Compliance News Roundup: 2018 Fraud Takedown

1. Former Healthcare Chief Executive Sentenced to 9.5 Years in Federal Prison – “United States Attorney Josh J. Minkler today announced the sentencing of the former CEO of American Senior Communities (ASC) in a massive fraud, kickback, and money laundering conspiracy. James Burkhart, 53, of Carmel, was sentenced to 114 months imprisonment by U.S. District Court Judge Tanya Walton Pratt." Get the full scoop >>

2. Skilled Nursing Facility, Management Company, And Owner Agree To Pay $540,000 To Resolve Allegations Of Providing Worthless Services And Upcoding – “Preferred Care Inc. (Preferred Care); its Stanton, Kentucky skilled nursing facility, Stanton Nursing and Rehabilitation Center (Stanton Nursing); owner, Thomas D. Scott; Preferred Care Partners Management Group (PCPMG); and certain other affiliated entities have agreed to pay $540,000 to the United States and the Commonwealth of Kentucky, to resolve allegations that Stanton Nursing billed Medicare and the Kentucky Medicaid program for fraudulently inflated skilled nursing services and providing materially substandard care, in violation of the False Claims Act.” Get the full scoop >>

3. Deeper Than the Headlines: 2018 Fraud Takedown – “The DOJ and OIG recently announced the 2018 Fraud Takedown which resulted in charges against 601 individuals responsible for over $2 Billion in fraud, according to the federal government. Each year the government seems to set records in the fraud takedowns and this year is no different. According to the DOJ, this year’s enforcement action was the largest in DOJ history. It included charges against 76 doctors (and 90 more licensed professionals including nurses) as well as 84 opioid cases which involved more than 14 million illegal doses of opioids. Thirty state Medicaid Fraud Control Units also participated in the arrests which were announced on June 28, 2018. In addition, HHS announced that from July 2017 to the present, it has excluded 2,700 individuals from participation in Medicare, Medicaid, and all other Federal healthcare programs, which includes 587 providers excluded for conduct related to opioid diversion and abuse.” Get the full scoop >>