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LexisNexis® Mealey's™ Insurance Fraud Legal News
Headline Insurance Fraud Legal News from LexisNexis®

• Staten Island University Hospital To Pay $89 Million To Settle Whistle-Blower, Fraud Claims
  BROOKLYN, NY - Staten Island University Hospital (SIUH) has agreed to pay $89 million to settle federal allegations that the hospital defrauded Medicare, Medicaid and TRICARE, federal authorities announced Sept. 15. Full story on lexis.com
• 3 Doctors, Others Plead Guilty In Multimillion Dollar Florida Medicare Fraud Scheme
  MIAMI - Three doctors, a clinic administrator, a physician's assistant and several other alleged co-conspirators have pleaded guilty in the U.S. District Court for the Southern District of Florida to charges arising out of an alleged scheme to defraud Medicare of $110 million by billing for unnecessary or nonexistent HIV treatments. Full story on lexis.com
• 6th Circuit Vacates Dismissal Of RICO Action, Remands For Ruling On Proximate Cause
  CINCINNATI - Finding that three plaintiff insurance companies are no longer required to allege reliance to pursue a racketeering action under U.S. Code Section 1962(c), a Sixth Circuit U.S. Court of Appeals panel on Aug. 26 vacated the dismissal of a complaint against a woman who was accused of joining an ongoing medical overbilling conspiracy and remanded for consideration of whether the insurers could establish proximate cause (Grange Mutual Casualty Co., et al. v. Joni L. Mack, No. 07-6145, 6th Cir.; 08a0523n.06; 2008 U.S. App. LEXIS 18467; See April 2008, Page 7). Full story on lexis.com
• 7th Circuit Affirms Ballistics Admission In Medicare Fraud Murder
  CHICAGO - A ballistics expert used reliable data in concluding that bullets that killed a woman could have come from a gun owned by her podiatrist, who allegedly killed her to silence her testimony against him in an insurance fraud prosecution, a Seventh Circuit U.S. Court of Appeals panel held Aug. 25 (United States of America v. Ronald Mikos, Nos. 06-2375, 06-2376, 06-2421, 7th Cir.; 2008 U.S. App. LEXIS 18157). Full story on lexis.com
• Michigan Appeals Panel Affirms $3 Million Verdict Against Rehabilitation Center, Owners
  DETROIT - A Michigan appeals panel on Aug. 21 affirmed a $3 million jury verdict for Allstate Insurance Co. in an action alleging payment by mistake of fact, insurance fraud, breach of contract and unjust enrichment against Broe Rehabilitation Services Inc. and its owners Timothy and Eleanor Broe (Allstate Insurance Co. v. Timothy Broe, et al., No. 274809, Mich. App.; 2008 Mich. App. LEXIS 1684; See September 2006, Page 10). Full story on lexis.com
• Health Care Fraud Conviction, Sentence Affirmed For Iowa Physician
  ST. LOUIS - A federal panel on Sept. 8 affirmed an ear, nose and throat doctor's conviction and 51-month sentence for health care fraud and reversed a judgment of acquittal granted to the doctor on a charge of conspiracy to commit health care fraud (United States v. Peter V. Boesen, M.D., Nos. 06-3291/07-2217, 8th Cir.; 2008 U.S. App. LEXIS 19140; See June 2007, Page 5). Full story on lexis.com
• 1st Circuit Affirms Conviction, Sentence Of Testing Company Owner For Billing Fraud
  BOSTON - A federal appeals panel on Aug. 27 affirmed the conviction and four-year, three-month sentence of the owner and co-owner of two Massachusetts medical diagnostic testing companies on federal fraud charges arising out of a scheme to collect insurance payments for medical tests (United States v. Yelaun, No. 07-1651, 1st Cir.; 2008 U.S. App. LEXIS 18391; See April 2007, Page 12). Full story on lexis.com
• DME Company Owner Convicted Of Fraud By California Federal Jury
  LOS ANGELES - The owner of a Los Angeles durable medical equipment company was found guilty Sept. 22 of defrauding the Medicare program by billing for medically unnecessary motorized wheelchairs and wheelchair accessories (United States of America v. Leonard Uchenna Nwafor, No. 08-526 [B], C.D. Calif.). Full story on lexis.com
• DME, Medicare Fraud Charged In Los Angeles Indictments
  LOS ANGELES - Federal authorities on Sept. 18 arrested 18 people who are charged in eight indictments with participating in schemes to defraud Medicare of more than $33 million in claims for durable medical equipment (DME) and supplies. Full story on lexis.com
• Beneficiary Precluded From Recovering Benefits, 9th Circuit Rules
  SAN FRANCISCO - The Ninth Circuit U.S. Court of Appeals on Aug. 28 found no abuse of discretion by a lower court in barring a beneficiary from testifying and in admitting certain evidence reviewed in a bench trial over whether the primary beneficiary to a million-dol