Here are five multimillion-dollar false claims settlements in the last three months:
1. In July, Claribel Tan, MD, a rheumatologist, and her husband Daniel Tan were charged with fraud and tax evasion related to a scheme that defrauded healthcare benefits programs of more than $10 million.
The pair allegedly submitted false claims that misrepresented services provided to patients at their medical clinic in Anchorage, Alaska, and deceived patients regarding the necessity and type of treatments received. The indictment further alleges that, Dr. Tan and Mr. Tan fraudulently received more than $10 million from healthcare benefit programs and that the couple evaded income taxes by providing false information on their tax returns for 2014, 2015 and 2017. Further, the indictment alleges that Mr. Tan evaded taxes in 2017, and that the couple did not file tax returns from 2018 to 2021.
2. In July, A federal grand jury indicted Hoau-Yan Wang, PhD, 67, a pharmaceutical researcher and medical professor charging him with defrauding the National Institutes of Health of about $16 million in grant funds from 2015 to 2023.
Dr. Wang, a professor of medicine at City University of New York and an advisor at drug development company Cassava Sciences, fabricated and falsified scientific data in grant applications NIH seeking funds for the research of simufilam, a potential treatment and diagnostic test for Alzheimer's disease from May 2015 to April 2023.
3. In June, David Young, MD, a physician from Fredericksburg, Texas, was convicted for submitting more than $70 million in fraudulent claims for orthotic braces and generic tests.
Dr. Young submitted tests for more than 13,000 beneficiaries, receiving $475,000 in illegal kickbacks. He was convicted of one count of conspiracy to commit healthcare fraud and three counts of false statements relating to healthcare matters.
4. In June, a Natick, Mass., psychiatrist Gustavo Kinrys, MD, was sentenced to eight years and three months in prison for a $19 million Medicare and private insurance fraud scheme.
Between January 2015 and December 2018, Dr. Kinrys sought and received $19 million in reimbursements for unrendered services. As part of the scheme, he billed Medicare and private insurers $10.6 million for thousands of transcranial magnetic stimulation sessions he never provided. Dr. Kinrys, who owned and operated Advanced TMS Associates, also made false statements to patients, billing companies and payers. When payers sought records to justify his claims, Dr. Kinrys forced employees to create fake patient records to send to Medicare and private insurers.
5. In May, Desi Barroga, MD, and Deno Barroga, MD, pain management physicians in Dallas each pleaded guilty to a healthcare billing scheme that defrauded major insurers of at least $45 million.
The pair submitted fraudulent claims for corticosteroid injections that were never administered. They also required patients to come in for monthly office visits in order to continue the fraudulent billing, submitting fraudulent claims worth at least $45 million to payers including Blue Cross Blue Shield, Cigna and United Healthcare for injections that were never administered, as many as 80 injections per patient per visit. They also created and submitted false medical records and told patients to include false statements to validate their claims, each earning at least $9 million.