Healthcare Fraud Archives - Wisdom. Applied. https://blog.weisspc.com/category/healthcare-fraud/ Wisdom Applied - Decoding the Business of Healthcare — Mark Weiss’s Perspective Thu, 28 May 2026 17:28:40 +0000 en-US hourly 1 183918279 Fraud on Fridays: That’s Why They Go to Jail https://blog.weisspc.com/52m-healthcare-fraud-suboxone-scheme/ https://blog.weisspc.com/52m-healthcare-fraud-suboxone-scheme/#respond Fri, 29 May 2026 14:58:00 +0000 https://blog.weisspc.com/?p=37114 A 78-year-old Brooklyn clinic owner. A van outside where his staff directed patients to sell their Suboxone. A Florida nurse practitioner who signed prescriptions without seeing a single patient. And a federal informant with a hidden camera who heard Brown-Arkah explain, on the record, exactly why people in his business get arrested.

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]]> https://blog.weisspc.com/52m-healthcare-fraud-suboxone-scheme/feed/ 0 37114 Fraud on Fridays: No Sample Required  https://blog.weisspc.com/covid-testing-fraud-no-sample-required/ https://blog.weisspc.com/covid-testing-fraud-no-sample-required/#respond Fri, 22 May 2026 14:14:00 +0000 https://blog.weisspc.com/?p=37111 Two brothers from Naperville. Four laboratories. $293 million in claims for COVID-19 tests that were never performed. And then the gold bars, the overseas mansions, the luxury watches — and a superseding indictment.

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]]> https://blog.weisspc.com/covid-testing-fraud-no-sample-required/feed/ 0 37111 Fraud on Fridays: Football Fraudster Drops the Ball https://blog.weisspc.com/197m-dme-fraud-nfl-player/ https://blog.weisspc.com/197m-dme-fraud-nfl-player/#respond Fri, 15 May 2026 14:33:00 +0000 https://blog.weisspc.com/?p=37105 He signed with the Seahawks. He made the Packers’ practice squad. He never played a regular-season game. Then he built a $197 million fraud operation targeting the elderly and the families of disabled and deceased veterans. 

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]]> https://blog.weisspc.com/197m-dme-fraud-nfl-player/feed/ 0 37105 Fraud on Fridays: Not That Kind of Angel  https://blog.weisspc.com/fraud-on-fridays-opioid-prescribing-conviction/ https://blog.weisspc.com/fraud-on-fridays-opioid-prescribing-conviction/#respond Fri, 08 May 2026 13:59:00 +0000 https://blog.weisspc.com/?p=37097 A Houston strip mall clinic. Mirrored windows. A price list based on which drug you’d receive. And a doctor who prescribed the same opioid cocktail to more than 99% of her patients. 

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]]> https://blog.weisspc.com/fraud-on-fridays-opioid-prescribing-conviction/feed/ 0 37097 Fraud on Fridays: The Diagnosis That Wasn’t There https://blog.weisspc.com/fraud-on-fridays-the-diagnosis-that-wasnt-there/ https://blog.weisspc.com/fraud-on-fridays-the-diagnosis-that-wasnt-there/#respond Fri, 01 May 2026 13:28:00 +0000 https://blog.weisspc.com/?p=37066 $556 million. One settlement. One health system that is simultaneously the insurer and the physician group. The largest Medicare Advantage risk adjustment fraud settlement in history, and a warning for every physician group in an MA contract.

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]]> https://blog.weisspc.com/fraud-on-fridays-the-diagnosis-that-wasnt-there/feed/ 0 37066 Fraud on Fridays: Your Banker Is Watching https://blog.weisspc.com/fraud-on-fridays-your-banker-is-watching/ https://blog.weisspc.com/fraud-on-fridays-your-banker-is-watching/#respond Fri, 24 Apr 2026 15:19:00 +0000 https://blog.weisspc.com/?p=37051 Your bank’s been deputized as the front line of healthcare fraud detection. Here’s what that means for you.

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]]> https://blog.weisspc.com/fraud-on-fridays-your-banker-is-watching/feed/ 0 37051 Fraud on Fridays: Operation Gold Rush https://blog.weisspc.com/fraud-on-fridays-operation-gold-rush/ https://blog.weisspc.com/fraud-on-fridays-operation-gold-rush/#respond Fri, 17 Apr 2026 14:55:00 +0000 https://blog.weisspc.com/?p=37041 A Russian criminal organization allegedly bought dozens of legitimate Medicare-enrolled companies, installed fake owners, and submitted $10.6 billion in fraudulent DME claims. The government stopped almost all of it. Almost.

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]]> https://blog.weisspc.com/fraud-on-fridays-operation-gold-rush/feed/ 0 37041 Fraud on Fridays: Operation Never Say Die https://blog.weisspc.com/hospice-fraud-operation-never-say-die/ https://blog.weisspc.com/hospice-fraud-operation-never-say-die/#respond Fri, 10 Apr 2026 14:40:00 +0000 https://blog.weisspc.com/?p=37029 Healthy patients recruited at grocery stores, cash in envelopes, and a fraud ring that didn’t stop even when its ringleader was already sitting in a federal prison.

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]]> https://blog.weisspc.com/hospice-fraud-operation-never-say-die/feed/ 0 37029 Fraud on Fridays: Trash, Junk and 12.5 Years https://blog.weisspc.com/fraud-on-fridays-trash-junk-12-5-years/ https://blog.weisspc.com/fraud-on-fridays-trash-junk-12-5-years/#respond Fri, 03 Apr 2026 14:46:00 +0000 https://blog.weisspc.com/?p=37022 A Texas fraudster ran a wholesale market in fake doctors’ orders, pressured elderly Medicare patients with an offshore call center, then fled before sentencing. The U.S. Marshals had thoughts about that.

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]]> https://blog.weisspc.com/fraud-on-fridays-trash-junk-12-5-years/feed/ 0 37022 Fraud on Fridays: Bonnie and Clyde, M.D. https://blog.weisspc.com/fraud-on-fridays-bonnie-and-clyde-md/ https://blog.weisspc.com/fraud-on-fridays-bonnie-and-clyde-md/#respond Fri, 27 Mar 2026 13:55:39 +0000 https://blog.weisspc.com/?p=37017 A husband-and-wife team, expired injections, and 15 years of fraud. This Bonnie and Clyde didn’t rob banks, they robbed their patients.

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]]> https://blog.weisspc.com/fraud-on-fridays-bonnie-and-clyde-md/feed/ 0 37017 Fraud on Fridays: It’s What Was in the Goody Bag https://blog.weisspc.com/fraud-on-fridays-goody-bag-opioid-scheme/ https://blog.weisspc.com/fraud-on-fridays-goody-bag-opioid-scheme/#respond Fri, 20 Mar 2026 14:51:00 +0000 https://blog.weisspc.com/?p=37012 Opioids, unnecessary prescriptions, unlicensed interns, and a Goody Bag no patient actually wanted.

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]]> https://blog.weisspc.com/fraud-on-fridays-goody-bag-opioid-scheme/feed/ 0 37012 Fraud on Fridays: Fraudulent Visas, Kickbacks, and $32 Million in Medicaid Billing https://blog.weisspc.com/fraudulent-visas-kickbacks-32-million-medicaid-billing/ https://blog.weisspc.com/fraudulent-visas-kickbacks-32-million-medicaid-billing/#respond Fri, 13 Mar 2026 14:45:00 +0000 https://blog.weisspc.com/?p=37007 Visa fraud, kickbacks, and Medicaid billing under someone else’s name.

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]]> https://blog.weisspc.com/fraudulent-visas-kickbacks-32-million-medicaid-billing/feed/ 0 37007 Fraud on Fridays: Doctor Chasing: When Someone Wants to Borrow Your License  https://blog.weisspc.com/fraud-on-fridays-doctor-chasing/ https://blog.weisspc.com/fraud-on-fridays-doctor-chasing/#respond Fri, 06 Mar 2026 14:56:00 +0000 https://blog.weisspc.com/?p=36998 A former football player, marketers, and your medical license

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]]> https://blog.weisspc.com/fraud-on-fridays-doctor-chasing/feed/ 0 36998 Fraud on Fridays: Surgeon Sentenced for Compound Bribes https://blog.weisspc.com/fraud-on-fridays-surgeon-sentenced-compounded-bribes/ https://blog.weisspc.com/fraud-on-fridays-surgeon-sentenced-compounded-bribes/#respond Fri, 27 Feb 2026 15:41:00 +0000 https://blog.weisspc.com/?p=36989 A surgeon doesn’t get 102 months in federal prison because he “missed a detail.” He gets it because he treated prescribing like a revenue stream instead of a duty.

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]]> https://blog.weisspc.com/fraud-on-fridays-surgeon-sentenced-compounded-bribes/feed/ 0 36989 Fraud on Fridays: Inside Job https://blog.weisspc.com/fraud-on-fridays-inside-job/ https://blog.weisspc.com/fraud-on-fridays-inside-job/#respond Fri, 20 Feb 2026 15:03:00 +0000 https://blog.weisspc.com/?p=36984 Some of the most damaging fraud in medical practices doesn’t come from CMS, payors, or regulators—it comes from trusted employees.

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]]> https://blog.weisspc.com/fraud-on-fridays-inside-job/feed/ 0 36984 Fraud on Fridays: Shocking Double Stack Fraud https://blog.weisspc.com/double-stack-healthcare-securities-fraud/ https://blog.weisspc.com/double-stack-healthcare-securities-fraud/#respond Fri, 13 Feb 2026 12:44:00 +0000 https://blog.weisspc.com/?p=36976 A former CEO and COO are accused of healthcare fraud used to drive securities fraud. Learn the lessons for healthcare leaders and investors.

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]]> https://blog.weisspc.com/double-stack-healthcare-securities-fraud/feed/ 0 36976 Fraud On Fridays: The Fake Doctor Will See You Now https://blog.weisspc.com/fake-doctor-healthcare-fraud/ https://blog.weisspc.com/fake-doctor-healthcare-fraud/#respond Fri, 06 Feb 2026 12:52:00 +0000 https://blog.weisspc.com/?p=36967 A Connecticut physician is accused of knowingly employing a fake doctor for years. Learn the risks of credential misuse and how identity‑based fraud ensnares practices.

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]]> https://blog.weisspc.com/fake-doctor-healthcare-fraud/feed/ 0 36967 Fraud on Fridays: Brace Yourself  https://blog.weisspc.com/dme-fraud-layered-scheme/ https://blog.weisspc.com/dme-fraud-layered-scheme/#respond Fri, 30 Jan 2026 12:36:00 +0000 https://blog.weisspc.com/?p=36962 A Florida LNA built a layered $11.4M DME fraud scheme involving hidden ownership, kickbacks, and structuring.

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]]> https://blog.weisspc.com/dme-fraud-layered-scheme/feed/ 0 36962 Fraud on Fridays: From Telehealth to Telefraud https://blog.weisspc.com/fraud-on-fridays-telehealth-to-telefraud/ https://blog.weisspc.com/fraud-on-fridays-telehealth-to-telefraud/#respond Fri, 23 Jan 2026 13:38:00 +0000 https://blog.weisspc.com/?p=36716 Another week. Another fraud.
This Friday’s case shows how telehealth can quietly turn into federal wire fraud—without physicians realizing the risk until it’s too late.

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]]> https://blog.weisspc.com/fraud-on-fridays-telehealth-to-telefraud/feed/ 0 36716 Five Ophthalmology Practices See Eye to Eye in False Claims Act Settlement https://blog.weisspc.com/ophthalmology-kickback-false-claims-act-settlement/ https://blog.weisspc.com/ophthalmology-kickback-false-claims-act-settlement/#respond Mon, 19 Jan 2026 16:44:08 +0000 https://blog.weisspc.com/?p=36695 Five ophthalmology practices agreed to pay nearly $6M over alleged kickbacks and unnecessary testing. Learn the FCA risks every physician group must understand.

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]]> https://blog.weisspc.com/ophthalmology-kickback-false-claims-act-settlement/feed/ 0 36695 Fraud on Fridays: Bogus Billing for Botox? https://blog.weisspc.com/bogus-botox-billing-fraud/ https://blog.weisspc.com/bogus-botox-billing-fraud/#respond Sat, 17 Jan 2026 08:15:00 +0000 https://blog.weisspc.com/?p=36663 Learn why poor documentation and bad fixes can turn mistakes into criminal exposure—and how one physician allegedly blurred the lines of Botox billing.

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]]> https://blog.weisspc.com/bogus-botox-billing-fraud/feed/ 0 36663 Fraud on Fridays: DME and Dummies  https://blog.weisspc.com/telemedicine-dme-fraud/ https://blog.weisspc.com/telemedicine-dme-fraud/#respond Fri, 09 Jan 2026 13:52:00 +0000 https://blog.weisspc.com/?p=36636 The $1 billion telemedicine scam that finally caught up with its CEO.

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]]> https://blog.weisspc.com/telemedicine-dme-fraud/feed/ 0 36636 Fraud on Fridays: Pink Slipped https://blog.weisspc.com/healthcare-executive-fraud-risks/ https://blog.weisspc.com/healthcare-executive-fraud-risks/#respond Fri, 26 Dec 2025 10:30:00 +0000 https://blog.weisspc.com/?p=36467 From sell-mates to cellmates? Used car salesmen/financiers and the lesson for healthcare leaders.

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]]> https://blog.weisspc.com/healthcare-executive-fraud-risks/feed/ 0 36467 Off to Prison. An Update on How to Almost Make Half a Billion Dollars: The Arizona Wound Graft Fraud https://blog.weisspc.com/wound-care-graft-fraud/ https://blog.weisspc.com/wound-care-graft-fraud/#respond Mon, 22 Dec 2025 16:41:12 +0000 https://blog.weisspc.com/?p=36464 Now that they’ve been sentenced to prison, I can reveal the fate of the healthcare power couple, Alexandra Gehrke and her husband, Jeffrey King, whose wound care graft graft put close to $615,000,000 in their pockets, albeit temporarily.

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]]> https://blog.weisspc.com/wound-care-graft-fraud/feed/ 0 36464 Fraud on Fridays: Deceit Was in His Genes https://blog.weisspc.com/medicare-genetic-testing-fraud/ https://blog.weisspc.com/medicare-genetic-testing-fraud/#respond Fri, 19 Dec 2025 12:25:00 +0000 https://blog.weisspc.com/?p=36462 Perhaps he should have genetically tested himself for the propensity to commit fraud.

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]]> https://blog.weisspc.com/medicare-genetic-testing-fraud/feed/ 0 36462 Fraud on Fridays: Upcoding to Infinity and Beyond https://blog.weisspc.com/upcoding-fraud-healthcare/ https://blog.weisspc.com/upcoding-fraud-healthcare/#respond Fri, 12 Dec 2025 14:13:00 +0000 https://blog.weisspc.com/?p=36457 If we could call it upcoding, it would be an understatement to call it upcoding to infinity. 

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]]> https://blog.weisspc.com/upcoding-fraud-healthcare/feed/ 0 36457 Fraud on Fridays: Fraud on Physicians in the ASC Setting https://blog.weisspc.com/fraud-fridays-fraud-on-physicians-asc-setting/ https://blog.weisspc.com/fraud-fridays-fraud-on-physicians-asc-setting/#respond Fri, 05 Dec 2025 09:54:00 +0000 https://blog.weisspc.com/?p=36451 When you think about fraud at an ASC, you tend to think about fraud on payers, from Medicare to well, Blue Cross. You know, cases that never happened, patients who didn’t suffer from any medical issue, and the like. But what about fraud on physicians at an ASC? Because physicians hardly think about it, it...

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]]> https://blog.weisspc.com/fraud-fridays-fraud-on-physicians-asc-setting/feed/ 0 36451 Fraud on Fridays: $10.6 Billion – Does Crime Pay? https://blog.weisspc.com/largest-healthcare-fraud-case-operation-gold-rush-doj/ https://blog.weisspc.com/largest-healthcare-fraud-case-operation-gold-rush-doj/#respond Fri, 28 Nov 2025 15:46:55 +0000 https://blog.weisspc.com/?p=36446 In a healthcare billing and payment system that’s so complex, it’s sad to say that criminals can stay a few steps ahead of the Feds. With $10.6 billion in bogus billing, some cutouts got caught, but the masterminds appear to have escaped with close to $1 billion.

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]]> https://blog.weisspc.com/largest-healthcare-fraud-case-operation-gold-rush-doj/feed/ 0 36446 Fraud on Fridays: The Four Legs of Fraud https://blog.weisspc.com/kickbacks-consulting-agreements-doj-case/ https://blog.weisspc.com/kickbacks-consulting-agreements-doj-case/#respond Fri, 21 Nov 2025 13:38:00 +0000 https://blog.weisspc.com/?p=36437 The DOJ kicked back when it secured a conviction against compounding pharmacy executive Sam Glover for a six-year drug alteration and misbranding conspiracy involving free flowing prescription forms and, well, racehorses.

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]]> https://blog.weisspc.com/kickbacks-consulting-agreements-doj-case/feed/ 0 36437 Fraud on Fridays: The Case of Dr. Jorge Zamora-Quezada https://blog.weisspc.com/fraud-on-fridays-case-of-dr-jorge-zamora-quezada/ https://blog.weisspc.com/fraud-on-fridays-case-of-dr-jorge-zamora-quezada/#respond Sat, 15 Nov 2025 17:52:41 +0000 https://blog.weisspc.com/?p=36435 Dr. Jorge Zamora-Quezada, a Texas rheumatologist, was sentenced earlier this year to ten years in federal prison for a healthcare fraud so brazen it left even seasoned prosecutors shaking their heads. Read the full DOJ press release.

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]]> https://blog.weisspc.com/fraud-on-fridays-case-of-dr-jorge-zamora-quezada/feed/ 0 36435 Fraud on Fridays: The BS MSO: Kickbacks Disguised as Investments Snare Another Round of Settlements https://blog.weisspc.com/disguised-kickbacks-healthcare-msos/ https://blog.weisspc.com/disguised-kickbacks-healthcare-msos/#respond Fri, 07 Nov 2025 14:24:00 +0000 https://blog.weisspc.com/?p=36417 The Department of Justice just announced more than six million dollars in settlements with a former lab CEO, seven marketers, and two physicians. Their alleged wrong? Turning the concept of the “Management Services Organization” into a pay-to-play operation.

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]]> https://blog.weisspc.com/disguised-kickbacks-healthcare-msos/feed/ 0 36417 $500 Million in Alleged Phony Charges and the Dangers of Medical Directorship https://blog.weisspc.com/medical-directorship-fraud-500m-case/ https://blog.weisspc.com/medical-directorship-fraud-500m-case/#respond Mon, 18 Aug 2025 16:39:26 +0000 https://blog.weisspc.com/?p=35352 A $500M medical directorship fraud case exposes how physicians can be exploited. Protect your practice from legal and financial fallout.

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]]> https://blog.weisspc.com/medical-directorship-fraud-500m-case/feed/ 0 35352 Double Trouble: Prosecuted and Sued for the Same Scam https://blog.weisspc.com/physician-fraud-civil-and-criminal-charges/ https://blog.weisspc.com/physician-fraud-civil-and-criminal-charges/#respond Mon, 28 Jul 2025 15:57:50 +0000 https://blog.weisspc.com/?p=35120 Out of state. Still billing for in-person care.
A physician submitted claims while vacationing in Hawaii—and now faces criminal sentencing and a $500k civil payout.

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]]> https://blog.weisspc.com/physician-fraud-civil-and-criminal-charges/feed/ 0 35120 Healthcare Fraud and the Physician as Victim https://blog.weisspc.com/healthcare-fraud-and-the-physician-as-victim/ https://blog.weisspc.com/healthcare-fraud-and-the-physician-as-victim/#respond Mon, 14 Jul 2025 16:06:05 +0000 https://blog.weisspc.com/?p=34835 The majority of healthcare fraud schemes center on fraud perpetrated by physicians, but what about schemes orchestrated to victimize physicians?

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]]> https://blog.weisspc.com/healthcare-fraud-and-the-physician-as-victim/feed/ 0 34835 The Nation’s Largest Health Care Fraud Bust, Plus Bureaucratic Negligence https://blog.weisspc.com/the-nations-largest-health-care-fraud-bust-plus-bureaucratic-negligence/ https://blog.weisspc.com/the-nations-largest-health-care-fraud-bust-plus-bureaucratic-negligence/#respond Mon, 07 Jul 2025 15:52:01 +0000 https://blog.weisspc.com/?p=34540 It’s been said that people read published lists of disciplined fellow professionals out of a sense of schadenfreude, the pleasure derived from another’s misfortune.

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]]> https://blog.weisspc.com/the-nations-largest-health-care-fraud-bust-plus-bureaucratic-negligence/feed/ 0 34540 How to Almost Make Half a Billion Dollars: The Arizona Wound Graft Fraud https://blog.weisspc.com/how-to-almost-make-half-a-billion-dollars/ https://blog.weisspc.com/how-to-almost-make-half-a-billion-dollars/#respond Mon, 10 Feb 2025 15:58:37 +0000 https://blog.weisspc.com/?p=31571 If you thought health care fraud required medical knowledge, think again.

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]]> https://blog.weisspc.com/how-to-almost-make-half-a-billion-dollars/feed/ 0 31571 Will the Whistleblower Law Be Whistled Out? https://blog.weisspc.com/will-the-whistleblower-law-be-whistled-out/ https://blog.weisspc.com/will-the-whistleblower-law-be-whistled-out/#respond Mon, 20 Jan 2025 15:59:58 +0000 https://blog.weisspc.com/?p=31549 Is the False Claims Act’s whistleblower provision illegal?

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]]> https://blog.weisspc.com/will-the-whistleblower-law-be-whistled-out/feed/ 0 31549 Federal District Court Finds Whistleblower Actions Unconstitutional https://blog.weisspc.com/whistleblower-actions-unconstitutional/ https://blog.weisspc.com/whistleblower-actions-unconstitutional/#respond Mon, 21 Oct 2024 14:53:53 +0000 https://blog.weisspc.com/?p=31403 What if someone blows the whistle but it makes no sound?

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]]> https://blog.weisspc.com/whistleblower-actions-unconstitutional/feed/ 0 31403 Beware of Bogus Medicare and Medicaid Billings https://blog.weisspc.com/beware-of-bogus-medicare-and-medicaid-billings/ https://blog.weisspc.com/beware-of-bogus-medicare-and-medicaid-billings/#respond Mon, 19 Aug 2024 15:22:37 +0000 https://blog.weisspc.com/?p=31352 Certifying to Medicare that you’re here when you’re really there is a ticket to nowhere, or maybe to jail.

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]]> https://blog.weisspc.com/beware-of-bogus-medicare-and-medicaid-billings/feed/ 0 31352 Telehealth Plus Tell a Lie Means Likely End Up in Prison for Telefraud – Podcast https://blog.weisspc.com/telehealth-fraud-physician-compliance-audio/ https://blog.weisspc.com/telehealth-fraud-physician-compliance-audio/#respond Thu, 11 Jul 2024 10:15:00 +0000 https://blog.weisspc.com/?p=31141 Telehealth can be used to vastly improve patients’ access to medical care. At the same time, it can be used to vastly improve criminals’ access to Medicare dollars. It shouldn’t be that difficult for physicians to assess the bona fides of their proposed participation in a telehealth “business model” when the ones doing the proposing are telemarketers.

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]]> https://blog.weisspc.com/telehealth-fraud-physician-compliance-audio/feed/ 0 31141 Telehealth Plus Tell a Lie Means Likely End Up in Prison for Telefraud – Medical Group Minute https://blog.weisspc.com/telehealth-fraud-physician-compliance-video/ https://blog.weisspc.com/telehealth-fraud-physician-compliance-video/#respond Wed, 19 Jun 2024 09:13:00 +0000 https://blog.weisspc.com/?p=31121 Telehealth can be used to vastly improve patients’ access to medical care. At the same time, it can be used to vastly improve criminals’ access to Medicare dollars. It shouldn’t be that difficult for physicians to assess the bona fides of their proposed participation in a telehealth “business model” when the ones doing the proposing are telemarketers.

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]]> https://blog.weisspc.com/telehealth-fraud-physician-compliance-video/feed/ 0 31121 Are Medicare Recovery Auditors Submitting False Claims? – Success in Motion https://blog.weisspc.com/medicare-auditors-submitting-false-claims-sim/ https://blog.weisspc.com/medicare-auditors-submitting-false-claims-sim/#respond Tue, 28 May 2024 08:14:35 +0000 https://blog.weisspc.com/?p=30889 Ride along with Mark as he muses over whether Medicare recovery auditors are themselves committing fraud.

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]]> https://blog.weisspc.com/medicare-auditors-submitting-false-claims-sim/feed/ 0 30889 Telehealth Plus Tell a Lie Means Likely End Up in Prison for Tele-fraud https://blog.weisspc.com/telehealth-fraud-physician-compliance/ https://blog.weisspc.com/telehealth-fraud-physician-compliance/#respond Mon, 06 May 2024 13:30:00 +0000 https://blog.weisspc.com/?p=30960 Telehealth can be used to vastly improve patients’ access to medical care. At the same time, it can be used to vastly improve criminals’ access to Medicare dollars. It shouldn’t be that difficult for physicians to assess the bona fides of their proposed participation in a telehealth “business model” when the ones doing the proposing are telemarketers.

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]]> https://blog.weisspc.com/telehealth-fraud-physician-compliance/feed/ 0 30960 What Do You Know? Scienter and the False Claims Act – Success in Motion https://blog.weisspc.com/what-do-you-know-scienter-sim/ https://blog.weisspc.com/what-do-you-know-scienter-sim/#respond Tue, 26 Dec 2023 08:06:00 +0000 https://blog.weisspc.com/?p=30017 Ride along with Mark as he discusses the influence of scienter in False Claims Act cases.

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]]> https://blog.weisspc.com/what-do-you-know-scienter-sim/feed/ 0 30017 Big Development in False Claims Act Liability: Supreme Court Defines the Required Knowledge of Falsity https://blog.weisspc.com/big-development-in-false-claims-act-liability-supreme-court-defines-the-required-knowledge-of-falsity/ https://blog.weisspc.com/big-development-in-false-claims-act-liability-supreme-court-defines-the-required-knowledge-of-falsity/#respond Mon, 05 Jun 2023 15:54:54 +0000 https://blog.weisspc.com/?p=29848 What you know, both about the FCA and about the falsity of claims is now even more relevant.

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]]> https://blog.weisspc.com/big-development-in-false-claims-act-liability-supreme-court-defines-the-required-knowledge-of-falsity/feed/ 0 29848 False Claims Act Settlement Skins Plastic Surgeon For Close To $24 Million And Extracts An Additional Pound Of Flesh https://blog.weisspc.com/false-claims-act-settlement-skins-plastic-surgeon-for-close-to-24-million-and-extracts-an-additional-pound-of-flesh/ https://blog.weisspc.com/false-claims-act-settlement-skins-plastic-surgeon-for-close-to-24-million-and-extracts-an-additional-pound-of-flesh/#respond Mon, 08 May 2023 15:40:25 +0000 https://blog.weisspc.com/?p=29774 You can settle civil allegations in the morning and be arrested before the end of lunch...

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]]> https://blog.weisspc.com/false-claims-act-settlement-skins-plastic-surgeon-for-close-to-24-million-and-extracts-an-additional-pound-of-flesh/feed/ 0 29774 A Stark Reminder About “Normal” Business Practices That Violate the AKS – Success in Motion https://blog.weisspc.com/normal-business-practices-that-violate-aks-sim/ https://blog.weisspc.com/normal-business-practices-that-violate-aks-sim/#respond Tue, 27 Dec 2022 12:00:00 +0000 https://blog.weisspc.com/?p=28227 Sit back and relax while Mark warns you that kickback violations can arise from what are usually seen as common business practices.

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]]> https://blog.weisspc.com/normal-business-practices-that-violate-aks-sim/feed/ 0 28227 Doctor Settles Allegations but Doesn’t Admit She Can’t Be Two Places at the Same Time – Podcast https://blog.weisspc.com/physician-coverage-allegations-podcast/ https://blog.weisspc.com/physician-coverage-allegations-podcast/#respond Thu, 06 Oct 2022 11:00:00 +0000 https://blog.weisspc.com/?p=27894 That’s odd, because physicians sometime demonstrate that ability, at least on billing records.

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]]> https://blog.weisspc.com/physician-coverage-allegations-podcast/feed/ 0 27894 Doctor Settles Allegations but Doesn’t Admit She Can’t Be Two Places at the Same Time – Medical Group Minute https://blog.weisspc.com/physician-coverage-allegations-video/ https://blog.weisspc.com/physician-coverage-allegations-video/#respond Wed, 28 Sep 2022 11:00:00 +0000 https://blog.weisspc.com/?p=27867 That’s odd, because physicians sometime demonstrate that ability, at least on billing records.

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]]> https://blog.weisspc.com/physician-coverage-allegations-video/feed/ 0 27867 Doctor Settles Allegations but Doesn’t Admit She Can’t Be Two Places at the Same Time https://blog.weisspc.com/physician-coverage-allegations/ https://blog.weisspc.com/physician-coverage-allegations/#respond Mon, 04 Apr 2022 15:29:07 +0000 https://blog.weisspc.com/?p=27515 That’s odd, because physicians sometime demonstrate that ability, at least on billing records.

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]]> https://blog.weisspc.com/physician-coverage-allegations/feed/ 0 27515 The Other Final Four: Hospital Executives Sentenced to Prison – Medical Group Minute https://blog.weisspc.com/hospital-executive-sentencing-video/ https://blog.weisspc.com/hospital-executive-sentencing-video/#respond Wed, 23 Jun 2021 11:00:00 +0000 https://blog.weisspc.com/?p=24489 In my experience, most kickback schemes are not as brazen as this. They involve fewer numbers of people and, sometimes, behavior that is more easily rationalized by the participants as “sort of legal”.

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]]> https://blog.weisspc.com/hospital-executive-sentencing-video/feed/ 0 24489 Physician Extender Sentenced to Prison for Fraud – Success in Motion https://blog.weisspc.com/physician-extender-sentenced-to-prison-sim/ https://blog.weisspc.com/physician-extender-sentenced-to-prison-sim/#respond Tue, 01 Jun 2021 11:00:00 +0000 https://blog.weisspc.com/?p=24479 Ride along with Mark as he discusses the danger of identity fraud on physicians.

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]]> https://blog.weisspc.com/physician-extender-sentenced-to-prison-sim/feed/ 0 24479 The Other Final Four: Hospital Executives Sentenced to Prison https://blog.weisspc.com/hospital-executive-sentencing/ https://blog.weisspc.com/hospital-executive-sentencing/#respond Mon, 26 Apr 2021 16:28:32 +0000 https://blog.weisspc.com/?p=24358 In my experience, most kickback schemes are not as brazen as this. They involve fewer numbers of people and, sometimes, behavior that is more easily rationalized by the participants as “sort of legal”.

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]]> https://blog.weisspc.com/hospital-executive-sentencing/feed/ 0 24358 Uncompensated Medical Directorship Leads to $3.2 Million False Claims Act Settlement – Podcast https://blog.weisspc.com/uncompensated-directorship-false-claims-whistleblower-audio/ https://blog.weisspc.com/uncompensated-directorship-false-claims-whistleblower-audio/#respond Thu, 13 Dec 2018 17:33:08 +0000 https://blog.weisspc.com/?p=10165 You may have seen their websites: Anesthesia "practice management companies" that advertise "no stipends!" to obtain facility contracts.

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]]> https://blog.weisspc.com/uncompensated-directorship-false-claims-whistleblower-audio/feed/ 0 10165 $2.6 Billion Collected by Feds From Compliance Cheats. ROI Makes Warren Buffett Look Like an Amateur. https://blog.weisspc.com/2-6-billion-collected-by-feds-from-compliance-cheats/ https://blog.weisspc.com/2-6-billion-collected-by-feds-from-compliance-cheats/#respond Mon, 16 Apr 2018 15:00:41 +0000 https://blog.weisspc.com/?p=9224 Federal government collects $2.6 Billion stemming from compliance violations in 967 criminal healthcare fraud investigations from 2015-2017.

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]]> https://blog.weisspc.com/2-6-billion-collected-by-feds-from-compliance-cheats/feed/ 0 9224 Uncompensated Medical Directorship Leads to $3.2 Million False Claims Act Settlement https://blog.weisspc.com/uncompensated-directorship-false-claims-whistleblower/ https://blog.weisspc.com/uncompensated-directorship-false-claims-whistleblower/#respond Mon, 09 Apr 2018 15:00:36 +0000 https://blog.weisspc.com/?p=9191 You may have seen their websites: Anesthesia “practice management companies” that advertise “no stipends!” to obtain facility contracts. Or, you may have seen the RPFs, usually drafted by “consultants” or “management companies”  (and others specializing in perhaps unknowingly committing federal crimes) who promise the surgeon-owners of ASCs that they’ll get anesthesia groups to provide a plethora...

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]]> https://blog.weisspc.com/uncompensated-directorship-false-claims-whistleblower/feed/ 0 9191 For Whom the Whistle Blows: Texas County Hospital Settles False Claims Act Suit – Podcast https://blog.weisspc.com/texas-hospital-settles-false-claims-act-suit-audio/ https://blog.weisspc.com/texas-hospital-settles-false-claims-act-suit-audio/#respond Thu, 04 Jan 2018 17:00:50 +0000 https://blog.weisspc.com/?p=8886 Once again, this case demonstrates that simple, facial reliance on safe harbors under the Federal Anti-Kickback Statute and Stark do not guaranty safety for either hospitals or their physician employees and subcontractors.

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]]> https://blog.weisspc.com/texas-hospital-settles-false-claims-act-suit-audio/feed/ 0 8886 For Whom the Whistle Blows: More Debris From the Fate of Fata – Medical Group Minute https://blog.weisspc.com/whistleblower-settlement-indirect-kickbacks-video/ https://blog.weisspc.com/whistleblower-settlement-indirect-kickbacks-video/#respond Wed, 25 Jan 2017 17:00:55 +0000 https://blog.weisspc.com/?p=7757 The scalpel of surgeon Farid Fata, M.D. continues to cut from beyond the metaphorical grave...

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]]> https://blog.weisspc.com/whistleblower-settlement-indirect-kickbacks-video/feed/ 0 7757 For Whom the Whistle Blows #2: More Debris From the Fate of Fata https://blog.weisspc.com/whistleblower-settlement-indirect-kickbacks/ https://blog.weisspc.com/whistleblower-settlement-indirect-kickbacks/#respond Mon, 19 Dec 2016 16:00:20 +0000 https://blog.weisspc.com/?p=7688 The scalpel of surgeon Farid Fata, M.D. continues to cut from beyond the metaphorical grave, i.e., from behind the walls, gates, and concertina wire of the United States Penitentiary in Atlanta, Georgia. In mid-2015, Dr. Fata traded in his scrubs for a prison uniform when he was sentenced to 45 years in jail for a...

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]]> https://blog.weisspc.com/whistleblower-settlement-indirect-kickbacks/feed/ 0 7688 For Whom the Whistle Blows: Texas County Hospital Settles False Claims Act Suit https://blog.weisspc.com/texas-hospital-settles-false-claims-act-suit/ https://blog.weisspc.com/texas-hospital-settles-false-claims-act-suit/#respond Wed, 29 Apr 2015 15:33:56 +0000 https://blog.weisspc.com/?p=6080 Citizens Medical Center, a county-owned hospital in Victoria, Texas, paid the United States government $21,750,000 to settle, without admitting wrongdoing, a whistleblower suit under the False Claims Act. The whistleblowers, competing physicians, will receive $5,981,250 from the recovery.

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]]> https://blog.weisspc.com/texas-hospital-settles-false-claims-act-suit/feed/ 0 6080