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Articles Posted in Staff Privileges and Licensing

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Over $225 million in false billing, 111 defendants, and 9 cities across the country. The Medicare Fraud Strike Force charged doctors, nurses, physical and occupational therapists, healthcare company owners and executives and others in the largest Medicare fraud takedown ever. The defendants are accused of various healthcare fraud-related crimes, including conspiracy to defraud Medicare, criminal false claims, anti-kickback statute violations, money laundering and aggravated identity theft. According to the Department of Justice, the defendants allegedly submitted claims to Medicare for medically unnecessary services and for services that were not provided. Furthermore, the defendants allegedly paid patient recruiters kickbacks for supplying beneficiary information to providers to submit fraudulent billing to Medicare for services that were medically unnecessary or never provided. The charges are based on a number of alleged fraud schemes involving home health agencies, physical and occupational therapy, nerve conduction tests and durable medical equipment.

Among the nine cities that were included in the scheme were Detroit and Brooklyn. In Detroit 21 defendants were named–including three doctors, three physical therapists and one occupational therapist–charged with defrauding Medicare for more than $23 million and in Brooklyn 10 defendants were named–including three doctors and one physical therapist–charged with defrauding Medicare for $90 million in false claims billings for physical therapy, proctology services and nerve conduction tests.

Over the last two years, the number of anti-fraud Strike Force teams operating in fraud “hot spots” increased from two to nine, with Chicago and Dallas being the most recent additions. Since its inception in 2007, the Strike Force teams have charged nearly 1000 individuals who have falsely billed Medicare for over $2.3 billion.
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Elizabeth L. Johnson, a former New York pharmacist was charged with grand larceny, offering a false instrument for filing and unauthorized practice for her allegations that she defrauded Medicaid out of approximately $191,000. While Johnson’s license to practice as a pharmacist was suspended and she was excluded from participating in Medicaid, she allegedly continued to dispense prescriptions to Medicaid recipients for months. She was scheduled to appear in court on February 17.
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