Kickbacks

May 2007

In Tennessee, the owner of a physical therapy company pled guilty to violating the anti-kickback statute and was sentenced to 4 months in prison and ordered to pay $173,000 in restitution. The woman paid kickbacks to doctors based on the percentage of her profits for the patients referred to her company for physical therapy services. During the investigation, it was also revealed that the woman employed unlicensed physical therapists, billed for more therapy than was provided, and prepared fraudulent medical records for a Medicare audit.

Practitioners

May 2007

In Oklahoma, a physician was sentenced to 33 months in prison and ordered to pay $544,000 in restitution for health care fraud. From January 2000 to May 2005, the physician billed for dosages of Remicade and Procrit which far exceeded the amount of those drugs in his inventory.

In Tennessee, a psychologist was sentenced to 5 months in prison, 5 months home detention and ordered to pay $63,000 in restitution for his scheme to defraud Medicare and Medicaid. The psychologist billed Medicare and Medicaid for services provided to beneficiaries at nursing homes that were not rendered. Some of the services billed were for dates of service that occurred after the beneficiaries’ date of death or were for dates of service when the psychologist was not at the nursing home.

Medicaid Fraud

May 2007

In California, a man was sentenced to 18 months imprisonment and ordered to pay $140,000 in restitution for mail fraud. The investigation revealed that the man submitted false information to obtain benefits for which he was not entitled including In-Home Support Services, an HHS-funded program.