Latest "Health Care Fraud" Posts

What does Tammie Sensenig have to do with Healthcare Fraud?

What makes this case of healthcare fraud so egregious isn’t the dollar amount that was stolen, but the lack of checks and balances that permitted repeat offenses by the same provider. It also makes me wonder how many hundreds, maybe thousands of similar cases are discovered every year. In Lancaster, Pennsylvania about a month ago Tammie Sensenig was charged with healthcare fraud.

Tammie Sensenig is a behavioral health consultant. I could not resist, and I had to do some research to determine if my hunches about what a behavioral consultant did were accurate. Sure enough, they often counsel patients on the best therapies to improve their physical and mental health; they teach, consult and treat patients. That’s pretty important stuff, and their patients look to them for advice on their physical and emotional well-being.

Continue Reading

Posted by Chuck Gallagher in Health Care Fraud and tagged , , , ,

Steven Rawlins Guilty of $8 Million Health Care Fraud

STEVEN RAWLINS, a former Chief Financial Officer to two healthcare services companies based outside Nashville, Tennessee, was found guilty today of engaging in a scheme to defraud that yielded over $8 million in ill-gotten gains.   This is health care fraud at it most basic. Following an 11-day trial a jury found that RAWLINS, as the acting Chief Financial Officer for both privately-held healthcare companies, abused his Health Care Fraudauthority to withdraw company funds for payment of legitimate business expenses and tax obligations by, among other things, using such funds to pay personal expenses incurred by RAWLINS, his family, and his associates.

Continue Reading

Posted by Chuck Gallagher in Health Care, Health Care Fraud and tagged , , ,

Health Care Fraud in America – What’s the Truth?

Health Care Fraud in America – What’s the Truth is a guest article by Helen Bray

The numbers behind health care fraud mean it has to be taken seriously, by patients, hospitals, and law enforcement. According Health Care Fraudto the FBI, health care fraud (and abuse) costs the country billions of dollars each year. However you look at it, that accounts for staggering amounts of cash, even in a multi-trillion dollar health industry.

What constitutes fraud?

Fraud can take place by both patients and healthcare providers. In the patient’s case, this includes knowingly using another person’s insurance as their own or failing to remove a person who is no longer eligible to be on their insurance. By medical providers, the most common example of healthcare fraud is when a patient is given drugs or treatment they do not need. This allows the medical center to charge the insurance company much more than they should have been able to.

Continue Reading

Posted by Chuck Gallagher in Health, Health Care, Health Care Fraud and tagged , ,

Guardian Hospice pays $3 million to resolve Medicare Claims – At the Core Unethical Behavior?

Hospice – word that for most means care, compassion, comfort and dignity.  When you ask the majority of their opinion of “Hospice” the opinion is favorable!  Yet, not everyone will make the right ethical decisions when faced with temptation to financially succeed or survive.  That is apparently true when it comes to Guardian Hospice of Georgia.

Hospice Medicare FraudThe United States Attorney’s Office for the Northern District of Georgia announced that Guardian Hospice of Georgia, LLC, Guardian Home Care Holdings, Inc., and AccentCare, Inc., (collectively Guardian) agreed to pay $3 million to resolve allegations that Guardian knowingly submitted false claims to the Medicare program for hospice patients who were not terminally ill. Guardian is a for-profit hospice that provides hospice services in the Atlanta, Georgia, area.

Continue Reading

Posted by Chuck Gallagher in Business and Personal Ethics, Health, Health Care, Health Care Fraud and tagged , , , ,

Medicare Fraud Runs Rampant

When a friend forwarded this widely circulated CNN-Money news article the other day, I thanked him for his kindness but told him, “Oh I’ve already seen it.” I owe my friend an apology; it was new information and a whole new set of fraudulent charges and rotten ethics.

Medicare Fraud

Medicare Fraud

The article, by Katie Lobosco, entitled: “Doctors and nurses busted for $712 million Medicare fraud,” states:

“The FBI arrested 46 doctors and nurses across the country this week in the largest Medicare fraud bust ever. In total, 243 people were arrested in 17 cities for allegedly billing Medicare for $712 million worth of patient care that was never given or unnecessary.”

Continue Reading

Posted by Chuck Gallagher in fraud, Health Care, Health Care Fraud, Medicare fraud and tagged , ,

Ethics gone wrong! Medical Equipment Company – Doris Vinitski – John Lachman plead guilty to Health Care Fraud Scheme and Illegal Health Care Kickbacks

As I prepare to speak to members of the Laboratory Products Association meeting on ethics, I ran across this news release from the Department of Justice about yet another health care fraud.  I am pleased that so many folks in the health related field are ethical and have a strong desire to do the right thing – or make the right choices.  As I visited with LPA members this evening, I got that very real sense, as many didn’t know that I was their final event speaker, that they welcomed the opportunity to feature ethics and ethics training so that they could help others (employees, vendors, etc) know the value of making positive choices – even in the face of economic uncertainty.

Continue Reading

Posted by Chuck Gallagher in ethics, Fraud Pure and Simple, Health Care Fraud, New Website, prison, white collar crime and tagged , , , , ,