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gavel-4-1409594-mA 43-year-old woman who owns and operates a Shreveport, Louisiana-based intensive outpatient company is facing 30 years of jail time over charges of health care fraud and wire fraud. Sharon Monroe, the owner of Monroe Medical Management LLC (MMM), pleaded guilty today before U.S. District Judge S. Maurice Hicks Jr. to charges of bilking money from Medicare.

According to the U.S. Attorney’s Office for the Western District of Louisiana, Monroe and her company submitted for approximately $6 million in fraudulent Medicare reimbursement claims between 2007 and 2011. Medicare paid out $2 million of that total.

Here are some examples of the egregious claims made by Monroe and MMM:

  • The company submitted claims were for psychotherapy services that were never performed.
  • Monroe admitted that her employees rendered services for longer than 24 hours a day.
  • MMM billed for services performed by employees not qualified to perform the services.
  • MMM submitted claims for services purportedly in medical offices when they were not.
  • Monroe used doctors’ Medicare provider numbers to submit claims without their knowledge.

If convicted, Monroe could face up to 10 years in prison for the health care fraud count and up to 20 years in prison for the wire fraud count. She is also looking at restitution for both counts and a potential fine of $250,000.

This case highlights the need for whistleblowers to come forward with health care fraud information. In cases of this kind, a whistleblower may be entitled to a reward of up to 25 percent of any money successfully recovered by the government.

usa-dollar-bills-1431130-mThe owner of a Miami home health care company was sentenced to 75 months behind bars for her role in a Medicare fraud scheme worth over $6.5 million. The Justice Department announced the sentencing of 64-year-old Cruz Sonia Collado in a press release issued Monday. In addition to prison time, Collado will serve three years of supervised release and pay $6,536,657 in restitution.

Collado owned and operated the now-defunct Nestor’s Health Services Inc., which purportedly provided home health care and physical therapy services to patients receiving Medicare benefits. According to the DOJ, Collado doled out kickbacks to patient recruiters in exchange for the recruiters referring patients to Nestor’s Health Services. Patients that were supposed to be receiving home health care or physical therapy services were either never provided the services or the services were considered medically unnecessary, according to court documents.

This didn’t stop Collado from billing Medicare for the illegitimate services. Between 2009 and 2014, Nestor’s Health Services submitted over $6.5 million in Medicare reimbursement claims. Medicare paid out $6.1 million of that total.

Collado pleaded guilty in June to one count of conspiracy to offer and pay health care kickbacks and one count of offering and paying health care kickbacks.

California Nursing Homes Accused of ‘Severely Overmedicating’ Patients

September 3, 2014

Two northern California nursing homes, owned by Arba Group, are the subjects of a False Claims lawsuit that claims they “severely overmedicated” their patients, causing injuries and death. The two homes allegedly received over $20 million in Medicare and Medicaid reimbursements between 2007 and 2012. During this time, the both homes allegedly overmedicated their patients [...]

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San Diego Hospice Whistleblower Lawsuit Settles for Millions

September 2, 2014

The whistleblower law firm of Baum, Hedlund, Aristei & Goldman has announced a multi-million dollar settlement with San Diego Hospice & Palliative Care Corporation. The settlement resolves a 2012 qui tam lawsuit filed by whistleblower attorneys Mark H. Schlein and Diane Marger Moore on behalf of a former hospice nurse who claimed that San Diego [...]

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SEC Whistleblower to Receive $300,000 for Role in Exposing Alleged Fraud

August 29, 2014

The Securities and Exchange Commission (SEC) has awarded more than $300,000 to an audit and compliance whistleblower who filed a claim in connection with allegations of high-level insider trading. The SEC whistleblower reward is the first given out to an audit and compliance professional. Under SEC rules, potential whistleblowers working in audit and compliance functions [...]

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Nursing Home will Return $2.2 Million for Submitting Thousands of False Claims

August 25, 2014

The Justice Department announced last week that a New Rochelle, New York nursing and rehabilitation facility submitted over 62,000 false claims for Medicare reimbursement between 2002 and 2006. Relax Services Inc. and its owner, Leah Friedman, have been ordered to return the $2.2 million the company made by submitting false claims over the span of [...]

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Samsung Electronics America to Pay $2.3 Million to Settle False Claims Allegations

August 19, 2014

The American division of Samsung (Samsung Electronics America Inc.) has agreed to pay the U.S. government $2.3 million to settle allegations that the company violated trade agreements by lying about where Samsung products purchased under government contracts were manufactured. The settlement resolves whistleblower allegations filed by former Samsung employee Robert Simmons. At this time, it [...]

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Carondelet Health Network to Pay $35 Million to Settle Health Care Fraud Allegations

August 18, 2014

Carondelet Health Network has agreed to pay $35 million to settle health care fraud allegations initially filed by a whistleblower. The settlement represents the largest amount recovered by the state of Arizona under the False Claims Act. Two Carondelet Health Network hospitals were accused of knowingly eimbursement from Medicare and other government health agencies between [...]

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Former Owner of Los Angeles Medical Clinic Management Company Pleads Guilty to $3.2 Million Health Care Fraud Scheme

August 15, 2014

The former owner of a Los Angeles area medical clinic management company entered a guilty plea today for his role in a Medicare fraud scheme worth $3.2 million. Mihran “Mike” Meguerian pleaded guilty to one count of conspiracy to commit health care fraud before U.S. District Judge Beverly R. O’Connell of the Central District of [...]

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HHS Investigation: Medicare Spent Over $30 Million on Suspicious AIDS Medication Costs

August 6, 2014

The U.S. Department of Health and Human Services (HHS) says that Medicare spent over $30 million in 2012 on possibly dubious AIDS medication costs. The HHS investigation flagged 1,578 Medicare beneficiaries that questionably received AIDS medications. More than half of those flagged had never received an HIV diagnosis, had not visited labs to monitor the [...]

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