FRAUD/ABUSE

Three Sentenced in Medicare Fraud Scheme: According to the Department of Justice, a former hospital president and two co-conspirators were sentenced for their contribution to a Medicare fraud scheme. From 2005 to 2012, the three defrauded Medicare of $158 million by billing for services that were not provided. The former president was sentenced to 45 years in prison and ordered to pay $46,753,180 in restitution; the others received sentences of 20 years and $7,518,480 restitution, and 12 years and $46,255,893 restitution for their roles in the scheme. For more information, visit http://www.justice.gov/opa/pr/former-president-riverside-general-hospital-sentenced-45-years-prison-158-million-medicare Read more…

FRAUD/ABUSE

Payroll Scam: Two employees of a Pennsylvania nursing home have been charged with stealing $144,000 from the facility in a payroll scheme that ran from January 2012 to April 2015. According to McKnight’s Long-Term Care News, an employee who created schedules for the facility added additional hours to another employee’s payroll sheets for time that was not worked. The two then split the extra money. To view the McKnight’s article, visit http://www.mcknights.com/news/two-employees-charged-in-alleged-144000-nursing-home-payroll-scam/article/417016/

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FRAUD/ABUSE

1. Anti-Kickback Violations: According to McKnight’s Long Term Care News, a pharmacy services company in North Carolina has agreed to pay a civil fine of $5 million to resolve anti-kickback violations. The U.S. Attorney for the Eastern District of North Carolina stated that the prior owners of the pharmacy allegedly offered monetary rewards to Medicare and Medicaid beneficiaries for enrollment or referrals. The McKnight’s Long Term Care News article can be found at http://www.mcknights.com/news/new-pharmacy-owner-agrees-to-5-million-settlement-in-anti-kickback-case/article/413524/

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