Bloomberg BNA Publishes Outlook for Health Care Fraud in 2016

Bloomberg BNA has published its Outlook for Health Care Fraud for 2016, which includes information gathered from interviews with health care attorneys, trade association executives and health care consultants and recommendations on what health care providers can do to protect themselves. The report focuses on the following health care fraud trends: False Claims Act litigation … Continued

Two North Texas Men Indicted for $65M Health Care Fraud

Two North Texas men — Richard Robert Cesario, 44, of Plano and John Paul Cooper, 47, of Southlake — are under felony indictment for allegations they engaged in a health care fraud conspiracy that cost military health system TRICARE more than $65 million in losses, according to the FBI. TRICARE is the U.S. Department of … Continued

Two DFW Doctors and Four Others Charged with Medicare Fraud

Two Dallas-area physicians and four other healthcare workers have been indicted for allegedly participating in a $13.4 million Medicare fraud scheme involving home health services, according to the FBI. The two doctors — Dr. Angel Claudio, 60, of Hood County, Texas, and Dr. Kelly Robinett, 66, of Denton County, Texas — have each been charged … Continued

Two Texans Convicted in Separate Health Care Fraud Cases

A San Angelo psychiatrist and a Denton nurse have been convicted of health care fraud in two separate cases. Dr. Robert Hadley Gross of San Angelo pleaded guilty to health care fraud and has been sentenced to six years in federal prison and ordered to repay more than $1.8 million in restitution.  He was indicted … Continued

Dallas County Woman Sentenced for Medicaid Fraud

A 48-year-old Dallas County woman has been sentenced to 57 months in federal prison and ordered to pay $887,809 in restitution following her guilty plea to one count of health care fraud. Brenda Ward of Cedar Hill, Texas, formerly president and CEO of H.E.L.P.-Ing Communities Inc. (HCI), pleaded guilty to participating in a Medicaid fraud … Continued

DOJ’s Worthless Services Investigations of Long-Term Care Providers Continues

Last year, at a speech before the Taxpayers Against Fraud Education Fund Conference, Department of Justice Assistant Attorney General Leslie R. Caldwell announced a new DOJ policy for all new qui tam complaints.  Caldwell stated that the Department’s civil and criminal prosecutors would review all new qui tam complaints simultaneously to determine whether parallel investigations … Continued

Common Characteristics of White Collar Crimes

White collar crimes present many different challenges and issues than “street” or violent crimes, both in how they are charged and how they are defended.  Some of the common characteristics of white collar crimes include: Non-violent — white collar crimes differ primarily from other types of crime in that they are non-violent offenses. Deception — … Continued

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