The year may have just begun but healthcare billing frauds are already running rampant across the nation. Continue reading to learn about nine of the biggest billing fraud cases taking over the headlines.
From Cincinnati-based Bon Secours Mercy Health agreeing to pay $1 million to settle allegations that it improperly billed Medicare, to a Florida physician being convicted of billing health insurance companies for $110 million in medically unnecessary services, here are nine healthcare billing fraud cases making headlines since Jan. 1:
1. 3 Ohio providers to pay $3M to settle improper billing allegations
Three Ohio providers will pay $3.19 million to settle allegations of submitting improper claims to Medicare and the Ohio Bureau of Workers’ Compensation.
2. Florida physician convicted of $110M fraud
A Florida physician was convicted on Feb. 10 for his role in a healthcare fraud scheme that involved billing health insurance companies for $110 million in medically unnecessary services, according to the Justice Department.
3. Justice Department: Florida lab owner filed $42M in false claims to UnitedHealthcare
UnitedHealthcare received $42 million in fraudulent claims over four years from a South Florida clinic, the Justice Department said on Feb. 10.
4. Georgia nurse practitioner found guilty of $3M telemedicine fraud
A jury found a Georgia nurse practitioner guilty of five counts of healthcare fraud, aggravated identity theft, and other charges related to a multimillion-dollar telemedicine scheme. Under the alleged scheme, more than $3 million of fraudulent claims were submitted to insurers.
5. Former Michigan physician accused of healthcare fraud, falsifying medical records
A Grand Rapids, Mich.-based federal grand jury charged a former physician of Bronson Hospital in Battle Creek, Mich., with 34 counts of healthcare fraud and eight counts of making false statements. As part of the alleged scheme, the physician allegedly billed for surgeries to remove diseased tissue from his patient’s sinuses despite there not being any diseased tissue.
6. Bon Secours Mercy Health settles false claims case for $1M
Cincinnati-based Bon Secours Mercy Health agreed to pay $1 million to settle allegations that it submitted false claims to Medicare.
7. Physicians among those charged in $100M healthcare fraud scheme
Two indictments recently unsealed 13 defendants, including physicians and other medical professionals, charged with a $100 million healthcare fraud, money laundering, and bribery scheme. The 13 defendants allegedly orchestrated one of the largest no-fault insurance frauds in history by allegedly bribing emergency dispatch operators, hospital employees, and other parties for confidential vehicle accident victim information and fraudulently overbilling auto insurance companies.
8. UC San Diego Health settles with feds in a false claims case
UC San Diego Health has agreed to pay $2.98 million to resolve allegations that it violated the False Claims Act by ordering and submitting referrals for medically unnecessary genetic testing. The genetic testing was performed by CQuentia labs, which allegedly submitted false claims to Medicare for the tests, according to the Justice Department.
9. North Carolina physician faces charges over $46M in Medicare billings
A North Carolina physician is facing several charges after allegedly billing Medicare more than $46 million for procedures used for the treatment of chronic sinusitis over a four-year period, according to the Justice Department.