Health Care Fraud Report Index-Summary

TAXATION

– Data sharing between CMS and IRS

See LEGISLATION, FEDERAL, HR 4213

– Kickbacks, donations to tax-exempt group allowed, IG, 733
– Medical loss ratio rule, fraud expenses, draft released, 791
– Physician sentenced for tax fraud (E.D. Mich.), 802

TENNESSEE

– Ambulance employee/whistleblower, retaliation (W.D. Mich.), 79
– Dermatologists, whistleblower/HIPAA concerns, amended case (E.D. Tenn.), 456
– Dialysis services firm to repay $19.3M (M.D. Tenn.), 291
– Fake insurance sales, TRO issued (M.D. Tenn.), 711
– MA billing, Fla. resident with Tenn. firm indicted (M. D. Tenn.), 797
– Pediatrician's seized patient files, suppression vacated (6th Cir.), 521
– Physical therapy, $1.8M settlement for billing claims, 590
– SNF failed to report changed condition, immediate jeopardy finding upheld (6th Cir.), 582
– State regulations

– – Emergency rule on CHOICES in long-term care program, 351; 351
– – TennCare CHOICES in long-term care program, 305

TERMINATIONS

See EXCLUSIONS AND TERMINATIONS

TESTS AND SCREENING

– Blood gas tests, Tex. hospital, 14
– Cardiac bioimpedance tests, Ariz. doctor settles charges, 836
– Chemotherapy tests, Medicare denial ignored evidence (W.D. Pa.), 794
– EMTALA issues

See PATIENT DUMPING

– Massachusetts, urine drug tests

– – Clinical Science Lab., billing, settlement, 762
– – Life Labs., billing, settlement, 177

– Physicians falsified test results, indictments (E.D. Cal.), 457

TEXAS

– Ambulance services, nonemergency dialysis transports

– – Dallas, manager pleads guilty (N.D. Tex.), 294; owner pleads guilty, 843
– – Executive sentenced (S.D. Tex.), 511
– – Houston, owners sentenced (S.D. Tex.), 663

– Artificial limbs, diabetic supplies (S.D. Tex.), 171
– Billing for services not performed, doctor pleads guilty (E.D. Tex.), 757
– Blood gas tests, 14
– Cardiologists' declaratory judgment suit alleging hospital kickbacks dismissed (S.D. Tex.), 618
– Counseling firm, unqualified provider (S.D. Tex.), 217
– Dental care

– – Billing fraud, oral surgeon indicted (S.D. Tex.), 580
– – False claims, dentist indicted (N.D. Tex.), 702
– – Unperformed services, conviction (S.D. Tex.), 806

– DME

– – Adult diapers

– – – Firm owner indicted (S.D. Tex.), 171; guilty plea, 344; sentenced, 757
– – – Houston, federal grand jury indictments (S.D. Tex.), 577

– – “Arthritis kits”

– – – Doctor and supply firm owner plead guilty (S.D. Tex.), 552
– – – Family Med. Services, guilty pleas (S.D. Tex.), 292; health care fraud guilty plea, 806; Medicare fraud guilty plea, 842

– – Houston firm, willful obstruction, resentencing ordered (5th Cir.), 419
– – Longview, operator pleads guilty (S.D. Tex.), 619
– – Orthopedic kits, indictment (E.D. Tex.), 173
– – Provider identity theft, indictment (S.D. Tex.), 171; guilty plea, 218
– – San Antonio, indictments (W.D. Tex.), 77
– – Wheelchairs

See Wheelchairs, this heading

– Evidence

– – Medical board files denied defendant doctor (Tex. Ct. App.), 516
– – Qui tam relators may use documents obtained by state enforcers (S.D. Tex.), 612

– Home health care

– – Falsifying patient forms, nurse indicted (S.D. Tex.), 758
– – Houston, indictments (S.D. Tex.), 584

– Nursing homes

– – Prevention of patient wandering inadequate, petition for review dismissed (5th Cir.), 754
– – Supervisor, discharge, patient abuse reported (5th Cir.), 169

– Pain clinics

– – Houston doctors plead guilty (S.D. Tex.), 384
– – Untrained personnel, manager sentenced (E.D. Tex.), 27

– Podiatrists

– – Foot care clinic, unqualified staff, sentence (S.D. Tex.), 512
– – Houston, guilty plea (S.D. Tex.), 127

– State regulations

– – Medical board/settlement of out-of-network claims, 431
– – Physicians/sanction guidelines, 431

– Unlicensed personnel at Alton clinic, indictments (S.D. Tex.), 254
– Wheelchairs

– – Conspiracy, doctor sentenced 10 years (S.D. Tex.), 28
– – DME manager pleads guilty (S.D. Tex.), 78
– – Hurricanes

– – – Loss and damage, false claims, sentence (S.D. Tex.), 619
– – – Patient recruiters plead guilty (S.D. Tex.), 805
– – – Relief claim modifier, owner sentenced (S.D. Tex.), 340

– – Medical necessity, evidence did not support claim (S.D. Tex.), 844
– – Onward Med. Supply, guilty pleas (S.D. Tex.), 424; doctor convicted, 515
– – Operator of two DME businesses sentenced (S.D. Tex.), 619
– – Orthotic equipment and chairs, guilty pleas (S.D. Tex.), 423
– – Scooters billed as motorized chairs, owners sentenced (S.D. Tex.), 33
– – Sugarland, Tex., $1.1M restitution (5th Cir.), 116

– Whistleblowers, professor's report of alleged violations raises fact issue (Tex. Ct. App.), 617

TRANSPORTATION SERVICES

– Ambulances

See AMBULANCE SERVICES

– Kickbacks, transport firm owner charged (Mass. Dist. Ct.), 631
– Va., assistance services, patients' identities (4th Cir.), 121