hospice fraud case announced
Preying on the most vulnerable among us is especially reprehensible. The defndant got off easy, in my opinion. //As part of the...

James A. Gustino
Jul 9, 20242 min read
1 view
0 comments
Fraud against the Paycheck Protection Program is widespread. Here the Government obtained an entitlement to a $120M claim in the defrauding company's bankruptcy. The whistleblowers received $2.5M
for bringing the fraudulent scheme to light. //The resolution announced today addresses two different violations allegedly committed by...

James A. Gustino
Jul 9, 20242 min read
4 views
0 comments
Unsupervised medical services rendered by non-physician personnel is a recurring Medicare fraud theme...
//Tareen Dermatology, P.A., Dr. Mohiba Tareen, and Basir Tareen, CEO (collectively, the “Defendants”) have agreed to pay the Unites...

James A. Gustino
Jul 1, 20241 min read
161 views
0 comments
Another day, another multi-million dollar fraud...
//Cameron [a chiropractor] and her conspirators owned, operated, and had a financial interest in ... companies through which they...

James A. Gustino
Jul 1, 20241 min read
2 views
0 comments
Patient care be damned!
Every physician and hospital that elects to participate in he Medicare and Medicaid programs (yes, it is purely voluntary) pledges to...

James A. Gustino
Jun 26, 20242 min read
3 views
0 comments
Among fraudulent schemes in the Medicare/Medicaid universe, this is one of my personal "favorites"...
A doc bills Medicare and Medicaid for office services allegedly performed in Pensacola, Florida when he was provably out of the...

James A. Gustino
Jun 26, 20241 min read
4 views
0 comments
It's the Big House for Big Fraud!
//Chief U.S. District Judge Randy Crane has now ordered Gaviola to serve 120 months in federal prison to be immediately followed by three...

James A. Gustino
Jun 26, 20241 min read
3 views
0 comments
Medical Device Manufacturer Innovasis Inc. and Two Top Executives Agree to Pay $12M to Settle Allegations of Improper Payments to Physicians
Kickback arrangements--both subtle and blatant ones--that seek to influence physician choice re: the use of a specific care facility or a...

James A. Gustino
Jun 6, 20241 min read
17 views
0 comments
$14,902,000 Paid to Settle False Claims Act "Upcoding" Case
This "upcoding" phenomenon, i.e., submitting bills for Medicare/Medicaid reimbursements that claim more extensive services were provided...

James A. Gustino
Jun 6, 20241 min read
6 views
0 comments
HOME HEALTH SERVICES AGENCY OWNER AND PARENT OF DISABLED CHILD BUSTED FOR MEDICAID FRAUD
//Latrena Marie Thomas ... is accused of hiring non-licensed individuals to provide hands-on personal care services to Medicaid...

James A. Gustino
May 24, 20241 min read
11 views
0 comments
$10.1 Million Settlement Reached With Managed Long-Term Care Plan For Improper Receipt Of Medicaid Payments
//The settlement resolves allegations that RIVERSPRING submitted false claims to Medicaid for months during which RIVERSPRING failed to...

James A. Gustino
May 24, 20241 min read
12 views
0 comments
CMS Enacts Final Rule Mandating Minimum Staffing Levels for Long-Term Care Facilities - Much welcomed!
Virtually everyone has had, has or will have a loved one in a long-term care facility, but for some staffing levels has been inadequate...

James A. Gustino
May 23, 20241 min read
2 views
0 comments
bottom of page