Tag

Healthcare Fraud

All articles tagged with #healthcare fraud

crime25 days ago•5 min saved

DOJ expands healthcare-fraud crackdown in Philadelphia with 19 charged in $4M Medicare/Medicaid scheme

The Justice Department is expanding its Northeast Health Care Fraud Strike Force to Philadelphia, charging 19 defendants in more than $4 million in Medicare and Medicaid fraud tied to home-health services. The cases involve false clock-ins, services billed while defendants were incarcerated or away, overlapping hours, and a Medicaid recipient who worked as a carpenter while claiming extensive home-health needs. The expansion strengthens federal enforcement in the Eastern District of Pennsylvania through partnerships with HHS OIG, FBI, and DEA, following broader nationwide actions targeting billions in losses in 2025–2026.

via Fox News|

#crime #doj #healthcare-fraud

crime-and-courts2 months ago•5 min saved

Fort Worth and Southlake physicians hit with federal fraud charges in sweeping crackdown

More than 400 defendants, including about 90 doctors, were charged in a nationwide healthcare-fraud takedown for over $6.5 billion in false claims; North Texas cases include Southlake's Dr. James Lou Carlisle Jr. and Desoto's Dr. Olubayo Idowu with nurse practitioner Vaughn Anthony Brozek, accused of taking kickbacks for medically unnecessary EEG testing, and Fort Worth cardiologist Dr. Jason Finkelstein charged in an $89 million cardiovascular-testing scheme that allegedly billed insurers falsely and was linked to the death of a student-athlete 24 days after testing.

via Fort Worth Star-Telegram|

#crime-and-courts #eeg-testing #federal-charges

crime2 months ago•5 min saved

Florida-linked sweep charges 455 in $6.5B health-care fraud crackdown

A two-week federal enforcement operation charged 455 people in a $6.5 billion health-care fraud and insurance scheme, with Florida accounting for 36 defendants across federal and state cases. Highlights include a Boca Raton cardiologist accused of billing for unnecessary student-athlete heart screenings, a Tampa Bay nurse practitioner-led wound-care scheme billing Medicare $118 million, and a Miami individual allegedly directing a phantom-supplies scheme totaling about $3.76 billion. The DOJ says the crackdown aims to protect vulnerable patients and recover taxpayer funds, with asset seizures and ongoing prosecutions across multiple jurisdictions.

via WUSF|

#crime #doj-crackdown #florida

crime2 months ago•2 min saved

Louisville medical professionals among defendants in federal health care fraud crackdown

Four Louisville-area defendants, including a physician and a nurse, are among those charged in a nationwide, multi-case federal health care fraud crackdown—the 2026 National Health Care Fraud Takedown that charged 455 people with over $6.5 billion in false claims. In Louisville, Angela Renfro and Briana Gosnell (KLF Company LLC and Freedom Center LLC) allegedly submitted more than $11 million in Medicaid claims for peer-support and psychoeducation services using providers’ NPI numbers without authorization. Dr. Christian Berkhahn is charged with conspiracy to obtain controlled substances and health care fraud for prescriptions written under others' names; nurse Meredith Douglass is accused of stealing medications and falsifying records to obtain fentanyl and other Schedule II drugs. A fourth defendant, Einar Serrano Reyes, allegedly used a Louisville location to bill Medicare for over $450,000 for services never provided. Prosecutors say the schemes diverted funds from programs for vulnerable patients; defendants are presumed innocent unless proven guilty.

via WDRB|

#crime #doj #healthcare-fraud

crime2 months ago•2 min saved

Louisville residents among defendants in nationwide healthcare fraud takedown

As part of the DOJ's 2026 National Health Care Fraud Takedown, four Kentucky cases accuse Louisville residents and local companies of defrauding Medicaid, misusing provider identifiers, and submitting fraudulent claims totaling more than $11 million for peer-support services; a Louisville physician allegedly fraudulently procured controlled substances using others’ names; a nurse is charged with stealing medications and falsifying records; and a Florida man is accused of billing Medicare for services never provided. The nationwide crackdown charged 455 defendants with more than $6.5 billion in false claims.

via WDRB|

#crime #healthcare-fraud #louisville

crime2 months ago•1 min saved

New Mexico medical transport firm linked to sweeping $6.5B healthcare fraud crackdown

The Department of Justice announced a nationwide healthcare fraud takedown involving $6.5 billion in false claims, charging 455 defendants across 56 U.S. attorneys' offices in 45 states and territories. A New Mexico non-emergency medical transportation provider, SafeWay Medical Transportation, allegedly billed Medicaid for trips that did not occur, with inflated mileage and duplicate trips. The DOJ seeks more than $2 million in restitution and proceeds tied to money laundering, with officials pledging to safeguard taxpayer-funded health programs.

via KOB.com|

#crime #department-of-justice #healthcare-fraud

politics2 months ago•16 min saved

DOJ unveils sweeping healthcare-fraud crackdown with hundreds charged

The U.S. Department of Justice announced a nationwide crackdown on healthcare fraud, filing hundreds of criminal charges as part of a multi-billion-dollar effort to root out improper billing and illicit schemes tied to Medicare and Medicaid.

via AP News|

#ap-news #criminal-charges #department-of-justice

politics2 months ago•184 min saved

Massive healthcare-fraud crackdown nets 455 charges totaling $6.5B

The Justice Department announced a nationwide crackdown on healthcare fraud and opioid-abuse schemes, charging 455 defendants—including 90 doctors—over about $6.5 billion in false Medicare and Medicaid claims across 45 states; cases included wound-care fraud and hospice billing, marking the largest DOJ healthcare-fraud takedown in history.

via CNN|

#doctors-charged #doj-takedown #healthcare-fraud

crime2 months ago•3 min saved

Fed probe uncovers $30M health services fraud tied to luxury-car seizures

Federal authorities say they busted a $30 million fraud conspiracy that billed for children’s behavioral health services that were never provided; 14 luxury cars, including a Maserati, Mercedes, Bentley and McLaren, were seized as prosecutors allege the ringleaders diagnosed every recipient with a behavioral adjustment disorder to bill Medicaid, while no assessments or care were ever delivered. Four defendants turned themselves in as the DOJ’s anti-fraud task force pursued charges, highlighting a scheme that exploited vulnerable youths attending camps and programs.

via CBS News|

#crime #doj #fraud

politics3 months ago•3 min saved

White House Launches Nationwide Crackdown on Government Fraud

The White House announces a sweeping, accelerated campaign led by President Trump and Vice President Vance to root out fraud in federal programs, detailing a rapid series of actions from February to May 2026—halting Medicaid payments, charging fraud rings, suspending hospice and home-health providers, launching a whistleblower program, expanding the DOJ’s fraud divisions, and triggering billions in identified or recovered losses across Medicaid, SNAP, student loans and healthcare—with audits and strike forces aimed at restoring taxpayer trust and recovering funds.

via The White House (.gov)|

#enforcement #fraud #government

local3 months ago•4 min saved

Minneapolis to host major fraud crackdown as federal indictments surface

In Minneapolis, top Trump administration officials will announce major fraud enforcement actions in Minnesota, following several federal indictments tied to healthcare, housing, and child-care schemes.

via kare11.com|

#fraud #healthcare-fraud #indictments

politics3 months ago•14 min saved

Six-month Medicare enrollment freeze targets hospice and home health to curb fraud

The Trump administration's CMS announced a six-month nationwide moratorium on new Medicare enrollments for hospice and home-health agencies to thwart fraud, while continuing investigations and removals of fraudulent providers; existing providers remain in operation, and the move is part of a broader anti-fraud push led by VP JD Vance, amid concerns about access and potential impacts on compliant providers.

via AP News|

#cms #healthcare-fraud #home-health

business5 months ago•4 min saved

FinCEN Targets Health-Care Benefit Fraud, Proposes Whistleblower Rewards

FinCEN issues an advisory warning financial institutions to watch for schemes exploiting government health care benefit programs like Medicare and Medicaid, detailing how fraud rings and transnational criminal organizations file false claims and launder funds through banks and international networks; the agency also unveiled a proposed rule to compensate whistleblowers with 10–30% of penalties from qualifying actions, funded by penalties under the Bank Secrecy Act and the International Emergency Economic Powers Act, as part of a broader effort to protect federal payments.

via U.S. Department of the Treasury (.gov)|

#business #fincen #healthcare-fraud

healthcare5 months ago•4 min saved

Aetna Pays $117.7 Million to Resolve Medicare Advantage Coding Allegations

Aetna will pay $117.7 million to settle False Claims Act allegations that it submitted or failed to withdraw inaccurate diagnosis codes to inflate Medicare Advantage payments, including morbid obesity codes for 2018–2023, and related issues from a 2015 chart-review program; a whistleblower, a former Aetna risk-adjustment coder, will receive about $2.01 million. The case was pursued by the DOJ Civil Division, Fraud Section, and HHS-OIG with the U.S. Attorney’s Office for the Eastern District of Pennsylvania.

via Department of Justice (.gov)|

#aetna #false-claims-act #healthcare

politics6 months ago•1 min saved

White House Deploys AI-Driven Crackdown on Medicare Fraud

The administration unveiled a multi-pronged plan to curb healthcare fraud, including deferring $259.5 million in Minnesota Medicaid payments pending review, a nationwide DMEPOS enrollment moratorium, and a CRUSH initiative inviting public input, all backed by real-time AI tools to detect and stop improper payments before they occur, aiming to reduce fraud, save taxpayer dollars, and improve affordability for patients.

via HHS.gov|

#ai #fraud-prevention #healthcare-fraud