2011
- 11-29-2011
- After it self-disclosed conduct to the OIG, City Hospital, Inc., The Charles Town General Hospital d/b/a Jefferson Memorial Hospital, and West Virginia University Hospitals-East, Inc. (collectively respondents), West Virginia, agreed to pay $949,595 for allegedly violating the Civil Monetary Penalties Law provisions applicable to physician self-referrals and kickbacks. The OIG alleged that the respondents entered into several arrangements with physicians or physician groups for which the hospitals failed to collect office rental payments. The conduct included: (1) payments of costs and expenses pursuant to recruitment agreements in excess of the actual additional incremental costs; (2) payment of student loans without a written recruitment agreement; and (3) payment of costs and expenses pursuant to unwritten extensions of recruitment agreements.
- 10-04-2011
- After it self-disclosed conduct to the OIG, County of Monterey d/b/a Natividad Medical Center (NMC), California, agreed to pay $174,508.46 for allegedly violating the Civil Monetary Penalties Law provisions applicable to physician self-referrals and kickbacks. The OIG alleged that NMC entered into a professional medical services agreement with a physician group for certain call coverage and clinic services. The compensation terms of the agreement offered incentives for the physician group to refer their private practice and medically indigent adult patients to NMC.
- 10-03-2011
- After it self-disclosed conduct to the OIG, Westfields Hospital, Wisconsin, agreed to pay $204,150 for allegedly violating the Civil Monetary Penalties Law provisions applicable to physician self-referrals and kickbacks. The OIG alleged that Westfields Hospital provided space, services, and supplies to certain physician group practices without entering into a formal written contract and without collecting payment.
- 9-08-2011
- After it self-disclosed conduct to the OIG, Whidbey Island Hospital District (WIHD), Washington, agreed to pay $858,571 for allegedly violating the Civil Monetary Penalties Law provisions applicable to physician self-referrals and kickbacks. The OIG alleged that WIHD had over 100 violations surrounding various physician contracts and arrangements. Some of the violations included: (1) a number of hospitalist contracts had expired and new contracts had not been signed; (2) there were no written agreements in place for a number of medical staff leadership and call coverage arrangements; and (3) a variety of improper lease arrangements, personal service arrangements, malpractice subsidies, and a housing allowance and an equipment loan with one physician.
- 07-13-2011
- After it self-disclosed conduct to the OIG, Good Samaritan Hospital Medical Center (GSHMC), New York, agreed to pay $55,018.50 for allegedly violating the Civil Monetary Penalties Law provisions applicable to physician self-referrals and kickbacks. The OIG alleged that GSHMC entered into an improper financial relationship with a physician professional corporation. The contract did not specify the terms of the intended agreement and the physician profession corporation received accelerated payments from GSHMC that did not comply with contractually agreed to payments. The payments were not consistent with fair market value.
- 07-13-2011
- After it self-disclosed conduct to the OIG, St. Catherine of Siena Medical Center (St. Catherine), New York, agreed to pay $2,596,014 for allegedly violating the Civil Monetary Penalties Law provisions applicable to physician self-referrals and kickbacks. The OIG alleged that St. Catherine contracted with a physician owned professional services company. The company received remuneration that was not consistent with fair market value and received payments for services that were not performed under the contract.
- 05-11-2011
- After it self-disclosed conduct to the OIG, Pacifica Hospital of the Valley (Pacifica), California, agreed to pay $764,250 for allegedly violating the Civil Monetary Penalties Law provisions applicable to physician self-referrals and kickbacks. The OIG alleged that Pacifica paid indirect improper remuneration to a physician in the form of payments to a marketing firm for marketing services that were never rendered under joint marketing agreements. The remuneration created a financial relationship between Pacifica and the physician that caused Pacifica to present claims for health services that resulted from prohibited referrals in violation of the Stark law.
- 03-24-2011
- After it self-disclosed conduct to the OIG, Fairview Northland Regional Health Care (FNRHC), Minnesota, agreed to pay $50,000 for allegedly violating the Civil Monetary Penalties Law provisions applicable to physician self-referrals and kickbacks. The OIG alleged that FNRHC entered into an unwritten lease agreement with a physician practice.
2011
- 11-17-2011
- After it self-disclosed conduct to the OIG, Pitt County Memorial Hospital (PCMH), North Carolina, agreed to pay $68,479.04 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that PCMH employed an individual that it knew or should have known was excluded from participation in Federal health care programs.
- 11-14-2011
- After it self-disclosed conduct to the OIG, Providence Hospital, Alabama, agreed to pay $5,938.54 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that Providence Hospital employed an individual that it knew or should have known was excluded from participation in Federal health care programs.
- 11-02-2011
- After it self-disclosed conduct to the OIG, Sonoma Healthcare Center (SHC), California, agreed to pay $106,650.11 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that SHC employed an individual that it knew or should have known was excluded from participation in Federal health care programs.
- 10-26-2011
- After it self-disclosed conduct to the OIG, New York City Health and Hospital Corporation (HHC), New York, agreed to pay $442,909.35 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that HHC employed eight individuals that it knew or should have known were excluded from participation in Federal health care programs.
- 10-26-2011
- After it self-disclosed conduct to the OIG, Conestoga View Nursing, L.P. d/b/a Conestoga View, Pennsylvania, agreed to pay $264,879.84 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that Conestoga View employed an individual that it knew or should have known was excluded from participation in Federal health care programs.
- 10-06-2011
- After it self-disclosed conduct to the OIG, Blue Hill Memorial Hospital (BHMH), Maine, agreed to pay $40,000 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that BHMH employed an individual that it knew or should have known was excluded from participation in Federal health care programs.
- 09-20-2011
- After it self-disclosed conduct to the OIG, Maine Coast Memorial Hospital (MCMH), Maine, agreed to pay $186,398.71 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that MCMH employed an individual that it knew or should have known was excluded from participation in Federal health care programs.
- 09-15-2011
- Jenq-Sheng Liu, Jenq-Sheng Liu, M.D., P.S.C. d/b/a Blue Grass Women's Clinic, and Su-Mei Liu, (defendants), Kentucky, agreed to pay $58,952.57 for allegedly violating the Civil Monetary Penalties Law. OIG alleged that the defendants fraudulently billed Medicaid for six different Current Procedural Terminology codes. Su-Mei Liu agreed to a five-year period of exclusion from all Federal health care programs.
- 09-06-2011
- After it self-disclosed conduct to the OIG, Cape Cod Hospital (CCH) a subsidiary of Cape Cod Healthcare, Inc., Massachusetts, agreed to pay $115,605.36 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that CCH employed an individual that it knew or should have known was excluded from participation in Federal health care programs.
- 09-06-2011
- After it self-disclosed conduct to the OIG, Visiting Nurse Association of Cape Cod (VNA) a subsidiary of Cape Cod Healthcare, Inc., Massachusetts, agreed to pay $278,169.84 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that VNA employed an individual that it knew or should have known was excluded from participation in Federal health care programs.
- 08-30-2011
- After it self-disclosed conduct to the OIG, St. Joseph Health Services of Rhode Island (St. Joseph), Rhode Island, agreed to pay $123,032 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that St. Joseph employed an individual that it knew or should have known was excluded from participation in Federal health care programs.
- 08-23-2011
- Savient Pharmaceuticals, Inc. (Savient), New Jersey, agreed to pay $100,000 to resolve Civil Monetary Penalties liability under the Medicaid Drug Rebate Program. Savient failed to submit pricing information and to pay a rebate to state Medicaid programs for covered drugs that the state Medicaid programs reimburse.
- 08-19-2011
- After it self-disclosed conduct to the OIG, Hospice of the Finger Lakes (HFL), New York, agreed to pay $35,831.70 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that HFL employed an individual that it knew or should have known was excluded from participation in Federal health care programs.
- 08-09-2011
- After it self-disclosed conduct to the OIG, Kmart Corporation (Kmart), Indiana, agreed to pay $945,021.19 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that Kmart employed four individuals that it knew or should have known were excluded from participation in Federal health care programs.
- 08-09-2011
- After it self-disclosed conduct to the OIG, North American Partners in Anesthesia (NAPA), New York, agreed to pay $506,231 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that five physicians formerly associated with NAPA had furnished services at a gastroenterologist's office that inaccurately reflected procedures as having been done on two separate days when they were actually done on a single day. The false statements resulted in higher charges and caused NAPA to submit false claims in connection with those services.
- 07-25-2011
- After it self-disclosed conduct to the OIG, Trustees of Indiana University (IU), Indiana, agreed to pay $603,522 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that IU improperly claimed services provided by third and fourth year students in its professional optometry degree program under the physician fee schedule. The services could not be properly claimed under the physician fee schedule because the students were not in a graduate medical education program and the services were not provided in a teaching hospital or teaching setting.
- 07-22-2011
- After it self-disclosed conduct to the OIG, Health Management Services, Inc. (HMS), Louisiana, agreed to pay $6,545.61 for allegedly violating the Civil Monetary Penalties Law. Specifically, HMS disclosed the alteration of continuous positive airway pressure downloads for patients by two individuals at HMS in order to obtain Federal health care program reimbursement.
- 07-22-2011
- After it self-disclosed conduct to the OIG, Margaret R. Pardee Memorial Hospital (Pardee), North Carolina, agreed to pay $94,729 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that Pardee employed an individual that it knew or should have known was excluded from participation in Federal health care programs.
- 07-18-2011
- After it self-disclosed conduct to the OIG, Premier Health Care Services (PHCS), Ohio, agreed to pay $39,039 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that PHCS's wholly owned subsidiary, Lucas County Emergency Physicians (LCEP), submitted false claims to Medicare and Medicaid. Specifically, while employed by LCEP, a physician provided physician services at two hospitals where he improperly billed Medicare and Medicaid under the physician fee schedule for services which were performed by residents only.
- 07-18-2011
- After it self-disclosed conduct to the OIG, Mercy Health Partners (MHP), Ohio, agreed to pay $82,855 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that two of MHP's hospitals, St. Vincent Mercy Medical Center and St. Charles Mercy Hospital, submitted false claims to Medicare and Medicaid. Specifically, a physician improperly billed under the physician fee schedule for physician services which were performed by residents only.
- 06-10-2011
- After it self-disclosed conduct to the OIG, Valley Obstetrics and Gynecology (VOG), Washington, agreed to pay $72,439.62 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that VOG employed an individual that it knew or should have known was excluded from participation in Federal health care programs.
- 06-22-2011
- After it self-disclosed conduct to the OIG, University of Nevada School of Medicine (UNSOM), Nevada, agreed to pay $138,321.70 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that UNSOM submitted or caused to be submitted claims for physicians' services provided by two physicians to beneficiaries of Federal health care programs using the provider identification numbers of two physicians who did not furnish the services.
- 06-21-2011
- Daniel Herrington, the owner of One Source Medical Services a durable medical equipment (DME) company, Florida, agreed to pay $124,141.50 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that Herrington, through the DME company, billed Medicare for custom molded diabetic shoe inserts when in fact only prefabricated inserts were provided to beneficiaries.
- 06-10-2011
- After it self-disclosed conduct to the OIG, WellStar Cobb Hospital (WCH), Georgia, agreed to pay $9,216.73 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that WCH employed an individual that it knew or should have known was excluded from participation in Federal health care programs.
- 06-06-2011
- After it self-disclosed conduct to the OIG, University of North Texas Health Science Center at Fort Worth (UNTHSC), Texas, agreed to pay $859,500 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that UNTHSC submitted claims for physicians' services provided to beneficiaries of Federal health care programs using the provider identification numbers of 103 physicians who neither furnished the service nor personally supervised the services rendered.
- 05-13-2011
- After it self-disclosed conduct to the OIG, Internal Medicine Associates (IMA), Indiana, agreed to pay $58,573.55 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that IMA employed an individual that it knew or should have known was excluded from participation in Federal health care programs.
- 05-12-2011
- Beth Israel Deaconess Medical Center in Boston, Massachusetts (BIDMC) agreed to pay $233,932.54 for allegedly violating the Civil Monetary Penalties Law. OIG alleged that BIDMC improperly billed Medicare for Lupron drug injections to male patients under HCPCS Code J1950 when BIDMC should have known that the proper code for these claims was the lower reimbursed HCPC Code J9217.
- 05-12-2011
- Beth Israel Deaconess Hospital in Needham, Massachusetts (BIDH-N) agreed to pay $59,701.60 for allegedly violating the Civil Monetary Penalties Law. OIG alleged that BIDH-N improperly billed Medicare for Lupron drug injections to male patients under HCPCS Code J1950 when BIDH-N should have known that the proper code for these claims was the lower reimbursed HCPCS Code J9217.
- 05-10-2011
- After it self-disclosed conduct to the OIG, Colorado-Fayette Medical Center (CFMC), Texas, agreed to pay $50,000 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that CFMC presented claims for items or services that it knew or should have known were not provided as claimed and were false or fraudulent.
- 04-29-2011
- Fort Smith Regional Healthcare Foundation (Foundation), Arkansas, agreed to pay $233,000 to resolve Sparks Health System's (Sparks) liability for allegedly violating the Civil Monetary Penalties Law. The Foundation was created from the sale of Sparks and bears liability for this settlement. Sparks self-disclosed conduct to the OIG and the OIG alleged that Sparks presented claims for items that it knew or should have know were false or fraudulent.
- 04-06-2011
- After it self-disclosed conduct to the OIG, Calvin Community, Iowa, agreed to pay $56,663 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that Calvin Community employed an individual that it knew or should have known was excluded from participation in Federal health care programs.
- 03-21-2011
- Betty J. Feir, PhD, Texas, agreed to pay $61,270 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that Dr. Feir billed Federal health care programs for services provided by auxiliary personnel instead of her and for services performed by the auxiliary personnel while she was not present.
- 03-11-2011
- Deaconess Hospital (Deaconess), Indiana, agreed to pay $76,592.52 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that Deaconess employed an individual that it knew or should have known was excluded from participation in Federal health care programs.
- 02-07-2011
- Logan Emergency Ambulance Service Authority (Logan), West Virginia, agreed to pay $79,176 for allegedly violating the Civil Monetary Penalties Law. The OIG alleged that Logan employed an individual that it knew or should have known was excluded from participation in Federal health care programs.
December 2011
- December 14, 2011; U.S. Department of Justice
- Three Patient Recruiters for Miami Home Health Companies Sentenced to Prison in $25 Million Health Care Fraud Scheme
WASHINGTON - Two patient recruiters for a Miami health care agency were sentenced today to 18 and 12 months in prison, respectively, for their participation in a $25 million home health Medicare fraud scheme, announced the Department of Justice, the FBI and the Department of Health and Human Services.
- December 14, 2011; U.S. Department of Justice
- Owners of Houston Mental Health Company and Assisted Living Facility Indicted for Alleged Roles in $90 Million Medicare Fraud Scheme
WASHINGTON - Two owners of a Houston mental health care company, Spectrum Care P.A., and the owner of a Houston assisted living facility were arrested today on charges related to their alleged participation in a $90 million Medicare fraud scheme, announced the Department of Justice, the Department of Health and Human Services and the FBI.
December 14, 2011; U.S. Attorney; Eastern District of Pennsylvania
Philadelphia Doctor Charged With Running Pill Mill
PHILADELPHIA - A 23-count Indictment was returned and four Informations were unsealed today charging a total of eight defendants, including Philadelphia physician Dr. Kermit B. Gosnell and members of his former staff, in a drug conspiracy case. Gosnell is charged with illegally prescribing highly-addictive painkillers and sedatives outside the usual course of professional practice and not for a legitimate medical purpose, along with related charges.
December 14, 2011; U.S. Attorney; District of Arizona News Release
Pain Management Doctor and Clinic Administrator Indicted On 130 Counts
PHOENIX- A federal grand jury in Phoenix returned a 130 count indictment against Angelo Chirban, 62, and Marilyn Chirban, 60, of Queen Creek, Arizona, for Conspiracy to Illegally Distribute Controlled Substances, Illegal Distribution of Controlled Substances, Health Care Fraud Conspiracy, Health Care Fraud, and Transactional Money Laundering.
December 12, 2011
Co-owners of Pocatello Physical Therapy, P.A. Sentenced in Federal Court
POCATELLO - The co-owners of Pocatello Physical Therapy, P.A., were sentenced in U.S. District Court today for altering records in a federal health care audit, U.S. Attorney Wendy J. Olson announced. Dan DesFosses, 65, and Colin "Ric" Benedetti, 58, both of Pocatello, appeared before U.S. District Judge Edward J. Lodge at the federal courthouse. DesFosses and Benedetti were each sentenced to three years of probation. DesFosses was fined $1,000 and ordered to pay $9,757.66 in restitution. Benedetti was ordered to pay $2,442 in restitution. Both will be required to do 300 hours of community service.
December 13, 2011; U.S. Attorney; District of New Jersey
Fourteen New Jersey Health Care Providers Arrested, Charged With Taking Cash Payments for Patient Referrals
NEWARK, N.J. - Thirteen New Jersey doctors and a nurse practitioner are charged in a cash-for tests referral scheme for allegedly taking illegal kickback payments to refer patients to an Orange, N.J., medical testing facility, New Jersey U.S. Attorney Paul J. Fishman and U.S. Department of Health and Human Services, Office of Inspector General Special Agent in Charge Tom O'Donnell announced.
