Tag

Healthcare Fraud

All articles tagged with #healthcare fraud

crime-and-courts15 days ago•2 min saved

Texas Clinic Owner Convicted in $26M TRICARE Fraud Scheme

A federal jury in Fort Worth has convicted Kevin D. Curry, a 64-year-old Texas mental health clinic owner, on nine counts related to a $26 million fraud scheme targeting the TRICARE military health program. Prosecutors allege Curry orchestrated the theft of approximately $17 million by billing for unnecessary or unprovided transcranial magnetic stimulation (TMS) therapy. He is accused of paying over $5.5 million in illegal kickbacks to recruit service members and veterans, fabricating medical records, and using the credentials of other doctors without consent. Curry used proceeds from the scheme to purchase luxury items, including a gold-plated Tesla Cybertruck valued at over $100,000, and fund lavish parties. He faces a maximum potential sentence of 10 years in prison for each of the nine counts, with sentencing scheduled for a later date.

via Fox News|

#crime-and-courts #federal-prosecution #healthcare-fraud

health-policy20 days ago•410 min saved

Vance and Oz Disenroll 750,000 ACA Users, Citing Fraud

The Trump administration has canceled coverage for approximately 750,000 Affordable Care Act enrollees, claiming they were fraudulently enrolled or did not exist. Vice President JD Vance and CMS Administrator Mehmet Oz stated the move will save taxpayers $2.2 billion. While the administration is investigating an additional 419,000 cases, health experts dispute the scale of the fraud, arguing that enrollment declines are largely due to the expiration of pandemic-era subsidies rather than widespread fraud.

via NBC News|

#affordable-care-act #cms #health-policy

health-policy20 days ago•12 min saved

Vance-led task force cancels 315,000 ACA enrollments, citing fraud

The Trump administration has canceled 315,000 Affordable Care Act marketplace enrollments, affecting approximately 760,000 people, citing widespread fraud and improper eligibility. Vice President JD Vance and CMS Administrator Mehmet Oz announced the action on September 22, 2026, estimating it will save the federal government $2.2 billion. The administration is also verifying the eligibility of another 419,000 enrollees and suspending insurance brokers accused of facilitating fraudulent sign-ups. While officials describe the move as a necessary crackdown on 'phantom' enrollees and ineligible recipients, critics argue the criteria are vague and may strip coverage from legitimate beneficiaries.

via The New York Times|

#affordable-care-act #cms #health-policy

health-policy21 days ago•78 min saved

Vance-led task force cuts 760,000 ACA enrollees over fraud claims

The Trump administration has disenrolled approximately 760,000 individuals from Affordable Care Act (ACA) marketplaces, citing fraudulent enrollment. Vice President JD Vance announced the move on Tuesday, stating it will save the government $2.2 billion. The administration is also conducting additional verification on 419,000 other enrollees and suspending insurance brokers involved in improper signups. This action is part of a broader anti-fraud initiative led by Vance, HHS, and CMS, which has shifted to a proactive 'stop and caught' model using AI analytics. Critics argue the process bypassed standard regulatory channels and may impact legitimate enrollees, while supporters contend it addresses significant waste following the expiration of pandemic-era subsidies.

via AP News|

#affordable-care-act #cms #health-policy

politics21 days ago•2 min saved

Vance Announces Removal of 760,000 ACA Enrollees in Fraud Crackdown

Vice President JD Vance announced the removal of approximately 760,000 individuals from Affordable Care Act coverage, alleging fraudulent enrollment. The administration claims these actions will save $2.2 billion in federal spending. Officials also plan to verify the status of another 419,000 people and suspend insurance brokers accused of improper sign-ups. This move follows a broader decline in ACA enrollment since the current administration took office, with critics arguing that policy changes, rather than fraud, are driving the loss of coverage.

via washingtonpost.com|

#affordable-care-act #cms #healthcare-fraud

healthcare27 days ago•27 min saved

Private Equity and Fraud Crackdowns Reshape the $10 Billion Autism Therapy Industry

A massive surge in Medicaid spending for autism therapy, driven by private equity acquisitions and lax oversight, has triggered a federal fraud crackdown that is now restricting access for vulnerable children. While private equity firms have consolidated the industry to maximize profits, often at the expense of care quality, new state regulations and federal audits are cutting costs and services. Critics argue these blunt measures harm legitimate providers and children, while advocates call for quality-based metrics to replace flat-rate reimbursement.

via MinnPost|

#applied-behavior-analysis #autism-therapy #healthcare

crime2 months 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-courts3 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

crime3 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

crime3 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

crime3 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

crime3 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

politics3 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

politics3 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

crime4 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