Fraud Cases

Pediatrician Convicted of Medicaid Fraud in Alabama (2001)

Fraud Cases | Medicaid Fraud Cases

Alabama convicted pediatrician Nival Miller of Medicaid fraud in June 2001. She pleaded guilty to billing for many services that she did not provide, including: breathing treatments, hearing tests, and antibiotic injections.

“This doctor not only defrauded the State of money that was intended for treatment of needy and deserving patients, but may well have placed her own patients’ health at risk with inappropriate tests and treatment,” said Alabama Attorney General Bill Pryor. “We are grateful to the principled former employees who brought this matter to the attention of authorities.”

New Jersey Man Convicted for Submitting False Pharmacy Claims

Fraud Cases

December 2002. Matt Lilenfeld submitted $38,252 of phony pharmacy receipts to Celtic Life Insurance Company. Lilenfeld admitted that he submitted 121 claims during 1998 for prescriptions that did not exist.

“The creation and submission of fictitious prescription receipts to health insurance carriers is a crime and the Office of Insurance Fraud Prosecutor will investigate and prosecute anyone who endeavors to steal from insurance companies, ” said Insurance Fraud Prosecutor Greta Gooden Brown.

Operation LabScam in the 1990s Recovered $800 Million

Fraud Cases | Medicaid Fraud Cases

Several of the nation’s largest laboratories billed Medicaid and Medicare for millions of unneeded tests during the late 1980s and early 1990s. The labs used forms that seemed to package uncommon lab tests with commonly ordered blood panels. Doctors were tricked into thinking the additional (and unnecessary tests) were provided at no extra charge. In fact, these extra procedures were billed to Medicare and Medicaid.

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