healthcare fraud

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Southwest Virginia Home Health Company Charged With Fraud

Southwest Virginia Home Health Company Charged With Fraud 1200 800 Bo Frith

This week, nine people were charged with healthcare fraud involving a company that provided home care to residents of Western Virginia. A recently unsealed November 2023 indictment revealed the extent of the scheme. All nine individuals that were charged were owners or employees of Adult N Pediatric Healthcare Service, a…

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Healthcare Fraud: A Call for Whistleblowers

Healthcare Fraud: A Call for Whistleblowers 1200 800 Dan Frith

I recently read an article in the June/July edition of the AARP Magazine on healthcare fraud. The article was titled, “The $80 Million Healthcare Fraud,” and described the criminal activity of a family of chiropractors who operated the Dolson Avenue Medical Clinic in New York.  It appears the two brothers,…

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Whistleblowers for Opioid Fraud

Whistleblowers for Opioid Fraud 150 150 Bo Frith

One of the most common areas for whistleblowers is the opioid crisis. As chronicled in countless books, podcasts, and TV shows, the opioid industry is rife with fraud. In 2020 and 2021 alone, the Justice Department secured settlements in excess of $3 billion arising from whistleblower and False Claims Act…

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What are medically unnecessary procedures?

What are medically unnecessary procedures? 150 150 Bo Frith

Medically unnecessary procedures are health care items and services that are not “reasonable and necessary for the diagnosis or treatment of illness or injury.”[1] The False Claims Act provides a mechanism for individuals to “blow the whistle” on instances of waste, fraud, or abuse for systemic unnecessary procedures in healthcare…

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Illegal Kickbacks and Referrals in Healthcare Fraud

Illegal Kickbacks and Referrals in Healthcare Fraud 150 150 Bo Frith

A whistleblower may bring a variety of different allegations of healthcare fraud. One such allegation concerns improper referral fees. Whistleblowers can bring a lawsuit for this type of fraud through the Anti-Kickback Statute and the Stark Law. The Anti-Kickback Statute and Stark Law prohibit medical providers from paying or receiving…

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Medical Malpractice and Whistleblower Claims

Medical Malpractice and Whistleblower Claims 150 150 Bo Frith

Our law firm has a fairly unique practice…we represent patients in medical malpractice cases against health care providers and whistleblower cases on behalf of honest folks who report cases of financial and billing fraud.  I recently learned of a case which deals with both issues: a whistleblower on illegal kickbacks…

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Healthcare Fraud: Inflated Medicaid Billing

Healthcare Fraud: Inflated Medicaid Billing 150 150 Bo Frith

Healthcare providers violate the False Claims Act by knowingly submitting false claims for payment to government insurers. One of the most frequent sources for whistleblower lawsuits is inflated Medicaid billing. In September of 2020, a Virginia mental health agency agreed to pay over $250,000 to settle a false claims act…

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Allergists and Fraud: A Dangerous Combination

Allergists and Fraud: A Dangerous Combination 150 150 Dan Frith

An allergist is a physician specially trained to diagnose, treat and manage allergies and asthma.  In this area of Virginia, with untold numbers of trees, flowers, and grasses, their services are in high demand. Just getting an appointment with an allergist is almost impossible and the first available appointment is…

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Whistleblowers for Nursing Home Fraud

Whistleblowers for Nursing Home Fraud 150 150 Bo Frith

  Fraud occurs with surprising frequency in facilities with especially vulnerable patients. For this reason, nursing homes can be easy targets for Medicare and Medicaid fraud. These facilities are not under as much official scrutiny as hospitals. Nursing home residents are often unable to advocate for themselves. It is up…

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