Hospitals, Laboratories, and Clinics

In Illinois, a laboratory owner was sentenced to 5 years incarceration and ordered to pay $2.5 million in restitution for his guilty plea to mail fraud. The laboratory company employed more than 50 employees and provided laboratory services to over 100 nursing homes. Through his company, the man billed Medicare and Medicaid for tests not performed and fraudulently claimed mileage to obtain lab specimens.

Physicians and Other Health Care Professionals

In Pennsylvania, pursuant to his guilty plea, a man was ordered to pay a $1,000 fine for false claims; he previously paid $20,000 in restitution. The man, who only held a Master’s degree, billed Medicare for psychological procedures he provided that are reimbursable by Medicare only if performed by a PhD level psychologist. In order to bill for the services, the man billed Medicare utilizing another doctor’s provider number and as agreed, paid the doctor 15 percent of the Medicare payment.

Employee Misconduct

In Maryland, a former Government employee was ordered to pay $7,000 in restitution and fines for misuse of her Government-issued IMPAC credit card. Formerly employed with National Disaster Medical Systems, which is now part of the Department of Homeland Security, the woman fraudulently used her IMPAC card to rent vehicles for her own personal use from various car rental centers from May 2003 to August 2003.