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On April 8, 2021, the U.S. Attorney’s Office for the District of South Carolina announced a $22.5 million settlement with a network of urgent care providers, Doctors Care, P.A. (Doctors Care), and its management company, UCI Medical Affiliates of South Carolina, Inc. (UCI), for alleged False Claims Act (FCA) violations.
According to the U.S. Attorney’s Office’s press release, Doctors Care submitted claims for payment falsely indicating that certain credentialed providers approved to bill Federal healthcare programs provided certain reimbursable services, when in reality, other clinicians that did not have the required billing credentials actually provided the services.
RALEIGH, NC A Las Vegas, Nevada man pleaded guilty today to Conspiracy to Commit Health Care Fraud and Wire Fraud, Conspiracy to Commit Money Laundering, and Aggravated Identity Theft, and further agreed to forfeit the proceeds of his crimes. In additional to cash, forfeitable property included the defendant s interest in a British Aerospace Bae 125-800A Aircraft, a 2017 Aston Martin DB 11 sports car; a 2016 Ford F-150 Super-Crew pickup truck; real property held in the name of Assured Healthcare Systems in Hertford County, North Carolina; real property located in Charles County, Maryland; as well as various other items of designer jewelry and luxury items seized from the defendant s penthouse condominium in Las Vegas.
Updated: 1:59 PM EDT Apr 22, 2021 WXII12.com Web Staff North Carolina Attorney General Josh Stein announced a $13 million Medicaid fraud conviction Wednesday.Timothy Mark Harron, of Las Vegas, pleaded guilty to conspiracy to commit health care fraud and wire fraud, conspiracy to commit money laundering and aggravated identity theft, according to the state.Click the video player above for headlines from WXII 12 News.Harron admitted to working with his wife, Latisha Harron, to defraud the North Carolina Medicaid program by billing the government for fake home health services and using the money for personal items.According to the courts, Latisha Harron already pleaded guilty to similar charges and is awaiting sentencing. She created and was operating Agape Healthcare Systems, Inc., which was an alleged Medicaid home health provider in Roanoke Rapids.By enrolling Agape as a Medicaid provider, she concealed her previous felony conviction for identity theft and co
A recent Fourth Circuit decision,
United States v. Mallory (988 F.3d 730), upheld damages and penalties for more than $100 million for violations of the Anti-Kickback Statute (42 U.S.C. § 1320a-7b(b)) (the “AKS”) and the False Claims Act (31 U.S.C. § 3729) by a blood testing laboratory and its contracted sales agents. The Court held that commission payments made by the laboratory to its sales agents (sales companies that, in turn, hired and contracted salespeople to sell the laboratory blood tests), which were based on the percentage of revenue the sales agents generated for the laboratory through marketing services, constituted improper “remuneration” that intended to induce the sales agents to sell as many laboratory tests as possible. The defendants failed to show that the arrangements fit within an AKS Safe Harbor.
Tuesday, April 20, 2021
A recent Fourth Circuit decision,
United States v. Mallory (988 F.3d 730), upheld damages and penalties for more than $100 million for violations of the Anti-Kickback Statute (42 U.S.C. § 1320a-7b(b)) (the “AKS”) and the False Claims Act (31 U.S.C. § 3729) by a blood testing laboratory and its contracted sales agents. The Court held that commission payments made by the laboratory to its sales agents (sales companies that, in turn, hired and contracted salespeople to sell the laboratory blood tests), which were based on the percentage of revenue the sales agents generated for the laboratory through marketing services, constituted improper “remuneration” that intended to induce the sales agents to sell as many laboratory tests as possible. The defendants failed to show that the arrangements fit within an AKS Safe Harbor.