Tag: Department of Justice (DOJ)
DOJ sues UnitedHealth to block Amedisys deal
November 20, 2024HME News Staff
WASHINGTON – The U.S. Department of Justice, together with the attorneys general of Maryland, Illinois, New Jersey and New York, has filed a civil antitrust lawsuit to block UnitedHealth Group’s proposed $3.3 billion acquisition of Amedisys because it would eliminate competition between the two companies.
Since UnitedHealth’s acquisition of LHC Group, a competitor of Amedisys, in 2023, UnitedHealth and Amedisys have been two of the largest home health and hospice providers...
DOJ targets health care monopolies, collusion
May 14, 2024HME News Staff
WASHINGTON – The U.S. Department of Justice has formed a Task Force on Health Care Monopolies and Collusion (HCMC) within its Antitrust Division to guide its enforcement strategy and policy approach, including by facilitating advocacy, investigations and, where warranted, civil and criminal enforcement in health care markets.
“Every year, Americans spend trillions of dollars on health care, money that is increasingly being gobbled up by a small number of payers, providers and...
DOJ announces record number of settlements
February 26, 2024HME News Staff
WASHINGTON – Settlements and judgments under the False Claims Act exceeded $2.68 billion in the fiscal year ended Sept. 30, 2023, the U.S. Department of Justice has announced.
The government and whistleblowers were party to 543 settlements and judgments, the highest number in a single year, the DOJ says.
“Protecting taxpayer dollars from fraud and abuse is of paramount importance to the Department of Justice – and these enforcement figures prove it,” said...
Feds highlight fraud efforts for FY20
July 15, 2021HME News Staff
WASHINGTON – The Department of Justice opened 1,148 new criminal health care fraud investigations in fiscal year 2020, according to an annual report published this week.
Federal prosecutors filed criminal charges in 412 cases involving 679 defendants. A total of 440 defendants were convicted of health care fraud-related crimes.
The DOJ also opened 1,079 new civil health care fraud investigations and had 1,498 civil health care fraud matters pending at the end of fiscal year 2020.
Investigative...
Guilty plea entered for $424M fraud scheme
September 10, 2019HME News Staff
WASHINGTON - The owner and CEO of a telemedicine company has pleaded guilty to a $424 million conspiracy to defraud Medicare and receive illegal kickbacks in exchange for DME orders, the Department of Justice has announced.
Lester Stockett, the owner of Video Doctor USA and Telemed Health Group, has pleaded guilty to one count of conspiracy to defraud the United States and pay and receive healthcare kickbacks, and one count of conspiracy to commit money laundering. In connection with his plea...
Pricing structure costs Respironics $34.8M
March 25, 2016Liz Beaulieu, Editor
MURRYSVILLE, Pa. - HME providers must now pay for automated resupply services from Respironics regardless of whether or not they buy the company's products.
Respironics, one of the “big three” manufacturers of sleep therapy products, changed the pricing structure for medSage services to a per-patient, per-month fee for all providers, in the wake of a whistleblower lawsuit and investigation by the Department of Justice that has cost the company millions of dollars to settle.
“As...
Orbit agrees to $7.5 million settlement
May 28, 2015HME News Staff
WASHINGTON - Orbit Medical and its partial successor, Rehab Medical, have agreed to pay $7.5 million to settle allegations that it altered and forged physician prescriptions and supporting documentation for power wheelchairs and accessories, the U.S. Department of Justice announced today.
Orbit Medical says it fully cooperated and offered full transparency during the DOJ's four-year investigation.
“We are relieved to close this chapter and move forward growing our business,”...
Gov't to Orbit Medical: We want our money back
April 15, 2014HME News Staff
WASHINGTON - The Department of Justice (DOJ) has intervened in a False Claims Act lawsuit against Orbit Medical and Jake Kilgore for allegedly altering and forging physician prescriptions and supporting documentation for power wheelchairs and accessories.
On Oct. 23, 2013, a federal grand jury in Utah indicted Kilgore, former vice president and sales manager, on three counts of healthcare fraud, three counts of false statements related to health care and three counts of wire fraud.
“The...
Texas provider sentenced in $6.7M fraud scheme
June 19, 2013HME News Staff
WASHINGTON - The owner and operator of a Louisiana-based HME company received a 97-month prison sentence for his role in a $6.7 million Medicare fraud scheme, according to a press release from the Department of Justice (DOJ). On Dec. 13, 2012, a federal grand jury found Kenny Msiakii, of Houston, guilty of eight counts of healthcare fraud. Msiakii was the owner and operator of Joy Supply and General Services, based in Shreveport, La., a company that purported to provide orthotics and other HME, including...
Gov't, TENS provider resolve lawsuit
May 21, 2013HME News Staff
COLUMBIA, S.C. - The government and RS Medical, a provider of TENS units and orthotics supplies, have reached a settlement for more than $1.2 million to resolve claims that employees at the company submitted false claims for several products, according to a press release from the Department of Justice. The documents lacked physician orders, the required documentation and/or medical necessity, according to the DOJ. The investigation began in February 2011 when whistleblower Sally Balentine filed...