Category Archives: Healthcare Fraud
Miami Therapists Sentenced for $63 Million Scheme
The FBI recently announced that a Miami doctor and several therapists involved in the Health Care Solutions Network scam have been sentenced to lengthy federal prison terms. Dr. Roger Rousseau received 192 months as a guest of the Bureau of Prisons, as did therapist Liliana Marks. Therapists Doris Crabtree and Angela Salafia were each… Read More »
South Florida’s New Home Health Agency Ban Extended
Due in part to South Florida’s status and reputation as the number one place for organized fraud in the country, specifically health care fraud, a federal moratorium on new home health agencies has been extended. Under current federal health care law, a temporary ban can be put in place to prevent the enrollment of… Read More »
Adventist Health Reaches Huge Fraud Settlement
In what is being called the largest settlement ever reached in a health care fraud case relating to hospitals’ relationship with doctors, Adventist Health System has agreed to settle the claims for $118.7 million. The fraud claims stem from a white-collar lawsuit alleging the hospital violated a federal law that limits the financial relationships… Read More »
Governor Scott Wants Audits of Medicaid-Managed Contracts
In an arguably surprising move, Governor Rick Scott wants many hospitals in the state to undergo random audits of their Medicaid contracts. This decision comes hand in hand with the state’s desire to investigate nearly 130 hospitals to ensure they are not violating Florida law. The governor has specifically asked the state Department of… Read More »
Florida Medicare Fraud Goes Beyond Borders
Another tactic used by suspected Medicare fraudsters has piqued the attention of state and federal authorities looking to crack down on Medicare fraud. This strategy, known as the foreign-enrollment loophole, occurs when Medicare is paid to individuals living abroad. In general, Medicare is not available outside the U.S., except for certain emergency situations. Thus,… Read More »
Biggest Health Care Fraud Takedown Just Happened in Miami
In what is being touted as the largest health care fraud takedown in U.S. history, over 70 individuals were arrested in Miami recently. The Florida Attorney General, the FBI, and other federal agencies all worked jointly to arrest 73 individuals involved in various health care fraud schemes. This was a massive operation that encompassed… Read More »
Florida Doctor with Senatorial Ties Charged with Fraud and Corruption
Florida doctor Salomon Melgen has been indicted on fraud and corruption charges tied to his medical practice and his connections with Senator Robert Menendez (D-New Jersey). Federal prosecutors in the Southern District of Florida recently hit Dr. Melgen with an indictment charging 46 counts of health care fraud associated with his ophthalmology practice. Nineteen… Read More »
Medicare Fraud Takes Down Major Florida HMO
Florida state regulators recently took over Florida Healthcare Plus after the insurer found itself in the middle of an FBI Medicare fraud investigation. Florida Healthcare Plus was a $130 million-per-year company with over 200 employees. It had almost 10,000 Medicare beneficiaries as members. While the company itself was not charged with fraud, 11 individuals… Read More »
Federal Moratorium Leading to Miami Convictions
To combat health care fraud, the federal government has the power to prohibit unscrupulous health care providers from enrolling in Medicare and Medicaid. In 2013 the Centers for Medicare and Medicaid Services exercised that power to ban several providers and ambulance suppliers in the Miami, Houston, and Chicago areas from enrolling. This ban was… Read More »
Fake Doctor Gets 17 Years for Medicare Fraud
A Miami-area woman was recently found guilty of posing as a doctor and engaging in years of health care fraud. Alejandro Collazo pretended to be a doctor at a Hialeah clinic. There she used the identities of real doctors to write thousands of prescription referrals, and tricked patients into thinking she was a real… Read More »