Twelve-Year Sentence for Medicaid Diaper Scam

Maria Paz Garza was the King Midas of incontinence supplies: she turned diapers into dollars—over two and a half million of them, according to the government’s indictment. She did it through a scheme that charged Texas Medicaid for diapers and other incontinence supplies that were never provided, or never …

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Co-Winners of May’s Low-Return Fraud Award

We have a tie! Danielle Burroughs and Tim Arthur are co-winners of the Low-Return Fraud Award for the month of May. On May 30 a federal court ordered Danielle to pay a whopping $2.8 million in restitution for her role in a health care con that according to prosecutors paid her only $191,000. That means she owes …

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$4 Million Liability for Bad Legal Advice to a Chiropractor

Allstate Insurance has won a judgment of nearly $4 million against a NY lawyer and Calif. consultant who guided a NJ chiropractor in structuring a medical practice designed to appear to meet the requirements of the state Insurance Fraud Protection Act (Act) while actually violating them. The defendants owned a …

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Biblical Name No Shield Against Fraud Charge

On May 2 a New Orleans federal jury found that Psalms 23 DME, LLC—its Biblical name notwithstanding--was part of a fraud scheme that illegally billed Medicare $3.2 million. In 2013 the government indicted Psalms 23 owner Tracy Brown and a colleague for a fraud scheme that involved billing Medicare for …

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Aetna Wins $37.5 Million for Overbilling Scheme

It’s easy to fall into the habit of regarding self-referrals and kickbacks as strictly a matter of federal law, governed only by the federal Stark Law and Anti-Kickback Statute.  But an April 13 verdict in California provides a vivid reminder that state law also has a role and that private insurers can be as …

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Texas-Size Sentences for Texas-Size Medicare Fraud

They do things big in Texas.  The latest example is the punishments being handed out for a Medicare fraud scheme at Riverside General Hospital in Houston. Let’s start with the fraud scheme.  It was Texas-size, too, resulting in a whopping $158 million in false Medicare claims for partial hospitalization …

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