Legal Pointers

Courtroom Drama - Best Healthcare and DOJ Stories of 2022

Posted by Ben Mirza | Dec 07, 2022

10 Biggest Healthcare Fraud and Abuse Cases of 2022

Department of Justice Biggest Healthcare Cases

The following are MHL Team chosen top 10 Department of Justice - Healthcare cases for the year: 

1.“Physician Convicted for Unlawfully Prescribing Over 1 Million Opioid Pills”:

A Texas Physician along with his assistant issued prescriptions for a combination of controlled substances known as the “Las Vegas Cocktail” to hundreds of individuals posing as patients. Throughout the scheme, they made approximately $1,750,000 from prescriptions.  

More details at the DOJ website (Learn more) 

2.“Doctor Pleads Guilty to Role in $54 Million Medicare Fraud Scheme”: 

A Texas doctor pleaded guilty to conspiracy to commit wire fraud in a scheme to defraud Medicare resulting in illegally claiming $54 million, the accused doctor faces a maximum penalty of 20 years in prison.

More details at the DOJ website (Learn more) 

3.“Two Pharmacy Owners Plead Guilty in COVID-19 Money Laundering and Health Care Fraud Case”: 

Arkadiy Khaimov and Peter Khaim pleaded guilty to conspiracy to commit money laundering for using New York-area pharmacies to submit false and fraudulent claims to Medicare and then laundering the criminal proceeds of a value over $18 million. 

Their fraudulent claims included using the COVID-19 emergency for their own financial gain by using COVID-19-related “emergency override” billing codes to submit additional fraudulent.  

More details at the DOJ website (Learn more) 

4.“10 Charged in Business Email Compromise and Money Laundering Schemes Targeting Medicare, Medicaid, and Other Victims”: 

A network of 10 individuals in multiple states were charged with money laundering and wire fraud schemes that targeted public and private health insurers and numerous other victims resulting in total losses of more than $11.1 million. 

More details at the DOJ website (Learn more) 

5.“New York Diagnostic Testing Facility Owners Sentenced for Health Care Fraud Scheme”: 

A married couple that co-owned several diagnostic testing facilities in Brooklyn were sentenced to three years in prison for their roles in a more than $18 million health care fraud scheme. 

More details at the DOJ website (Learn more 

6.“Pain Clinic Owners Convicted of Unlawfully Distributing Opioids and Multimillion-Dollar Health Care Fraud”: 

A Tennessee physician and his wife who was his office manager were convicted for unlawfully disturbing controlled substances such as opioids, providing unnecessary services and defrauding insurers from their now-shuttered Alabama clinics. 

The physician and his wife caused over $50 million in fraudulent or unnecessary medical services to be charged to Medicare, TRICARE, Blue Cross Blue Shield of Alabama, and others. 

More details at the DOJ website (Learn more) 

7.“16 Defendants, Including 12 Physicians, Sentenced to Prison for Distributing 6.6 Million Opioid Pills and Submitting $250 Million in False Billings”: 

Sixteen defendants from Michigan and Ohio, including 12 physicians, were sentenced to prison for a $250 million health care fraud scheme that included the exploitation of addicted patients and the illegal distribution of over 6.6 million doses of medically unnecessary opioids. 

More details at the DOJ website (Learn more ) 

8.“Orthotic Brace Suppliers Convicted in $6.5 Million Health Care Fraud Scheme”: 

The owner and operators of four orthotic brace suppliers in Texas and Arkansas were convicted by a federal jury in Dallas for a $6.5 million illegal kickback scheme. Based on court documents, the defendants caused approximately $12.5 million to be billed in claims to Medicare for unnecessary braces based on brace orders received in exchange for illegal kickbacks. Each defendant faces up to 55 years in prison.  

More details at the DOJ website(Learn more) 

9.“Psychologist Convicted of Health Care Fraud Scheme”: 

A licensed Illinois psychologist was convicted of defrauding Medicare for several years by causing submission of fraudulent claims for psychotherapy services he never provided. The defendant faces a maximum penalty of 10 years in prison on each of four counts of health care fraud. 

More details at the DOJ website (Learn more) 

10.“Florida Man Pleads Guilty to $8.3 Million Pharmacy Fraud Scheme”: 

A Florida, Fort Lauderdale resident pleaded guilty to conspiring, with the help of his co-conspirators, to commit healthcare fraud in an $8.3 million scheme were pharmacy owners paid Kickbacks and bribes to telemarketers and telemedicine providers to secure orders for medically unnecessary prescriptions that were billed to Medicare. The defendant faces a maximum of 10 years in prison. 

More details at the DOJ website(Learn more) 

If you have questions about your specific situation, call us for a free consult. 

Ben Assad Mirza, Cell/Text 954-445-5503, [email protected]

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