Here are five healthcare antikickback cases to know from the last month:
1. A North Carolina mental health clinic owner pleaded guilty to a $4.7 million Medicaid fraud scheme in which he submitted over 1,500 fraudulent claims to the program.
Aljihad Shabazz allegedly obtained Medicaid beneficiaries' personal information through community outreach programs. He then used this information to submit more than 1,500 false claims to the program for behavioral health services never provided. Some of the claims added up to more than 24 hours in a day of services provided by Mr. Shabazz's clinic.
2. Dallas-based Tenet Healthcare, Detroit Medical Center and Vanguard Health Systems have agreed to pay $29.7 million to the federal government to resolve a whistleblower's allegations that they violated the False Claims Act by providing kickbacks to referring physicians.
3. A former New Hampshire physician pleaded guilty to healthcare fraud for his role in a $1.9 million Medicare fraud scheme. Steven Powell, MD, who now lives in Alpharetta, Ga., pleaded guilty to signing orders for durable medical equipment that he knew were used to submit fraudulent claims to Medicare. Dr. Powell was paid kickbacks for signing the orders
4. A Florida business owner was sentenced to 65 months in prison for a Medicare fraud scheme involving back, knee, and wrist braces.
Between August 2019 through May 2021, Christopher Margait and co-defendant Matthew Witkowski illegally obtained and sold fraudulent orders for durable medical equipment paid by Medicare. During the scheme he purchased and sold the fraudulent orders to pharmacies and DME suppliers. Those suppliers used the orders as the basis for at least $7 million in fraudulent claims.
5. James Ellner, MD, and his practice and ASC will pay $625,000 to resolve whistleblower allegations that they violated the False Claims Act.
Between May 1, 2015, and Dec. 31, 2019, Dr. Ellner and his Woodstock, Ga.-based pain management practice, Georgia Pain Management, and ASC, Samson Pain Center, allegedly submitted false claims to Medicare and TRICARE for services that were not reimbursable under federal healthcare programs.
Dr. Ellner and Georgia Pain also allegedly entered into an arrangement that violated the Anti-Kickback Statute. According to the Justice Department, a reference laboratory allegedly paid the salary of someone who functioned as an employee of Georgia Pain in exchange for Ellner's referral of medically unnecessary urine drug tests.