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Medicaid Law
 
State of New York v. Yury Baumblit and Rimma Baumblit Supreme Criminal Courthouse - Brooklyn, New York

Brooklyn, NY - Jury Convicts Slum Lord of Medicaid Fraud

The State of New York charged Yury Baumblit and Rimma Baumblit with:

PL 155.35 00
**TOP CHARGE** D Felony, 1 count, Not an arrest charge, Not an arraignment charge
Description Grand Larceny 3rd Degree
Indictment Count 4
Date Added 02/14/2018
Pled Guilty
PL 470.15 01 C Felony, 1 count, Arrest char... More...
   $0 (02-16-2018 - NY)

United States of America v. Eddie Wayne Cooper Western District of Missouri Federal Courthouse - Springfield, Missouri

Springfield, MO - Former Arkansas Lawmaker Pleads Guilty to $4 Million Charity Scheme

Conspiracy Included Several Charity Executives

A former Arkansas state representative pleaded guilty in federal court February 12, 2018 to his role in a conspiracy to embezzle more than $4 million from a Springfield, Mo.-based health care charity.

Eddie Wayne Cooper, 51, of Melbourne, A... More...
   $0 (02-13-2018 - MO)

United States of America v. Thurlee Belfrey, Roylee Belfrey and Lanora Belfrey District of Minnesota Federal Courthouse - Minneapolis, Minnesota

Minneapolis, MN - Health Care Business Owners Sentenced To Prison For Multi-Million Dollar Fraud And Tax Conspiracy

Three defendants were sentenced for their involvement in a years-long, multi-million dollar heath care fraud and tax conspiracy. THURLEE BELFREY, 52, ROYLEE BELFREY, 52, and LANORE BELFREY, 43, each entered guilty pleas on September 14, 2017, and were sentenced yesterday bef... More...
   $0 (02-12-2018 - MN)

Victoria G. Collins v. Commissioner of Social Security Northern District of Ohio Courthouse - Cleveland, Ohio

Victoria Collin brought suit against the Commissioner of
Social Security to recover moneys she says are “due and owing” as a result of the
Commissioner’s failure, for about a year, to garnish certain benefits paid to her ex-husband. The
district court dismissed the suit on grounds of sovereign immunity. We affirm.
>
No. 17-3733 Collin v. Comm’r of Soc. Sec. Page 2
Collin di... More...
   $0 (01-31-2018 - OH)

Philip Marsteller and Robert Swisher v. Lynn Tilton, Patriarch Partners, LLC, MD Helicopters, Inc., Norbert Vergez Northern District of Alabama Federal Courthouse - Birmingham, Alabama

Relators Philip Marsteller and Robert Swisher brought this action against
their former employer, MD Helicopters (“MD”), and codefendants Patriarch
Partners (“Patriarch”), Lynn Tilton, and Colonel Norbert Vergez, under the qui tam
provision of the False Claims Act (“FCA” or “Act”), 31 U.S.C. §§ 3729–30.1 The
allegations of the complaint concern a series of contracts between the Unit... More...
   $0 (01-31-2018 - AL)

United States of America v. Kenneth E. Fairley Southern District of Mississippi - Federal Courthouse - Jackson, Mississippi

Appellant-Defendant Kenneth Fairley appeals his jury conviction for theft of government property in violation of 18 U.S.C. § 641 (counts two and three) and conspiracy to commit theft of government property in violation of 18 U.S.C. § 371 (count one). Fairley argues that: (1) the indictment, jury instruction, and verdict form all misstated the elements of § 641; (2) the district court erroneously a... More...   $0 (01-25-2018 - MS)

VIVIAN L. MUNDY v. STATE OF KANSAS

The facts of Mundy's criminal case are tangential to her current appeal from her 60-1507 motion but nevertheless help explain her arguments. Mundy was a licensed, master's level social worker who enrolled as a Medicaid provider in 2003. She primarily provided behavioral and cognitive therapy to individuals with traumatic brain injuries. In 2007, after reviewing Mundy's billings, the fiscal agent f... More...   $0 (01-24-2018 - KS)

United States of America, ex rel. Steve Greenfield v. Medco Health Solutions, Inc., et al. District of New Jersey Federal Courthouses

Accredo Health Group, Inc., a specialty pharmacy that provides home care for patients with hemophilia (a rare condition that prevents blood from clotting properly), made donations to charities, two of which allegedly recommended Accredo as an approved provider for hemophilia patients. This raises whether the donations came with something expected in return for the recommendations, which might trig... More...   $0 (01-23-2018 - NJ)

United States of America v. Matilda Lynn Prince

Gainesville, GA - Eye care provider convicted of Medicare and Medicaid fraud

Matilda Lynn Prince has been convicted by a federal jury on January 16, 2018 of twenty-nine counts of health care fraud for filing fraudulent claims with Medicare and the Georgia Medicaid program for optometry and ophthalmology services that were never provided to patients.

“Prince stole hundreds of thou... More...
   $0 (01-22-2018 - GA)

Salomon G. martinez v. Department of Health Care Services

The California Department of Health Care Services
(Department) moved to determine the amount of a Medi-Cal lien
on the settlement of plaintiff’s medical malpractice action. (Welf.
& Inst. Code, § 14124.76, subd. (a)1.) The trial court determined
the amount of the lien to be $39,004.41. Plaintiff appeals. We
reduce the amount of the lien by 25 percent for statutory attorney
... More...
   $0 (01-16-2018 - CA)

Don Karms and Robert Parker v. Kathleen Shanahan, Sandra McKeon Crow and New Jersey Transit District of New Jersey Federal Courthouses

Don Karns and Robert Parker filed civil rights actions against the New Jersey Transit Corporation (“NJ Transit”) and NJ Transit Officers Kathleen Shanahan and Sandra McKeon Crowe in their official and individual capacities, alleging violations of the First, Fourth, and Fourteenth Amendments. Officers Shanahan and Crowe arrested Karns and Parker for defiant trespass and obstruction of justice after... More...   $0 (01-14-2018 - NJ)

United States, et al., ex rel. Abendano v. NCDR, LLC, et al. District of Connecticut Federal Courthouse - Bridgeport, Connecticut

New Haven, CT - Dental Management Company Benevis and its Affiliated Kool Smiles Dental Clinics to Pay $23.9 Million to Settle False Claims Act Allegations Relating to Medically Unnecessary Pediatric Dental Services

The Justice Department announced today that it has settled False Claims Act allegations against dental management company Benevis LLC (formerly known as NCDR LLC) and more tha... More...
   $33000000 (01-13-2018 - CT)

United States of America v. Gibson Buckley Condie District of Wyoming Federal Courthouse - Cheyenne, Wyoming

Cheyenne, WY - Powell, Wyoming Psychologist Sentenced to Three Years in Prison for Health Care Fraud

Gibson Buckley Condie, 57, of Powell, Wyoming, was sentenced on January 8, 2018, to serve three years in prison for felony health care fraud involving mental health services falsely billed to Wyoming Medicaid, announced United States Attorney Mark A. Klaassen. Condie was also ordered to pa... More...
   $0 (01-10-2018 - WY)

United States of America v. Kim Ricard Eastern District of Louisiana Federal Courthouse - New Orleans, Louisiana

New Orleans, LA - New Orleans Area Woman Sentenced to More Than Four Years in Prison for Role in Approximately $2 Million Home Health Kickback and Identity Theft Scheme

A New Orleans woman was sentenced today to 51 months in prison for her involvement in a $2 million home health kickback scheme carried out through a New Orleans area home health agency.

Kim Ricard, 51, of Gonzales... More...
   $1958000 (01-05-2018 - LA)

Carlos Morales v. David Barnes Dallas County Courthouse - Dallas, Texas

Appellant Carlos Morales asserts that the trial court erred in denying his motion to dismiss pursuant to chapter 27 of the Texas Civil Practice & Remedies Code. Morales also asserts that the trial court abused its discretion in granting appellee David Barnes’s motion to disregard Morales’s reply to Barnes’s response to motion to dismiss. We affirm in part and reverse in part.
BACKGROUND
Ba... More...
   $0 (12-31-2017 - )

United States of America v. EmCare, Inc. a subdivision of Envision Healthcare Corporation Western District of North Carolina Courthouse - Charlotte, North Carolina

Charlotte, NC - EmCare, Inc. to Pay $29.8 Million To Resolve False Claims Act Allegations

The Department of Justice on December 19, 2017 announced a settlement with Dallas based EmCare, Inc. a subdivision of Envision Healthcare Corporation that provides physicians to hospitals to staff their Emergency Departments (EDs). EmCare agreed to pay $29.8 million to resolve claims that, from 2008... More...
   $29800000 (12-28-2017 - NC)

United States of America, et rel. Garbe v. Kmart Corporation Southern District of Illinois Federal Courthouse - Benton, Illinois

Kmart Corporation to Pay U.S. $32.3 Million to Resolve False Claims Act Allegations for Overbilling Federal Health Programs for Generic Prescription Drugs

Kmart Corporation, a wholly owned subsidiary of Sears Holdings Corporation (SHC), has agreed to pay $32.3 million to the United States to settle allegations that in-store pharmacies in Kmart stores failed to report discounted prescripti... More...
   $32300000 (12-26-2017 - IL)

United States of America v. Bertha Blanco Southern District of Florida Courthouse - Miami, Florida

Miami, FL - Former Florida State Health Care Administration Official Sentenced to More Than Four Years in Prison for Accepting Bribes

A former employee of Florida’s Agency for Health Care Administration (AHCA) was sentenced today to 57 months in prison for accepting bribes in exchange for providing confidential information about health care facilities that received Medicare and Medicaid f... More...
   $0 (12-15-2017 - FL)

United States ex rel. Darla Reid v. Med-Fast Pharmacy, Inc. Western District of Pennsylvania Courthouse - Pittsburgh, Pennsylvania

Pittsburgh, PA - Iserve Technologies, Inc. Pled Guilty in Connection with Guilty Pleas of Former Exec and Manager of Med-Fast Pharmacy Inc.

Individuals and entities associated with Med-Fast Pharmacy, Inc. (“Med-Fast”) have resolved criminal and civil charges associated with Med-Fast’s improper submission of claims to the Medicare and Medicaid programs.

Iserve Technologies, Inc., ... More...
   $0 (12-13-2017 - PA)

United States of America v. Yunesky Fornaris Southern District of Florida Courthouse - Miami, Florida

Miami, FL - Owner of Miami Home Health Agency Sentenced to More Than Nine Years in Prison for Role in $15 Million Medicare Fraud Conspiracy

The owner and operator of a defunct Miami, Florida home health agency was sentenced to 115 months in prison on December 11, 2017 for his role in a $15 million conspiracy to defraud the Medicare program.

Yunesky Fornaris, 38, of Miami, was se... More...
   $0 (12-12-2017 - FL)

UNITED STATES OF AMERICA v. MOHSIN RAZA UNITED STATES OF AMERICA v. FARUKH IQBAL, UNITED STATES OF AMERICA v. MOHAMMAD ALI HAIDER UNITED STATES OF AMERICA v. HUMAIRA IQBAL United States Court of Appeals for the Fourth Circuit

On April 23, 2015, a federal grand jury in Alexandria, Virginia, returned a seven
count indictment against the defendants — who were former employees of SunTrust’s
Annandale branch.2 The indictment’s first count charged them with conspiracy to commit wire fraud affecting a financial institution, in contravention of 18 U.S.C. § 1349.3
Counts 2 through 7 made substantive allegations ... More...
   $0 (12-03-2017 - )

UNITED STATES OF AMERICA, EX REL ANTHONY R. SPAY v. CVS CAREMARK CORPORATION; CAREMARK RX UNITED STATES COURT OF APPEALS FOR THE THIRD CIRCUIT

Part D of the Medicare program is a voluntary prescription drug benefit program that subsidizes the cost of prescription drugs and prescription drug insurance premiums for Medicare enrollees.2 The Part D program operates as a public-private partnership between the Centers for Medicare and Medicaid Services (“CMS”) and government contractors. CMS contracts with private insurance companies called “S... More...   $0 (12-03-2017 - PA)

The People of the State of New York v. Stan XuHui Li Pain Clinic Doctor Is Sentenced in Overdose Deaths of 2 Patients

Defendant was a physician specializing in pain management. In 2004, he opened a pain management clinic in Queens. According to the People, the clinic was nothing more than a "pill mill" catering to people who were hopelessly addicted to pain medicine, primarily opioids. The People's evidence showed that, despite having been trained in the wide variety of methods for identifying legitimate pain and... More...   $0 (12-02-2017 - NY)

David Richard Sizemore v. Nancy A. Berryhill United States Court of Appeals for the Third Circuit

David Sizemore applied for disability benefits from the Social Security
Administration in July 2011, claiming that he was disabled due to diabetes and bipolar
disorder. After his application was denied by an administrative law judge (“ALJ”), who
found that Sizemore was not disabled, and review was denied by the Appeals Council, he
commenced this action in the district court. The di... More...
   $0 (12-01-2017 - NC)

United States of America v. Cardiovascular Consultants Heart Center (CVC Heart Center), et al. Eastern District of California Federal Courthouse - Fresno, California

Fresno, CA - CVC Heart Center to Pay $1.2 M to Settle Allegations of Billing Health Care Programs for Medically Unnecessary Nuclear Stress Tests

Cardiovascular Consultants Heart Center (CVC Heart Center), a cardiology clinic with offices in Fresno and Clovis, and its shareholder physicians — Dr. Kevin Boran, Dr. Michael Gen, Dr. Rohit Sundrani, Dr. Donald Gregory, and Dr. William Hanks — ... More...
   $1200000 (11-29-2017 - CA)

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