El Paso Doctor Pays $200,000 to Resolve Federal and State Fraud Allegations

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El Paso Physician Settles Controlled Substance and Fraud Allegations for $200,000 This case highlights recent concerns about El Paso doctor fraud in the medical community.

Dr. Brian August of El Paso, Texas, has agreed to pay $200,000 to resolve allegations that he violated the Controlled Substances Act (CSA), the False Claims Act (FCA), and the Texas Health Care Program Fraud Prevention Act (THCFPA) in connection with El Paso doctor fraud.

Federal and state authorities alleged that between December 23, 2017, and May 22, 2021, Dr. August issued 255 controlled‑substance prescriptions to 15 individuals without meeting the minimum standards required for treating pain or chronic pain conditions. This case is one of several involving El Paso doctor fraud. The prescriptions included multiple Schedule II drugs—such as morphine, fentanyl, hydrocodone, hydromorphone, oxycodone ER, tapentadol, and oxymorphone—as well as Schedule IV substances including carisoprodol, zolpidem, clonazepam, alprazolam, and tramadol.

According to the United States, Dr. August failed to document a legitimate medical purpose, did not demonstrate medical necessity, and did not issue the prescriptions in the usual course of professional practice. Allegations of El Paso doctor fraud often involve improper prescribing practices. Because the 15 individuals were beneficiaries of Medicare Part D and/or Texas Medicaid, the prescriptions were not eligible for reimbursement, triggering liability under federal and state fraud statutes.

Of the $200,000 settlement:

  • $994.22 is restitution to Texas Medicaid
  • $44,380.55 is restitution to Medicare Part D
  • The remainder represents civil penalties and damages under the CSA, FCA, and THCFPA

As part of the resolution, Dr. August surrendered his DEA registration and agreed not to seek a new one. He also voluntarily surrendered his Texas medical license, which had already been suspended by the Texas Medical Board during the investigation. El Paso doctor fraud can result in significant professional consequences.

The case was investigated and resolved through a coordinated effort involving the U.S. Attorney’s Office for the Western District of Texas, the Drug Enforcement Administration, the FBI, and the Texas Office of the Attorney General.

As with all civil settlements, the claims resolved are allegations only, and no determination of liability has been made.

Kaiser Permanente to Pay $556 Million Over Alleged Medicare Advantage Fraud

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Kaiser Permanente will pay $556 million to resolve federal allegations that it inflated Medicare Advantage payments by pressuring physicians to add unsupported diagnoses to patient records. Prosecutors say the scheme spanned nearly a decade, ignored internal warnings, and violated core CMS rules designed to protect taxpayers and program integrity.

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Florida Man Admits Role in Medicare Kickback Scheme for Unnecessary Prescriptions

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Florida Man Pleads Guilty in Medicare Prescription Kickback Scheme A Florida resident has admitted to running a telemarketing‑driven scheme that generated medically unnecessary prescriptions and defrauded Medicare of more than $1.3 million. Federal prosecutors announced that Eric Van Vleet, 30, of Delray Beach, pleaded guilty in Newark federal court to conspiracy to commit health care fraud and conspiracy to violate the Anti‑Kickback Statute. How the Scheme Operated Between February 2018 and September 2019, Van Vleet operated Hype Med LLC, a company that used aggressive telemarketing tactics to pressure Medicare beneficiaries into accepting high‑priced prescription creams and medications they did not … Read More

New York Doctor Sentenced for Kickback Scheme Involving Unnecessary Brain Scans

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A New York Doctor Sentenced for Fraudulent Brain Scan Scheme A New York physician has been sentenced in federal court for participating in a long‑running kickback scheme that involved ordering medically unnecessary brain scans. The scheme highlighted how kickbacks involving unnecessary brain scans functioned within fraudulent activities. According to federal prosecutors justice.gov, Dr. Vishnudat Seodat, 76, of Mattituck, New York, received cash payments in exchange for directing patients to undergo transcranial doppler (TCD) scans they did not need. On December 17, 2025, U.S. District Court Judge Nathaniel M. Gorton sentenced Seodat to two years of supervised release, including one year … Read More

Combating Durable Medical Equipment Fraud

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🚨 Take Action Against DME Fraud Fraud involving Durable Medical Equipment doesn’t just drain taxpayer dollars — it can also put patients’ health at risk and is a serious concern. If you suspect fraud, waste, or abuse in the healthcare system, you don’t have to stay silent. The HHS Office of Inspector General (OIG) encourages anyone with concerns to report them through the official hotline. Reporting can help investigators protect patients and hold bad actors accountable. Every tip helps. 👉 Report suspected fraud: HHS OIG Hotline or call 1‑800‑HHS‑TIPS (1‑800‑447‑8477). Don’t ignore signs of Durable Medical Equipment Fraud. Together, we … Read More

$45M Settlement: Vohra Wound Physicians Accused of Medicare Fraud Wound Care

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Medicare Fraud Wound Care Dr. Ameet Vohra and his companies, including Vohra Wound Physicians Management LLC, have agreed to pay $45 million to resolve allegations of widespread Medicare fraud related to wound care services. According to the U.S. Department of Justice, Vohra and his team knowingly caused the submission of false claims for medically unnecessary surgical procedures, inflated billing, and improper evaluation services linked to Medicare Fraud Wound Care. Allegations of Fraud The government alleged Vohra pressured and incentivized physicians to perform surgical debridement procedures during routine patient visits, regardless of medical necessity. Vohra’s electronic health record and billing software were … Read More

Patients Choice Laboratories Pays $9.6M to Settle Medicare Kickback and False Claims Allegations

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Indianapolis, Indiana – Patients Choice Laboratories (PCL), a diagnostic lab headquartered in Indianapolis, has agreed to pay $9.62 million to resolve allegations of violating the False Claims Act and the Anti-Kickback-Statute This Indiana Laboratory Fraud Settlement marks a significant legal resolution. Federal prosecutors allege that PCL knowingly billed Medicare for respiratory pathogen panels (RPPs) that were either medically unnecessary or obtained through kickbacks, contributing to the Indiana Laboratory Fraud Settlement. The lab also paid commissions to independent sales representatives and marketing firms based on referral volume, a clear violation of federal law. In November 2020, PCL entered into a Marketing Services … Read More

Pharmacy Owner Pleads Guilty in $2.5M Medicare Fraud Scheme

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Newark, N.J. – The U.S. Attorney’s Office has announced that Nestor E. Jaime, 37, of Pine Brook, New Jersey, pleaded guilty to a sweeping health care fraud scheme that siphoned millions from Medicare. This is a case of New Jersey Pharmacy Fraud involving significant deceit. Between December 2019 and December 2021, Jaime operated a pharmacy in Paterson, New Jersey, where he submitted hundreds of false claims for the high‑reimbursement drug Dificid—valued at more than $4,000 per prescription. The pharmacy’s fraudulent activities are an example of New Jersey Pharmacy Fraud, as it never purchased or dispensed the medication. To disguise the … Read More

Anchorage Doctor and Husband Admit $12.5M Medical Fraud and Tax Evasion

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Anchorage, Alaska – A shocking case of deception has come to light as Dr. Claribel Tan, 61, and her husband Daniel Tan, 70, pleaded guilty to orchestrating an Anchorage Medical Fraud Scheme involving a $12.5 million health care fraud scheme while evading more than $4 million in taxes. Operating a rheumatology clinic in Anchorage, Dr. Tan specialized in treating autoimmune and musculoskeletal diseases. Instead of providing proper care, she routinely underdosed patients, injected expired drugs, substituted free samples, or used medications purchased by other patients. This Anchorage Medical Fraud Scheme allowed the couple to bill insurance companies as if full, … Read More

Mother Sentenced in $11K Medicaid Fraud Scheme

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Concord, NH — October 15, 2025 Attorney General John M. Formella announced that Fawn Gobis, 60, of Manchester, has been sentenced in Merrimack County Superior Court for orchestrating a 14-month Medicaid Fraud Family Scheme involving her son. Between December 2020 and February 2022, Gobis submitted falsified timesheets to a Medicaid area agency, falsely claiming that her son, Cody Gobis, was providing in-home care services to a New Hampshire Medicaid recipient. The Medicaid Fraud Family Scheme was evident as Cody was residing in Colorado and could not have delivered any such services. These fraudulent submissions led to $10,998.15 in improper Medicaid … Read More

Reno OB-GYN Indicted for Massive Unnecessary Gynecologic Procedures Fraud Scheme

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RENO, NV — Dr. Samuel R. Chacon, a Reno-based OB-GYN and former owner of the Women’s Health Center of Reno, has been indicted for allegedly orchestrating a multi-year health care Unnecessary gynecologic procedures fraud scheme involving false claims for medically unnecessary gynecologic procedures. The indictment, returned by a federal grand jury, accuses Chacon of defrauding Medicaid and multiple private insurers between January 2017 and November 2022. According to federal prosecutors, Chacon submitted claims for procedures such as hysterectomies, bladder sling surgeries, and urodynamic studies that were not medically justified in what appears to be a scheme of unnecessary gynecologic procedures … Read More

$37M Settlement in Medicare Fraud Device Scheme: Semler & Bard Misled Providers on PAD Tests

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Two medical device companies—Semler Scientific Inc. and Bard Peripheral Vascular Inc.—will pay nearly $37 million to resolve allegations tied to a Medicare Fraud Device Scheme. The U.S. Department of Justice (DOJ) claims both companies knowingly caused healthcare providers to submit false Medicare claims for vascular tests using Semler’s FloChec and QuantaFlo devices. These devices, which rely on photoplethysmography—a method not covered by Medicare—were falsely promoted as qualifying for reimbursement under CPT codes 93922, 93923, and 93924. The settlement addresses claims that both companies knowingly caused healthcare providers to submit false Medicare claims for tests using Semler’s FloChec and QuantaFlo devices. … Read More

Reno OB-GYN Indicted for Massive Health Care Fraud Scheme

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  RENO, NV — Dr. Samuel R. Chacon, a Reno-based OB-GYN and former owner of Women’s Health Center of Reno, has been indicted for allegedly defrauding multiple health care benefit programs by submitting false claims associated with unnecessary procedures. This focus on false claims for unnecessary procedures emphasizes the severity of the case. The alleged scheme, spanning from 2017 to 2022, involved falsified patient records and misrepresented diagnoses, leading to surgeries that in some cases caused serious bodily harm. According to federal prosecutors, Dr. Chacon billed Medicaid and several private insurers for procedures such as hysterectomies, bladder slings, and vaginal … Read More

Medicare Skin Graft Fraud Scheme Uncovered in California

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Felipe Ruiz and Jose Gabriel Aguirre admitted to a multi-year scheme defrauding Medicare and Medi-Cal by submitting false claims for Medicare Skin Graft Fraud procedures never performed by a licensed provider. Ruiz, a podiatrist, purchased skin grafts from Aguirre, a sales rep with no medical license, and allowed him to treat patients, then billed for the work under his own name. They now face sentencing in 2026 with severe penalties. Case Details/Scheme Overview Felipe Ruiz, podiatrist, operated West Coast Podiatry across Fresno, Madera, Stanislaus counties, involved in a Medicare fraud scheme. Ruiz bought skin grafts from Jose Aguirre, a non-medical … Read More

Prenatal Medicaid Fraud Scheme Fraudster Convicted in Precious Cruse, Case

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On September 12, 2025, Precious Cruse, the former owner and operator of Milwaukee’s now-defunct Caring Through Love prenatal care coordination business, was found guilty of Prenatal Medicaid Fraud Scheme on seventeen federal charges, including healthcare fraud, making false statements related to health care matters, anti-kickback statute violations, aggravated identity theft, and money laundering. justice+1 Evidence showed that Cruse targeted vulnerable pregnant women and young mothers, enticing them to enroll in her company’s prenatal care coordination program with kickbacks such as free baby supplies. After enrollment, the company used the women’s personal information to file false Medicaid claims for services never … Read More

$17M Healthcare Chicago Healthcare Fraud Indictment Uncovered

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CHICAGO, IL — Federal prosecutors have indicted a suburban Chicago man for orchestrating a massive Chicago healthcare fraud indictment that allegedly defrauded a private insurer of over $17.3 million. This Chicago healthcare fraud indictment is a significant case highlighting the extent of deceit involved. According to the indictment unsealed in U.S. District Court, Shawn Bashir, 39, of Grayslake, Illinois, created two fictitious therapy providers—Success for Kids and Growing Kids Therapy—which claimed to offer early intervention services to children. Between 2019 and 2025, Bashir submitted thousands of fraudulent claims for therapy services that were never rendered, resulting in at least $1.4 … Read More

DOJ indicts church leaders in alleged multi-million-dollar fraud targeting military vets

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More on House of Prayer church leaders alleged $22M fraud scheme targeting military vets.  See previous post Stolen name, stolen benefits: New details on alleged cult, FBI raid on mansion The churches operated near Georgia’s Fort Gordon and Fort Stewart, and Fort Hood in Texas Federal prosecutors have indicted the founder and several leaders of the House of Prayer Christian Churches of America, accusing the Georgia-based ministry of running a decades-long, $22 million fraud scheme that targeted U.S. military members and veterans. Following the indictment, the FBI on Wednesday conducted a raid near Augusta, Georgia, arresting leaders after years of allegations that … Read More

Louisiana Chiropractor Insurance Scam Jailed Seven Years

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When it comes to your health, trust matters most. A recent case in Louisiana chiropractor insurance scam shows just how far some providers will go to exploit patients and insurers for financial gain. Dr. Benjamin Tekippe, a 40-year-old chiropractor from New Orleans, was sentenced to seven years in federal prison for defrauding Blue Cross Blue Shield of Louisiana (BCBSLA) and illegally collecting unemployment benefits. He lured patients with promises of “free” massages, then billed their insurance for services that weren’t covered—or, in many cases, never performed at all. Investigators even found that he charged patients for treatments while he was … Read More

Stolen name, stolen benefits: New details on alleged cult, FBI raid on mansion

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Stolen name, stolen benefits MARTINEZ, Ga. (WRDW/WAGT) – The FBI and Columbia County deputies raided a West Lake mansion Wednesday, arresting the leader of the House of Prayer — a group critics call a cult that scams veterans out of benefits. Columbia County deputies assisted with the raid at 3816 Honors Way, but it’s a Federal Bureau of Investigation case involving allegations of financial or identity theft and fraud. The founder of the House of Prayer was taken into custody and booked into jail, but we’re not even sure who the mysterious man really is. He goes by Rony Denis, … Read More

Keep Current with Electronic Medicare Summary Notices to Review for Fraud

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It’s easy, quick to access, and review your electronic Medicare Summary Notices (MSNs).  Learn what has been sent to Medicare and review for fraud. With electronic Medicare Summary Notices (MSNs), you can see your claims faster, making it easier to spot fraud. Any month you have processed claims, you’ll get a secure link to your eMSN. Sign up or log in to your secure Medicare account and stay current: https://t.co/JdyJkOI8Od pic.twitter.com/hCCL228kOZ — Medicare.gov (@MedicareGov) September 10, 2025

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$6M Settlements in Lab Kickback Scheme: CEO, Doctors, and Marketers Implicated

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Laboratory Kickback Fraud Settlements In a sweeping crackdown on healthcare fraud, former True Health Diagnostics CEO Christopher Grottenthaler has agreed to pay $4.25 million to resolve allegations of Laboratory Kickback Fraud Settlements to physicians for lab test referrals. The Department of Justice also secured $1.8 million in additional settlements from two doctors and seven marketers across Texas, accused of disguising kickbacks as investment distributions through Managed Service Organizations (MSOs). The scheme involved payments masked as consulting fees, handling charges, and copay waivers, targeting federally funded programs including Medicare, Medicaid, and TRICARE. Despite internal warnings about legal risks, Grottenthaler allegedly continued … Read More

Doctor Sentenced to 45 Years in Prison for Providing Medically Unnecessary Fraudulent Claims Cancer for Patients

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There are great providers who have your best interest, but this doctor lied and convinced his patients they had cancer.  It’s your health, get that second opinion and walk away if you feel uneasy.  This doctor has got 45 years in prison and had to forfeit $17.6 million to think whether it was all worth it when he provided Medically Unnecessary fraudulent claims for cancer.  Read the press release below from U.S. Attorney’s Office, Eastern District of Michigan. Doctor lied and told his patients they had cancer so he could collect over 17 million from chemo therapy companies. pic.twitter.com/NiReIvuBfg — … Read More

Burbank Lab Owner Admits $11M Medicare Tax Fraud Evasion

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LOS ANGELES — A Burbank man has pleaded guilty to orchestrating a multi-million-dollar Medicare fraud tax evasion and evading over $11.2 million in federal taxes, according to the U.S. Department of Justice. Armen Muradyan, 60, admitted to conspiracy to commit health care fraud, wire fraud, and tax evasion. He used a longtime friend as a front to illegally collect Medicare reimbursements through his blood-testing company, Genex Laboratories Inc., which had been barred from submitting claims. Muradyan paid the friend $2,000 monthly to pose as Genex’s owner, allowing him to funnel millions in reimbursements into bank accounts he secretly controlled. These … Read More

Health Agency CEO Sentenced in Houston Medicare Fraud Case

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At Medical Fraud Exposed, we spotlight the schemes that exploit our healthcare system— and the recent sentencing of a Houston man is another glaring example. Houston Health Agency CEO Sentenced in Medicare Fraud CaseAt Medical Fraud Exposed, we spotlight the schemes that exploit our healthcare system—and the recent sentencing of a Houston man is another glaring example. Paul Njoku, 64, owner and CEO of Opnet Health Care Services Inc. (doing business as P & P Health Care Services), has been sentenced to 75 months in federal prison after being found guilty of orchestrating a Houston Medicare fraud scheme that netted his … Read More

Connecticut Man Charged in Medicare Advantage Fraud Scheme

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Federal authorities recently charged Habroon Habib, a permanent U.S. resident from Pakistan living in Middletown, Connecticut, with a series of offenses linked to an alleged Medicare Advantage fraud scheme involving durable medical equipment (DME). According to court documents, Habib, founder of Around the World Solutions LLC, is accused of submitting fraudulent claims for orthotics—medical devices billed to Medicare Advantage sponsors for over 400 beneficiaries nationwide, none of whom actually received or requested the products. The alleged scheme began in early 2025, when Around the World Solutions used a shared office address to bill various insurers for DME not provided to … Read More

Jobs, they are hiring!! Get your Resume to Send Now

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Jobs…They are hiring. Click on each of the links below to see the different jobs, pay range, and location. Hurry, you only have a few days left to apply. Open & closing dates  08/26/2025 to 09/02/2025 Hiring opportunity! Help shape the future of Medicare & Medicaid: join us in transforming health systems to work better for patients, providers, & communities. Apply now⬇️ https://t.co/xoJr8sZljy https://t.co/YbkqvAFyHA https://t.co/1JlsseCaIK https://t.co/kEUvXHuC3t pic.twitter.com/xY01hiCHEZ — CMS Innovation Center (@CMSinnovates) August 28, 2025

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Bad Actors are Offering Free Medical-Related Services

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Please be on the lookout for Bad Actors Offering Free Medical-Related Services. Bad actors are offering “free” services like house-cleaning or medical equipment to trick people into signing up for hospice. Watch out! Always talk to your doctor before signing up for medical-related services. Report fraud: call 1-800-MEDICARE or visit: https://t.co/m9UDZKX6cj pic.twitter.com/Dkk2569zNJ — Medicare.gov (@MedicareGov) August 29, 2025

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First Medicaid Fraud Guilty Plea in Virginia Medicaid Fraud Scheme

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**First Co-Conspirator Pleads Guilty in Virginia Medicaid Fraud Guilty Plea** LYNCHBURG, Va. – Carolyn Bryant-Taylor, 61, of Clinton, Maryland, a former director and corporate officer of 1st Adult N Pediatrics Healthcare, pleaded guilty on August 26, 2025. She admitted to conspiring to commit federal healthcare fraud. Facing up to 10 years in prison, Bryant-Taylor is the first of six defendants to admit guilt in a scheme that defrauded Medicaid through false claims. Charged alongside Bryant-Taylor in March 2025 were Kafomdi “Josephine” Okocha, 48, Samuel Okocha, 50, Shekita Gore, 38, Elizabeth Ilome, 41, and Eno Utuk, 47. The group operated 1st … Read More

🩺When Good Doctors Are Undone by Bad Practices

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Not all medical care is created equal. Some Physician office staff impact deliver exceptional service, treating patients with dignity, transparency, and skill. But others—despite having competent physicians—are undermined by poorly run offices, careless staff, or unethical practices. A physician’s reputation is only as strong as the team behind them. Patients should never feel trapped in a substandard practice. If you sense dishonesty, repeated mistakes, or even fraud, trust your instincts. Your health is too important to gamble on a dysfunctional system. Over the years, I’ve walked away from multiple providers. In one case, I wrote a letter to a physician … Read More

Telemedicine Fraud: Telemedicine Scheme Uncovered

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🚨 Overview Federal prosecutors have charged Alabama physician Tommie Robinson, 43, in connection with a sweeping Medicare fraud telemedicine scheme that generated over $6 million in false claims. First, the fraudulent documentation sparked a telemedicine scheme, which in turn led to over $6 million in Medicare fraud claims.  Additionally, these claims involved equipment and tests that were neither medically necessary nor properly authorized. 🧬 Scheme Details Between December 2018 and March 2021, Robinson allegedly collaborated with telemedicine companies to authorize medical orders for durable medical equipment (DME) and cancer-related genetic testing—without ever examining or speaking to the patients.  Telemarketing scripts targeting … Read More

**Prescription Refill Manipulation: The Hidden Hook to Keep You Coming Back**

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One of my biggest frustrations with the healthcare system is how some providers use prescription refill manipulation as a tactic to keep patients tethered to recurring office visits. You go in for an appointment, they send a prescription to the pharmacy, and suddenly the refill becomes a reason to require another visit every few months—regardless of whether it’s medically necessary. Even worse is when a provider continues a medication simply because a previous doctor prescribed it, without doing their own due diligence. No lab work. No clinical justification. Just a blind continuation. In my case, a cardiologist prescribed a very … Read More

🚨 Medicaid Prescription Fraud Ring Busted Across Northeast

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Three individuals have been indicted in a Medicaid Prescription Fraud Ring multi-state scheme that exploited Medicaid and targeted pharmacies throughout the Northeastern United States. Federal prosecutors have charged Ciera Washington, 35, and Raven White, 35, both of the Bronx, New York, along with Bryan Otero, 36, of Wood-Ridge, New Jersey, with healthcare fraud, conspiracy to commit healthcare fraud, and aggravated identity theft. According to the indictment, between April 2023 and October 2024, White and Otero supplied Washington with personal information—including names, birthdates, and Medicaid ID numbers—of various individuals. Washington allegedly used this data to submit fraudulent prescriptions to pharmacies across … Read More

🏥 Oklahoma Counselor Admits $1.1M Health Care Fraud Scheme

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  Natasha Allmon, 48, of Oklahoma City, has pleaded guilty to orchestrating a massive health care fraud scheme involving false claims for behavioral health services. Between January 2021 and December 2023, Allmon operated as a behavioral health counselor under contract with Blue Cross Blue Shield (BCBS). According to federal court records, she submitted thousands of fraudulent claims for psychiatric treatment sessions allegedly provided to her own family members. These health care fraud scheme claims often included implausible billing—such as 60-minute sessions nearly every day of the year and treatment durations exceeding 24 hours in a single day. In total, Allmon … Read More

Bait-and-Switch Appointments

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My Story: Why I Started Medical Fraud Exposed Blog – One of the primary reasons I launched this blog was due to my personal encounters with bait-and-switch appointments in the healthcare system. I didn’t set out to become an advocate. I was just a patient in pain, trying to get help. But what I experienced revealed a disturbing pattern of deception in healthcare. 🔹 I booked an appointment with a top neurosurgeon—only to have a Bait-and-Switch Appointment with another doctor with no relevant specialty. 🔹 Unnecessary X-rays were ordered. My concerns were brushed aside. 🔹 After another Bait-and-Switch Appointment and … Read More

Common Health Care Fraud Types

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CMS gives great details on the many health care fraud types Fraud, waste, and abuse pose major risks for the Medicaid program. “Fraud means an intentional deception or misrepresentation made by a person with the knowledge that the deception could result in some unauthorized benefit to himself or some other person.” “Abuse means provider practices that are inconsistent with sound fiscal, business, or medical practices, and result in an unnecessary cost to the Medicaid program, or in reimbursement for services that are not medically necessary or that fail to meet professionally recognized standards for health care.” [1] Providers who engage … Read More

Houston Physician Pays $2M to Resolve Medicare neurostimulator fraud settlement

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📌 Introduction: Medicare neurostimulator fraud is an increasing concern that involves the misuse of Medicare funds for providing or billing unnecessary neurostimulator devices. Understanding the implications of such fraud is crucial for protecting patients and preserving healthcare resources. A Houston-based pain management doctor has agreed to a $2 million settlement over allegations of Medicare neurostimulator fraud. The case highlights deceptive billing practices involving non-surgical procedures misrepresented as complex spinal surgeries, which are central to Medicare neurostimulator fraud issues. 🩺 Summary of Allegations: Physician: Dr. Ajay Aggarwal, anesthesiologist and pain specialist Practices: Bellaire, Lake Jackson, Van Vleck Entities Involved: Ajay Aggarwal … Read More

💊 Pennsylvania Pharmacy Pays $825K to Resolve Medicare Fraud Allegations

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🧠 Overview West End Services, Inc. (WES), a Pennsylvania pharmacy, and its owner-pharmacist Christopher Leon have agreed to pay $825,000 to settle allegations that they violated the False Claims Act by billing Medicare for prescription drugs that were never dispensed. Between January 1, 2014, and February 24, 2019, WES submitted claims for medications such as Latuda, Humira, Abilify, Invega Sustenna, Seroquel, Acyclovir, Flovent, and Truvada—none of which were actually provided to patients. 🗣️ Federal Response “Pharmacy fraud remains a priority for our office,” said U.S. Attorney David Metcalf. “Taxpayer dollars should be spent on needed medications—not wasted on fraud and … Read More

Greensboro Woman Sentenced in $6.2M Medicaid Fraud Scheme Involving Fake Drug Tests

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🚨 $6.2 Million Medicaid Fraud Scheme Lands Greensboro Woman in Federal Prison A Greensboro woman has been sentenced to nearly four years in federal prison for orchestrating a multi-million dollar Medicaid fraud scheme involving fake urine drug tests. Jasmine Hoyle, 35, will serve 44 months behind bars, followed by three years of supervised release, and must repay $6,299,738.89 in restitution. Hoyle pleaded guilty to health care fraud and money laundering after investigators uncovered that her two Winston-Salem businesses—Harvest Focused & Consulting Services, LLC and The Ultimate Sacrifice—billed Medicaid for services that were never provided. Among the most egregious examples: 97 … Read More

⚠️ Connecticut APRN Pays $600K to Settle Medicare, Medicaid Fraud Allegations

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🧠 Overview Armand Ntchana, a licensed Advanced Practice Registered Nurse (APRN) in Connecticut, and his affiliated entities have agreed to pay over $600,000 to resolve allegations of submitting Medicare fraud false claims to Medicare and Connecticut Medicaid. These Medicare false claims arose from fraudulent billing practices investigated between 2016 and 2020. 🏥 Entities Involved Integrated Procare Services, LLC (IPS) – psychiatric medication management Brookside Residential Care Home, LLC – formerly operated in Danbury Riverview Residential Care Home, LLC – formerly operated in New Haven Associated Property LLCs – sold in August 2023 🚨 Allegations of Fraud Federal and state authorities … Read More

🚨 Bogus Medicare DME Fraud Claims Uncovered: DOJ Targets $33M

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🚨Bogus Medicare DME Fraud Claims Uncovered: DOJ Targets $33M 💡 SummaryThe Justice Department has launched civil forfeiture actions against two Florida-based durable medical equipment (DME) providers—Vida Med Center LLC and Med-Union Medical Center, Inc.—accused of defrauding Medicare  of over $33 million. These companies allegedly submitted Medicare DME fraud false claims for medically unnecessary equipment that was never provided. 🔍 What Happened? Vida Med Center LLC billed Medicare for $14.1 million and received $8.7 million in reimbursements. Med-Union Medical Center, Inc. submitted $19 million in claims and was paid $14.1 million—shockingly, all based on prescriptions from a single provider. The DOJ is … Read More

CEO of Spine Device Company Sentenced for False Statements in Connection With Mandatory Reporting to CMS

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BOSTON – The Founder, President and CEO of SpineFrontier, Inc. was sentenced yesterday in federal court in Boston for making false statements to the Centers for Medicare & Medicaid Services. Dr. Kingsley R. Chin, 61, the Founder, President and CEO of SpineFrontier, Inc., a Massachusetts-based medical device company, was sentenced by U.S. District Court Judge Indira Talwani to one year of supervised release with the first six months to be served in home confinement. The defendant was also ordered to pay a fine of $9,500, in addition to $40,000 the defendant personally agreed to pay as part of a related … Read More

Illinois Man Charged in Durable Medical Equipment Scheme

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BOSTON – A Geneva, Ill., man has been charged and has agreed to plead guilty in connection with an alleged fraud scheme to defraud Medicare of over $2 million by submitting claims for durable medical equipment (DME) that was medically unnecessary, not wanted by the Medicare beneficiaries and tainted by kickbacks. Kartik Bhatia, 36, was charged with one count of conspiracy to commit health care fraud and one count of making false statements. A plea hearing has not yet been scheduled by the Court. According to the charging documents, Bhatia allegedly worked with Raju Sharma, and other co-conspirators to own … Read More

Federal Prison for $10.6M Medicare Fraud – Glendale Hospice Kickbacks

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A Glendale woman has been sentenced to 9 years in federal prison for masterminding a $10.6 million Medicare hospice fraud and kickback fraud scheme. The case reveals how kickbacks for patient referrals continue to undermine Medicare integrity. Also, this lady had prior federal convictions for receiving illegal kickbacks and was on the Excluded list which meant she could not bill the Federal Government for health care. LOS ANGELES – A Glendale woman was sentenced today to 108 months in federal prison for participating in a scheme in which hundreds of thousands of dollars in illegal kickbacks were paid and received for patient referrals … Read More

Federal Government Exclusions Program

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Beware!  If you get convicted, you will find your name in Exclusions database which means that you are out of business.  You will not be able to get paid for services by the Federal government.  Anyone who hires an individual or entity on the LEIE searchable database may be subject to civil monetary penalties (CMP) OIG has the authority to exclude individuals and entities from Federally funded health care programs.  The database is available to anyone with a computer,  and one only needs to enter the first and last name of the individual. This webpage provides information about OIG’s exclusion … Read More

Greensboro Woman Sentenced in Conviction with Multi-Million Dollar Urine Drug Testing Scheme

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A North Carolina woman was sentenced to 44 months in prison, three years of supervised release, and ordered to pay over $6.2 million in restitution for submitting fraudulent urine drug test claims to #Medicaid. Read more: https://t.co/wmi1ApsH8V pic.twitter.com/qXwSBNrJQm — OIG at HHS (@OIGatHHS) August 6, 2025

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Florida Woman to Pay $400,000 to Settle Allegations of Falsifying Diagnoses in connection with an Amherst Compounding Pharmacy

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A Florida woman agreed to pay $400,000 to resolve allegations that she violated the False Claims Act by submitting false claims to #Medicare and #TRICARE based on unsupported medical diagnoses related to an Amherst compounding pharmacy. Read more: https://t.co/QR89X7zcF4 pic.twitter.com/5ERMl6HXWc — OIG at HHS (@OIGatHHS) August 5, 2025

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Gilead Sciences will pay $202 million to resolve claims that it paid kickbacks to doctors

Medical Fraud Exposed Posted on by  

RALEIGH – Attorney General Jeff Jackson announced that Gilead Sciences will pay $202 million to resolve claims that it paid kickbacks to doctors in exchange for promoting its HIV medications, resulting in millions of dollars of false claims submitted to government health care programs, including North Carolina’s Medicaid program. North Carolina’s Medicaid program will receive $760,106 from the settlement in principle, which was reached in partnership with the U.S. Department of Justice and 48 other states and came from a qui tam lawsuit. “Doctors are supposed to prescribe the medications that are best for patients – not the medication they get the biggest … Read More