The Top Healthcare Fraud Schemes of 2019

The Top Healthcare Fraud Schemes of 2019

The year 2019 was plagued with various healthcare fraud schemes noted across the nation. From retired NFL players to the owners and employees of major healthcare companies, fraud impacts many without regard to any socioeconomic boundaries. With the help of the National Health Care Anti-Fraud Association (NHCAA), the team at the Healthcare Fraud Group gathered some of the highlighting cases of 2019.

A Genetic Testing Scheme in South Carolina

During 2019, the Department of Justice brought forward an investigation against a man from Hilton Head. He fraudulently billed Medicare over $56 million while being involved in a $2.1 billion genetic test fraud scheme. This medical professional persuaded vulnerable elderly Americans to sign up for non-existent and unnecessary cancer screening tests.

A Pennsylvania Medicare Kickback Case

The owner of two Pennsylvania genetic testing laboratories faces multiple charges for allegedly billing Medicare to the tune of $127 million for genetic tests at his lab. These tests used DNA samples that were collected erroneously by marketers at health fairs across the state. The medical professional is accused of providing the marketers with kickbacks for providing samples from guests at the health fairs via cheek swab kits.

A Tennessee Pain Clinic Bust

Several culprits in Tennessee, and one from Mississippi, are accused of conspiring together in an elaborate healthcare fraud scheme, dubbed Pain MD, which operated pain and wellness clinics. These individuals used scare tactics and pushed aggressive productivity goals to render services like injections and the use of durable medical equipment for patients. In total, these individuals were involved in a scheme that resulted in over $38 million in healthcare charges for unnecessary services.

Wyoming Youth Treatment Center Scheme

Three employees at the Northwest Wyoming Treatment Center were accused of engaging in an $8.6 million fraud scheme that involved them submitting numerous questionable claims to Medicaid for substance abuse treatment services. Additionally, these employees billed Medicaid for leisurely activities, like playing video games, by claiming they were abuse treatment therapy.

NFL Health Insurance Scam

Ten retired NFL players were accused of engaging in a $3.9 million healthcare fraud scheme. This fake and fraudulent claims scheme involved submitting phony healthcare claims for reimbursements for medical equipment that was never purchased. Several players involved in the scheme were also accused of wire fraud. Some of the players were accused of impersonating other players over the phone to collect confident information from callers on the other end.

Recoveries by the Office of Inspector General

During 2019, the Health and Human Services Office of Inspector General was able to recover more than $5.9 billion from fraud investigations. This amount doubled the total for 2018 and brought justice to companies across the nation.

Healthcare Fraud Group Can Help You

Being accused of healthcare fraud can have a life-altering impact on a person’s career and personal life. Perpetrators face stacking fines, lengthy prison sentences, and the indefinite suspensions of their medical licenses. If you were accused of a crime or similar forms of healthcare fraud, contact our defense attorneys at Healthcare Fraud Group by calling (888) 402-4054to discuss your case as soon as possible.

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