A Texas man has been sentenced to 90 months in federal prison for his role in a $59.9 million conspiracy to pay kickbacks and submit claims for medically unnecessary durable medical equipment to Medicare. Patrick Cassells, 65, of Fulshear, Texas, owned and operated three DME companies and concealed his involvement in one of those entities […]
Four pharmacies in Puerto Rico and their owners have agreed to pay a combined total of $4.6 million to resolve allegations of Medicare and Medicaid fraud. The settlements, announced by the U.S. Attorney’s Office for the District of Puerto Rico, concluded a series of investigations conducted between February and May 2026. The government alleged that
Five Florida ophthalmology practices have agreed to pay a combined total of nearly $6 million to resolve allegations that they violated the False Claims Act by billing Medicare and Medicaid for medically unnecessary cranial ultrasounds. The settlements involve Clay Eye Holdings LLC, Retina Macula Specialist of Miami LLC, Florida Eye Institute P.A., Miami Eye LLC,
The operators of a day treatment program for children in Kentucky have agreed to a $15.2 million civil judgment to resolve allegations that they submitted false claims to Medicaid for services that were not covered or not provided as billed. The claims arose from therapy sessions where children were reportedly engaged in non-covered activities including
Aetna, a national-level insurance company, has agreed to pay $117.7 million to settle allegations that it violated the False Claims Act by submitting inaccurate diagnosis codes for members enrolled in its Medicare Advantage plans. The government claimed that between 2011 and 2019, Aetna knowingly caused the submission of unsupported diagnoses to the Centers for Medicare
Aetna Agrees to Pay $117.7 Million to Resolve False Claims Act Allegations Read More »
Community Care Health Network LLC (business name Matrix Medical Network) and HealthFair founder Shahriah “James” Ekbatani have agreed to pay a combined $56.5 million to resolve allegations that they submitted false diagnosis codes to the Medicare Advantage program in violation of the False Claims Act. The government alleged that between 2014 and 2019, Matrix knowingly
Three South Florida men have been sentenced to federal prison for their roles in laundering more than $2.2 million in proceeds generated by a fraudulent durable medical equipment scheme that billed Medicare roughly $6.9 million for unnecessary orthotic braces. Marco Scamarone, 34, received a 70-month sentence, Jose Mendez, 34, received 78 months, and Renee Vazquez,
Three Sentenced to Prison for Laundering Proceeds of $6.9 Million Medicare Fraud Scheme Read More »
A group of laboratory executives, sales professionals, marketers, and a Texas physician have agreed to pay a combined total of more than $2 million to resolve civil allegations that they participated in an illegal scheme to pay doctors for laboratory referrals. The settlements, announced by the Department of Justice, center on allegations that the defendants
A federal jury in the Eastern District of New York has convicted a New York clinic manager for her role in an $8 million healthcare fraud conspiracy that exploited Medicare through a sophisticated kickback scheme involving ambulette drivers. According to evidence presented at trial, Olga Popovych, 43, managed several physical therapy clinics that paid cash
Clinic Manager Convicted in $8M Medicare Fraud Kickback Scheme Read More »
Two non-profit organizations have agreed to pay the federal government a combined total of more than $450,000 to resolve allegations that they obtained Paycheck Protection Program (PPP) loans for which they were never eligible. The settlements, announced by the U.S. Attorney’s Office for the District of Columbia, represent the latest enforcement actions under the False
