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Preview: LexisNexis® Mealey's™ Insurance Fraud Legal News

LexisNexis® Mealey's™ Insurance Fraud Legal News

Headline Insurance Fraud Legal News from LexisNexis®


Administrators Cannot Violate Anti-Kickback Law, 3rd Circuit Finds
PHILADELPHIA - A Third Circuit U.S. Court of Appeals panel ruled July 19 that administrators of an outpatient surgical facility cannot be found liable for violating Pennsylvania's insurance fraud statute because the anti-kickback provision of the statute applies only to health care providers (Aetna Life Insurance Company v. Huntingdon Valley Surgery Center, et al., No. 16-1468, 3rd Cir., 2017 U.S. App. LEXIS 12971).

9th Circuit: Qui Tam Plaintiffs Cannot Intervene In Criminal Forfeiture Action
SAN FRANCISCO- A Ninth Circuit U.S. Court of Appeals panel on Aug. 10 held that two medical assistants who filed a qui tam lawsuit under the False Claims Act (FCA) against a podiatrist they worked for could not intervene in a criminal forfeiture action brought by the federal government seeking $1.2 million for false billing to Medicare because the employees lacked standing (United States v. Neil A. Van Dyck, et al., No. 16-10160, 9th Cir., 2017 U.S. Dist. LEXIS 14780).

DOJ: Pain Clinic, Owner To Pay $250,000 For Violating False Claims Act
ATLANTA - The U.S. Department of Justice announced Aug. 2 that an Atlanta-based pain clinic and its owner have agreed to pay $250,000 for violating the False Claims Act (FCA) by billing Medicare for services provided by a physician who was suspended from the program and administering foreign drugs that were not approved by the U.S. Food and Drug Administration and eligible for reimbursement.

Appeals Court Affirms Man's Convictions For Setting Fire For Insurance Money
DENVER - A Colorado appeals panel on Aug. 10 affirmed a man's convictions for first-degree arson, criminal mischief, theft and attempted theft for intentionally setting fire to a house he lived in with his mother and then-girlfriend to obtain insurance proceeds, finding that the trial judge did not err when allowing evidence regarding his previous insurance claims (People v. Christopher Wesley Welborne, No. 14CA2242, Colo. App., 5th Div., 2017 Col. App. LEXIS 1004).

Judge Orders Man To Pay Insurer For Costs Of Investigating Fire
BOSTON - A man who was sentenced to 48 months in prison for intentionally setting fire to a diner he and his wife owned for the purposes of obtaining insurance proceeds was ordered by a federal judge in Massachusetts on July 26 to pay the insurer the $15,327.86 it incurred in investigating the incident (United States v. Jeffrey Cordio, No. 16-40012-TSH, D. Mass., 2017 U.S. Dist. LEXIS 116640).

Judge Trims Some Of GEICO's Claims From Fraudulent Billing Suit
BOSTON - A federal judge in Massachusetts on Aug. 16 trimmed some claims from a lawsuit brought by the Government Employees Insurance Co. (GEICO) against a chiropractic firm and its owners, finding that while the insurer's claims were timely and not barred by Massachusetts' Strategic Litigation Against Public Participation (anti-SLAPP) statute, the company's claims for civil conspiracy, money had and received, breach of contract and intentional interference with advantageous business relationships were not sufficiently pleaded (Government Employees Insurance Co. v. Barron Chiropractic & Rehabilitation, P.C., et al., No. 16-cv-10642-ADB, D. Mass., 2017 U.S. Dist. LEXIS 130278).

Podiatry Firm, Owner Get Fraudulent Billing, Spoliation Claims Dismissed
CHICAGO - A federal judge in Illinois on Aug. 7 granted a motion for summary judgment filed by a podiatry firm and its owner that are accused by a former employee of violating the Illinois Insurance Claims Fraud Protection Act (IICFPA) and illegally destroying medical records, finding that there was not enough evidence to show that the procedures the firm billed to Medicare were not medically necessary and that the defendants were not aware of the lawsuit at the time the records were shredded (James Youn, M.D. v. Keith D. Sklar, et al., No. 10 CV 5583, N.D. Ill., 2017 U.S. Dist. LEXIS 124394).

Judge Denies Chiropractor's Motion To Amend Counterclaims Against Insurer
SEATTLE - A federal judge in Washington on July 27 denied a chiropractor and his practice's motion to amend counterclaims against State Farm Mutual Automobile Insurance Co., finding that the insurer had sufficient reason to report his billing practices to the National Insurance Crime Bureau (NICB) (State Farm Mutual Automobile Insurance Company v. Peter J. Hanson, P.C. d/b/a Hanson Chiropractic, et al., No. C16-1085RSL, W.D. Wash., 2017 U.S. Dist. LEXIS 118045).

Podiatrist Sentenced To 90 Months In Prison For Fraudulently Billing Medicare
ST. LOUIS - A federal judge on Aug. 15 sentenced a podiatrist to 90 months in prison and ordered him to pay $6.9 million in restitution for fraudulently billing Medicare for services that were not rendered (United States v. Yev Gray, No. 15cr464, E.D. Mo.).

Woman Sentenced To 46 Months For Obtaining Unlawful Compensation From Medicaid
HARRISBURG, Pa. - A federal judge in Pennsylvania on July 25 sentenced a woman to 46 months in prison for obtaining $84,500 in compensation from Medicaid for behavioral health services she provided even though she was excluded from the program for previous convictions for health care fraud, the U.S. Department of Justice announced (United States of America v. Tammie Sensenig, No. 17cr0043, M.D. Pa.).

Doctor Sentenced To 39 Months In Prison For Hospice Fraud Scheme
GREENVILLE, Miss. - The U.S. Department of Justice announced Aug. 10 that a federal judge in Mississippi has sentenced a doctor to 39 months in prison and ordered him to pay $1.9 million in restitution to the Medicare program for referring patients to hospice care when such treatment was not necessary (United States v. Nathaniel Brown, No. 16cr74, N.D. Miss.).

Owner Of 2 Home Health Companies Found Guilty Of Health Care Fraud
HOUSTON - A registered nurse who owned two home health care companies was found guilty on Aug. 10 by a federal jury in Texas of one count of conspiracy to commit health care fraud and four counts of health care fraud for her role in a $20 million Medicare fraud scheme (United States v. Evelyn Mokwuah, No. 16cr254, S.D. Texas).

Pennsylvania Appeals Court Affirms Denial of Request For Post-Conviction Relief
HARRISBURG, Pa. - A trial court judge properly denied a man's petition under the Post-Conviction Relief Act (PCRA) seeking reversal of his conviction for insurance fraud, the Pennsylvania Superior Court ruled July 26, holding that the man was ineligible for such relief because he was not incarcerated or under supervised relief at the time the request was filed (Commonwealth v. Robert Carl Bolus, No. 1300 MDA 2016, Pa. Super., 2017 Pa. Super. Unpub. LEXIS 2858).

Judge Finds New Evidence Does Not Warrant Reversing Fraud Convictions
SAN FRANCISCO - Newly discovered evidence pertaining to a government witness's embezzlement of more than $40,000 from Wells Fargo while working as a branch manager does not warrant reversal of the convictions of three defendants for their roles in a scheme to fraudulently obtain life insurance for strangers who did not want or need the policies, a federal judge in California ruled July 28, finding that the new evidence was merely impeaching and not sufficient to render the witness's testimony totally incredible (United States v. Benham Halali, et al., No. 14-cr-00627, N.D. Calif., 2017 U.S. Dist. LEXIS 119038).

Judge Refuses To Dismiss Suit Over Fraudulent Insurance Policies
FORT WORTH, Texas - A federal judge in Texas on Aug. 4 denied a motion to dismiss filed by an insurance agency accused of selling fraudulent commercial general liability policies to a framing contractor, finding that the court has personal jurisdiction over the lawsuit (Rankin Construction National Builders LLC v. Frank H. Reis, Inc., No. 17-CV-530-A, N.D. Texas, 2017 U.S. Dist. LEXIS 123096).

3rd Circuit Orders Resentencing Of Ambulance Transportation Company, Owner
PHILADELPHIA - A 2-1 panel of the Third Circuit U.S. Court of Appeals on June 21 ordered a federal judge in Pennsylvania to resentence the owner of an ambulance transportation company who pleaded guilty to health care fraud for submitting bills to Medicare for patients who did not need ambulance services, finding that the judge erred in calculating the amount of loss sustained by the insurer (United States of America v. Advantage Medical Transport, Inc., et al., No. 15-3853, 3rd Cir., 2017 U.S. App. LEXIS 10960).

Doctor's Fraudulent Billing Scheme Allegations Lack Particularity, Judge Says
MOBILE, Ala. - A federal judge in Alabama on June 30 dismissed a physician's claims that an ear, nose and throat practice engaged in a fraudulent billing scheme in violation of the False Claims Act (FCA), finding that the allegations did not satisfy the heightened pleading requirement of Federal Rule of Civil Procedure 9(b) (United States of America, ex rel. Mark R. Gacek Sr. v. Premier Medical Management, Inc., d/b/a Premier Medical Group, No. 14-0342-WS-B, S.D. Ala., 2017 U.S. Dist. LEXIS 101963).

DOJ: Owners Of Psychological Services Companies Sentenced For $25.2M Fraud Scheme
NEW ORLEANS - The owners of two psychological services companies were sentenced by a federal judge in Louisiana for their roles in a $25.2 million Medicare fraud scheme, the U.S. Department of Justice announced July 14 (United States of America v. Rodney Hesson, et al., No. 15-cr-152, E.D. La.).

DOJ: 3 Companies, Executives To Pay $19.5M For False Billing
CINCINNATI - Three companies and their executives have agreed to pay $19.5 million for allegedly violating the False Claims Act (FCA) by billing Medicare for medically unnecessary rehabilitation therapy and hospice services, the U.S. Department of Justice announced July 18 (United States, ex rel. Trakhter v. Provider Services Inc., et al., No. 11-CV-217, United States, ex rel. Goodwin, et al. v. Brian Colleran, et al.., No. 11-CV-935, S.D. Ohio.).

Judge Finds Health Care Fraud Defendant's Trial Counsel Was Effective
DETROIT - A federal judge in Michigan on July 7 refused to vacate a man's 204-month sentence for health care fraud, health care fraud conspiracy and conspiracy to distribute controlled substances, finding that his trial attorney acted effectively (Babubhai Patel v. United States of America, No. 11-cr-20468, E.D. Mich., 2017 U.S. Dist. LEXIS 104956).

Magistrate Judge Recommends Denying Man's Motion To Vacate Fraud Sentence
MIAMI - A federal magistrate judge in Florida on June 15 recommended denying a man's motion to vacate his 37-month sentence for mail fraud, finding that he should have raised the arguments regarding the ineffective assistance of counsel on direct appeal (Jason Keith Bailey v. United States of America, No. 16-CIV-23984-UNGARO, S.D. Fla., 2017 U.S. Dist. LEXIS 93102).

New York Appeals Court Affirms Ruling Denying Man's Motion To Withdraw Guilty Plea
ROCHESTER, N.Y. - An appeals court panel in New York on June 16 affirmed a trial court judge's ruling denying a man's motion to withdraw a plea of guilty to one count of insurance fraud, finding that his attorney properly advised him about the risk of deportation associated with the decision (People of the State of New York v. Rayon L. Wong, No. 799 KA 11-00094, N.Y. Sup., App. Div., 4th Dept., 2017 N.Y. App. Div. LEXIS 4919).

Magistrate Judge Say Bakery Owner Can Pursue Third-Party Claims Against Agent
KANSAS CITY, Kan.- A federal magistrate judge in Kansas on June 26 granted a bakery owner's motion to file a third-party lawsuit against an insurance agency and agent that it claims were aware of the fact that the bakery suspended use of an automated fire protection alarm but did not inform the insurer (Amco Insurance Co. v. Keim Properties LLC, No. 16-cv-2842-JAR-TJJ, D. Kan., 2017 U.S. Dist. LEXIS 99007).

Judge: Opioid Possession, Intent To Distribute Charges Preclude Pretrial Release
PHILADELPHIA - A federal judge in Pennsylvania on July 7 denied a motion for pretrial release filed by a man accused of health care fraud, conspiracy to commit health care fraud and 15 counts of possession of oxycodone with intent to distribute, finding that the nature of the drug trafficking claims showed that no condition would reasonably assure the safety of other people in the community (United States of America v. Michael Milchin, No. 17-cr-284, E.D. Pa., 2017 U.S. Dist. LEXIS 105570).

Defense Expert Excluded In Case Alleging Illegal Kickbacks For Lab Work
CHARLESTON, S.C. - An expert for health care defendants accused of running kickback schemes cannot testify because his opinion draws on legal conclusions that should be left to the court to decide, is based on unsound methodology and would mislead a jury, a South Carolina federal judge held June 26 in excluding the expert from the case (United States of America, et al. v. Berkeley Heartlab, Inc., et al., Nos. 9:14-cv-00230, 9:11-cv-1593 and 9:15-cv-2485, D. S.C., 2017 U.S. Dist. LEXIS 98147).

Discovery Of Non-ACA Plan Information Denied In Insurer's Dialysis Fraud Suit
WEST PALM BEACH, Fla. - Finding that a health insurer's fraud claims related to kidney dialysis were pleaded only for its Patient Protection and Affordable Care Act (ACA) plans, a Florida federal magistrate judge on July 10 denied in part a motion to compel non-ACA plan information from the dialysis provider defendants (UnitedHealthcare of Florida Inc., et al. v. American Renal Associates Holdings Inc., et al., No. 9:16-cv-81180, S.D. Fla.).

Health Insurer Anthem Sues Opioid Maker Insys For Kickbacks, Fraudulent Scripts
PHOENIX - Anthem Inc. and its 14 Blue Cross health insurance companies on July 12 sued drugmaker Insys Therapeutics Inc. for allegedly causing the insurer to pay $19 million for fraudulent prescriptions for the opioid Subsys (Blue Cross of California, Inc., et al. v. Insys Therapeutics, Inc., No. 17-2286, D. Ariz.).

Insys Sales Rep Pleads Guilty To Paying Kickbacks For Subsys Prescriptions
HARTFORD, Conn. - A former sales representative for Insys Therapeutics has pleaded guilty to a kickback scheme to get doctors to prescribe the opioid pain drug Subsys, the U.S. attorney for the District of Connecticut announced July 11.

8th Circuit Upholds Denial Of Release Of Restitution Duties To Insurer's Receiver
ST. LOUIS - In a criminal fraud case, an Arkansas trial court correctly denied, based on a lack of authority, a request by an insolvent insurer's owner to be released from any further obligations of restitution once payment of $300,000 was made to the insurer's receiver, the Eighth Circuit U.S. Court of Appeals ruled June 15 (United States of America v. Frank Whitbeck, No. 16-1720, 8th Cir., 2017 U.S. App. LEXIS 10606).

Appeals Panel Upholds Ruling Sentencing Man To Jail For Probation Violations
VENTURA, Calif. - A California appeals panel on June 20 affirmed a trial court judge's decision to imprison a man for the remainder of his six-year concurrent prison sentences for insurance fraud and possession of a controlled substance after finding that he violated the terms of his supervised release by failing to regularly report to his probation officer (People v. Chad Tadao Stukey, No. B279666, Calif. App., 2nd Dist., Div. 6, 2017 Calif. App. Unpub. LEXIS 4189).

Appeals Court Finds Judge Erred When Denying Motion To Strike Juror
NEW YORK - A New York appeals panel on July 5 ordered a new trial for a man who was convicted of insurance fraud and grand larceny in the second degree after finding that the presiding judge erred when denying the defendant's motion to strike a juror who worked for the insurance company that paid the benefits he wrongfully obtained (People v. George O. Guldi, Nos. 2011-03187, 2011-09167, N.Y. Sup., App. Div., 2nd Dept., 2017 N.Y. App. Div. LEXIS 5300).

Judge: Insurer Is Entitled To Rescind Policy In Suit Over Fall From Infinity Pool
MISSOULA, Mont. - A Montana federal judge on July 10 held that an excess insurer has a right to rescind its insurance policy in a coverage dispute over a claim that the insureds' island property was maintained in a dangerous condition that resulted in a catastrophic fall off the edge of an infinity swimming pool (Mount Vernon Fire Insurance Co. v. Jack L. Gabelhausen, Jr., et al., No. 16-91, D. Mont., 2017 U.S. Dist. LEXIS 106125).

Insured Entitled To Documents Related To Underwriting, Federal Magistrate Judge Says
BALTIMORE - A Maryland federal magistrate judge on June 23 determined that an insured is entitled to documents pertaining to an insurer's underwriting review because the documents may help the insured in defending the insurer's misrepresentation claim alleged against the insured in a lead coverage dispute (CX Reinsurance Co. Ltd., f/k/a CNA Reinsurance Co. Ltd. v. B&R Management Inc., et al., No. 15-3364, D. Md., 2017 U.S. Dist. LEXIS 97133).

Insurer Seeks Rescission Of Contamination Policy For Alleged Misrepresentation
NEW YORK - An insurer alleges in a June 14 complaint that rescission of a contamination products insurance policy is warranted because the insured, seeking coverage for a recall of frozen peas, failed to disclose that Listeria was discovered in its production facility prior to the issuance of the policy (Berkley Assurance Co. v. National Frozen Foods Corp., No. 17-4486, S.D. N.Y.).

6th Circuit Finds Judge's Failure To Make Factual Findings Warrants Resentencing
CINCINNATI - A federal judge in Michigan's failure to make a factual finding as to whether the government properly calculated the amount of loss Medicare, Medicaid and other insurers incurred as part of a health care insurance fraud scheme violated Federal Rule of Criminal Procedure 32, a Sixth Circuit U.S. Court of Appeals panel ruled June 1 in vacating the sentence (United States of America v. Vinod Patel, No. 15-1666, 6th Cir., 2017 U.S. Dist. LEXIS 9851).

Appeals Court: Jury Was Properly Instructed In Insurance Fraud Case
FORT WORTH, Texas - An appeals panel in Texas on June 8 affirmed a man's convictions for insurance fraud and fraudulent use or possession of identifying information, finding that a trial court judge did not err when denying the defendant's requests for jury instructions that would have downplayed the amount of the fraudulent claim for allegedly stolen jewelry (Herman Florez Jr. v. State of Texas, No. 02-16-00195-CR, Texas App., 2nd Dist., 2017 Tex. App. LEXIS 5247).

Appeals Court Says Woman Found Guilty Of Arson, Fraud Needs New Sentence
DETROIT - A Michigan appeals panel on June 1 ordered a new judge to sentence a woman convicted of arson and insurance fraud after finding that a term of probation for five years was not strong enough (People v. Mona Fawaz, No. 329162, Mich. App., 2017 Mich. App. LEXIS 890).

Woman Loses Bid For Habeas Relief Based On Fire Expert's Arson Finding
DETROIT - A Michigan federal judge on May 25 upheld the conviction of a woman for setting fire to her house to collect insurance money after rejecting her challenge to an expert's opinion that the fire was caused by arson (Audrey Pruitt v. Anthony Stewart, No. 2:15-cv-10812, E.D. Mich., 2017 U.S. Dist. LEXIS 80162).

Appeals Court Reverses Arson, Insurance Fraud Verdict Over Prosecutor's Misconduct
ROCHESTER, N.Y. - A New York appellate panel on June 9 reversed a jury's verdict finding a woman guilty of arson, attempted insurance fraud and conspiracy after finding that the prosecutor's questioning of her husband about his criminal history and comments about the defendant's financial condition were prejudicial (People of the State of New York v. Shallamar L. Hayward-Crawford, No. 405 KA 14-01824, N.Y. Sup., App. Div., 4th Dept., 2017 N.Y. App. LEXIS 4506).

Insurer Can Pierce Corporate Veil To Obtain Attorney Fees, Judge Rules
CAPE GIRARDEAU, Mo. - An insurance company can ask the owner of a restaurant that was damaged as a result of a fire that was intentionally set to obtain insurance proceeds to pay $109,049.50 in attorney fees, a federal judge in Missouri ruled June 2 in granting the company's motion to pierce the corporate veil (Depositors Insurance Company v. Hall's Restaurant, Inc., No. 14CV34, E.D. Mo., 2017 U.S. Dist. LEXIS 84747).

Appeals Court Dismisses Nationwide's Challenge Of Ruling Denying Discovery Stay
CHILLICOTHE, Ohio - An Ohio appeals panel on May 31 dismissed an appeal from Nationwide Mutual Fire Insurance Co.'s over the denial of its motion to stay discovery in a suit accusing a couple of intentionally setting fire to their home to collect insurance proceeds, finding that the ruling does not require the insurer to produce privileged documents (Nationwide Mutual Fire Insurance Company v. Mark Jones, et al., No. 15CA3709, Ohio App., 4th Dist., 2017 Ohio App. LEXIS 2300).

4th Circuit Affirms Man's Sentence, Finds Fraudulent Scheme Resulted In Deaths
RICHMOND, Va. - A Fourth Circuit U.S. Court of Appeals panel on June 9 affirmed a man's convictions and 10-year sentence for health care fraud resulting in death, holding that a fraudulent health care scheme that involved untrained X-ray technicians reading radiology results caused the death of two patients (United States of America v. Rafael Chikvashvili, No. 16-4393, 4th Cir., 2017 U.S. App. LEXIS 10292).

Psychiatrist Found Guilty Of 5 Counts Of Health Care Fraud For $158M Scheme
HOUSTON - A psychiatrist in Texas was found guilty by a federal jury on May 23 of five counts of health care fraud and one count of conspiracy to commit health care fraud for his role in a $158 million fraud scheme that involved submitting fraudulent claims for partial hospitalization program (PHP) services (United States of America v. Riyaz Mazkouri, No. 16cr213, S.D. Texas).

Jury Convicts Woman For Psychotherapy Services That Were Not Provided
NEW HAVEN, Conn. - A federal jury in Connecticut on May 26 convicted a woman on 23 counts of health care fraud and one count of conspiracy to commit health care fraud for operating a social services business that billed Medicaid for psychotherapy services that were not provided by a licensed professional or not provided at all (United States of America v. Ronnette Brown, No. 16cr66, D. Conn.).

Appeals Court Says Evidentiary Hearing Needed In Insurance Fraud Suit
LOS ANGELES - An evidentiary hearing should have been held to determine whether a California Highway Patrol (CHP) officer had sufficient information in 2010 to begin an investigation into whether a man committed insurance fraud by further damaging a tow truck, a California appeals panel ruled June 12 (Mark Jeffrey Tornow v. Superior Court of Los Angeles County, et al., No. B271895, Calif. App., 2nd Dist., 7th Div., 2017 Cal. App. Unpub LEXIS 4020).

Judge Denies Doctor's Motion To Dismiss State Farm's Fraud Suit
DETROIT - A federal judge in Michigan on May 31 denied a doctor's motion to dismiss a lawsuit brought by State Farm Mutual Automobile Insurance Co. accusing a number of doctors and medical practices of submitting false bills under Michigan's No-Fault Automobile Insurance Act for services that were medically unnecessary or never provided, finding that a mobile magnetic resonance imaging (MRI) center was not an indispensable party (State Farm Mutual Automobile Insurance Company v. Elite Health Centers, Inc., et al., No. 16-13040, E.D. Mich., 2017 U.S. Dist. LEXIS 82736).

Judge: Contractor's Misrepresentations Warrant Voiding Policy
CENTRAL ISLIP, N.Y. - A federal judge in New York on May 24 entered summary judgment in favor of Scottsdale Insurance Co., finding that misrepresentations made by a carpentry contractor on its policy application were material (Scottsdale Insurance Company v. Pine Construction Corp., No. 15-cv-4764, E.D. N.Y., 2017 U.S. Dist. LEXIS 80475).

Insurer Was Not Entitled To Rescind Policy, California Panel Says In Reversal
SAN FRANCISCO - A California appeals panel on June 12 reversed a lower court's finding that an insurer was entitled to rescind an "Owners, Landlords & Tenants Liability Coverage" insurance policy, finding that the insurer failed to satisfy its burden of showing that the insured made material misrepresentations on the insurance application (Victor Duarte v. Pacific Specialty Insurance Co., No. A143828, Calif. App., 1st Dist., Div. 2).

Judge Adopts Recommendation To Accept Woman's Plea In Staged Accident Scheme
CLARKSBURG, W.Va. - A federal judge in West Virginia on June 6 adopted a magistrate judge's recommendation to accept a woman's plea of guilty to one count of mail fraud for her role in an insurance fraud scheme involving staged automobile accidents, finding that she was competent to enter a plea (United States of America v. Chastity Costilow, No. 17CR17-06, N.D. W. Va., 2017 U.S. Dist. LEXIS 86217).

DOJ: Michigan Doctor Sentenced To 19 Years For Fraud, Distributing Drugs
DETROIT - A federal judge in Michigan on May 18 sentenced a doctor to 19 years in prison after the doctor was found guilty of conspiracy to distribute prescription drugs and conspiracy to commit health care fraud, the U.S. Department of Justice announced (United States of America v. Damon Mason, et al., No. 11cr20551, E.D. Mich.).

4 Sentenced For Roles In Fraudulently Billing Medicare For Services Not Provided
CLEVELAND - Four individuals were sentenced by a federal judge in Ohio on May 19 for their roles in an $8 million Medicare fraud scheme that involved forging documents and billing the insurer for medical services that were not provided (United States of America v. Delores L. Knight, et al., No. 15-cr-222, N.D. Ohio).

School Counselor Pleads Guilty To Fraudulently Billing N.C. Medicaid
ASHEVILLE, N.C. - A school counselor pleaded guilty on June 7 to one felony count of health care fraud for submitting nearly $400,000 in false bills to North Carolina Medicare for psychotherapy services that were not provided (United States of America v. Joseph Frank Korzelius, No. 17cr70, W.D. N.C.).