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Whistleblower Rewarded for Alleging FCA Billing Violations


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Whistleblower Rewarded for Alleging False Claims Act Healthcare Billing Violations Against Eye, Ear, Nose and Throat Healthcare Providers that Resulted in a $2.675 Million Recovery for the Government
Thursday, April 22, 2021
The United States Department of Justice settled a case against Massachusetts Eye and Ear Infirmary, Massachusetts Eye and Ear Associates, Inc., and the Foundation of the Massachusetts Eye and Ear Infirmary, Inc. (collectively “Massachusetts Eye and Ear”), healthcare providers and their management company.  Under the terms of the settlement Massachusetts Eye and Ear paid $2.675 Million.
Massachusetts Eye and Ear provides inpatient and outpatient services to people with a range of diseases involving the eye, ear, nose and throat. Over an eight-year period, Massachusetts Eye and Ear improperly billed Medicare and MassHealth (Massachusetts’ Medicaid program) for certain office visits and procedures, allegedly defraudi ....

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Father and son who defrauded numerous state Affordable Care Act programs sentenced to prison


Two California residents were sentenced today by U.S. District Judge Alvin W. Thompson in Hartford for defrauding Affordable Care Act programs in at least 12 states of more than $27 million. Jeffrey White was sentenced to 36 months of imprisonment and three years of supervised release, and Nicholas White was sentenced to 13 months of imprisonment and three years of supervised release. Both defendants reside in Twin Peaks, California.
Pursuant to the Coronavirus Aid, Relief, and Economic Security Act (CARES Act), the sentencings occurred via videoconference.
U.S. Attorney John H. Durham of the District of Connecticut, Acting Special Agent in Charge Ramsey E. Covington of IRS Criminal Investigation in New England, Special Agent in Charge Phillip Coyne of the Boston Regional Office of the Office of the Inspector General of the Department of Health and Human Services, Special Agent in Charge David Sundberg of the FBI s New Haven Division, and Inspector in Charge Joseph W. Cron ....

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EHR Vendor Pays $18M to Settle Kickback Allegations


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Electronic health record (EHR) company athenahealth will pay $18.25 million to settle charges that it paid illegal kickbacks to sell its products, the Department of Justice announced.
The DOJ alleged that athenahealth violated the False Claims Act and the Anti-Kickback Statute in three marketing programs aimed at generating sales for its EHR product athenaClinicals.
First, the company invited prospective and existing customers to sporting and entertainment events like the Kentucky Derby and the Masters Tournament, doling out free travel and luxury accommodations, meals, and alcohol, the department said. The firm agreed to the settlement without admitting guilt.
It is illegal for companies to extend invitations to all-expense-paid sporting, entertainment, and recreational events, and other perk-filled offers to its prospective customers to win business and boost their bottom line through illegal kickback schemes, said Joseph Bonavolonta, specia ....

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AG reaches $10M settlement with Lawrence-based health care company


Dec 22, 2020
LAWRENCE — The state has reached a $10 million settlement with a Lawrence-based home health care company that was accused of falsely billing Medicaid. 
Attorney General Maura Healey announced the agreement to resolve allegations that they falsely billed Medicaid was reached with Maestro-Connections Health Systems LLC and CEO George Kiongera. 
From January 2014 until August 2018, Maestro knowingly submitted claims to MassHealth and MassHealth managed care entities for home health services that had not been appropriately authorized by a physician, according to a statement released by Healey. 
Companies like Maestro that defraud MassHealth take vital resources away from the program and the people that need it most, Healey said. ....

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