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False and Fraudulent Claims

Archive False and Fraudulent Claims Archive

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In each CMP case resolved through a settlement agreement, the settling party has contested the OIG's allegations and denied any liability. No CMP judgment or finding of liability has been made against the settling party.

2009

04-21-2009
After it self-disclosed conduct to the OIG, National Medicare Recovery Services, Inc. (NMRS), California, agreed to pay $500,000 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that NMRS presented or caused to be presented claims for Medicare Part B wound care supplies that NMRS knew or should have known would result in greater payment to NMRS's nursing home clients than the code applicable to the items actually provided.
04-02-2009
After it self-disclosed conduct to the OIG, Marquis Healthcare, Inc. (MHI), Ohio, agreed to pay $7,714.68 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that MHI employed an individual that MHI knew or should have known was excluded from participation in Federal health care programs.
03-25-2009
After it self-disclosed conduct to the OIG, St. Mary Medical Center (SMMC), Pennsylvania, agreed to pay $172,617.10 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that SMMC employed an individual that SMMC knew or should have known was excluded from participation in Federal health care programs.
03-13-2009
West Valley Imaging Limited Partnership and two physicians (West Valley), Nevada, agreed to pay $2 million and to enter into a 5-year integrity agreement for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that West Valley performed radiology tests and exams that were not ordered by Medicare beneficiaries' treating physicians.
03-11-2009
After it self-disclosed conduct to the OIG, Walgreen Louisiana Co. (Walgreen), Louisiana, agreed to pay $1,053,774.82 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that Walgreen employed an individual that Walgreen knew or should have known was excluded from participation in Federal health care programs.
03-03-2009
After it self-disclosed conduct to the OIG, ShopKo Stores, Inc. (ShopKo), Utah, agreed to pay $669,824.74 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that ShopKo employed an individual that ShopKo knew or should have known was excluded from participation in Federal health care programs.
02-25-2009
After it self-disclosed conduct to the OIG, HealthWorks Rehab & Fitness, (HealthWorks), West Virginia, agreed to pay $8,132.16 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that HealthWorks inappropriately billed Medicare for the performance of iontophoresis services, which is not a covered service under Medicare because it is deemed experimental.
01-06-09
Methodist Health Care-Memphis Hospitals (Methodist), Tennessee, agreed to pay $136,627 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that Methodist employed an individual that Methodist knew or should have known was excluded from participation in Federal health care programs.

2008

12-29-08
Haven Nursing Home, Inc. (Haven), Maryland, agreed to pay $90,921.06 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that Haven employed an individual that Haven knew or should have known was excluded from participation in Federal health care programs.
12-12-08
After it self-disclosed conduct to the OIG, Ellsworth Municipal Hospital (Ellsworth), Iowa, agreed to pay $46,165.50 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that Ellsworth employed an individual that Ellsworth knew or should have known was excluded from participation in Federal health care programs.
11-18-2008
After it self-disclosed conduct to the OIG, City of Chicago, Illinois, agreed to pay $6.9 million for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that the City of Chicago submitted claims to Medicare for ambulance services that were not medically necessary, billed at the wrong level of service, and submitted claims without the patient's or other appropriate person's signature as required by CMS regulations.
09-30-2008
After it self-disclosed conduct to the OIG, Briarcliff Nursing and Rehabilitation Center LP (Briarcliff), Texas, agreed to pay $1,833 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that Briarcliff and its management company, Skilled Healthcare LLC, employed an individual that Briarcliff knew or should have known was excluded from participation in Federal health care programs.
09-30-2008
After it self-disclosed conduct to the OIG, Pacific Healthcare and Rehabilitation Center, LLC (Pacific), California, agreed to pay $4,657.50 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that Pacific and its management company, Skilled Healthcare LLC, employed an individual that Pacific knew or should have known was excluded from participation in Federal health care programs.
09-30-2008
After it self-disclosed conduct to the OIG, Rossville Healthcare and Rehabilitation Center, LLC (Rossville), Kansas, agreed to pay $46,216.50 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that Rossville and its management company, Skilled Healthcare LLC, employed an individual that Rossville knew or should have known was excluded from participation in Federal health care programs.
09-30-2008
After it self-disclosed conduct to the OIG, Town & Country Manor LP, Texas (Town & Country), Texas, agreed to pay $4,383 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that Town & Country and its management company, Skilled Healthcare LLC, employed an individual that Town & Country knew or should have known was excluded from participation in Federal health care programs.
09-30-2008
After it self-disclosed conduct to the OIG, St. Elizabeth Healthcare and Rehabilitation, LLC (St. Elizabeth), California, agreed to pay $6,223 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that St. Elizabeth and its management company, Skilled Healthcare LLC, employed an individual that St. Elizabeth knew or should have known was excluded from participation in Federal health care programs.
09-30-2008
After it self-disclosed conduct to the OIG, Hallmark Rehabilitation GP, LP (Hallmark), California, agreed to pay $68,055 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that Hallmark and its management company, Skilled Healthcare LLC, employed an individual that Hallmark knew or should have known was excluded from participation in Federal health care programs.
09-30-2008
After it self-disclosed conduct to the OIG, Royalwood Care Center (Royalwood), California, agreed to pay $1,054.50 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that Royalwood and its management company, Skilled Healthcare LLC, employed an individual that Royalwood knew or should have known was excluded from participation in Federal health care programs.
09-30-2008
After they self-disclosed conduct to the OIG, Eureka Healthcare and Rehabilitation Center, LLC (Eureka) and Grenada Healthcare and Rehabilitation Center, LLC (Grenada), California, agreed to pay $58,323 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that Eureka and Grenada and their management company, Skilled Healthcare LLC, employed an individual that Eureka and Grenada knew or should have known was excluded from participation in Federal health care programs.
09-18-2008
After it self-disclosed conduct to the OIG, Courtyard Manor of Farmington Hills (Courtyard Manor), Michigan, agreed to pay $1.7 million for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that Courtyard Manor received federal health care program funds while the entity was excluded. Courtyard Manor also agreed to be excluded from Medicare, Medicaid, and all other Federal health care programs for two years in addition to its original 10-year period of exclusion.
07-26-2008
After it self-disclosed conduct to the OIG, FutureCare Irvington, LLC (FutureCare), Maryland, agreed to pay $36,290.79 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that FutureCare employed an individual that FutureCare knew or should have known was excluded from participation in Federal health care programs.
07-24-2008
Whole Health Pharmacy (WHP), Colorado, agreed to pay $100,000 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that WHP employed an individual that WHP knew or should have known was excluded from participation in Federal health care programs.
07-16-2008
St. Barnabas Hospital, New York, agreed to pay $132,000 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that the hospital employed three individuals that the hospital knew or should have known were excluded from participation in Federal health care programs.
07-02-2008
Southern Illinois Healthcare Foundation (SIHF), Illinois, agreed to pay $562,021 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that SIHF employed an individual that SIHF knew or should have known was excluded from participation in Federal health care programs.
06-16-2008
After it self-disclosed conduct to the OIG, Sparks Health System, Sparks Medical Foundation, and Sparks Regional Medical Center (collectively, Respondents), Arkansas, agreed to pay $1,142,973 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that the Respondents billed Medicare for medically unnecessary hospital services.
05-09-2008
After it self-disclosed conduct to the OIG, Sabine County Hospital District, Texas, agreed to pay $82,341, for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that Sabine fraudulently included a physician recruiting fee on its cost report as a reimbursable expense.
04-15-2008
After it self-disclosed conduct to the OIG, Biotronic West, LLC, NeuralWatch, LLC, and The Regents of the University of California, for its University of California Davis Medical Center (collectively, Respondents), agreed to pay $41,488.24 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that the Respondents employed an individual that the Respondents knew or should have known had been excluded from participation in Federal health care programs.
04-03-2008
After it self-disclosed conduct to the OIG, Caritas Christi, Massachusetts, agreed to pay $250,060 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that Caritas Christi employed or contracted with five individuals that Caritas Christi knew or should have known were excluded from participation in Federal health care programs.
02-01-2008
Newton Memorial Hospital (NMH), New Jersey, agreed to pay $89,279.70 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that NMH employed an individual that NMH knew or should have known was excluded from participation in Federal health care programs.
01-04-2008
After it self-disclosed conduct to the OIG, Shands at Alachua General Hospital (Shands), Florida, agreed to pay $119,838 and to enter into a 3-year certification of compliance agreement for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that Shands employed an individual that Shands knew or should have known had been excluded from participation in Federal health care programs.

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