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Legal Actions in Healthcare Fraud Cases – Updates and Resolutions

As we approach the end of the year, we bring you significant updates on recent legal actions against healthcare fraud. Stay informed about the outcomes and resolutions in cases that impact the healthcare landscape.

Here's a brief overview:

Prema Thekkek and Paksn Inc., California

Issue: Medicare Fraud and Kickback
Summary: Entered into medical directorship agreements with physicians that purported to provide compensation for administrative services, but in reality were vehicles for the payment of kickbacks to induce the physicians to refer patients to the six SNFs. Specifically, the defendants hired physicians who promised in advance to refer a large number of patients to the SNFs, paid physicians in proportion to the number of their expected referrals and terminated physicians who did not refer enough patients.
Resolution: In addition to entering into a $45,645,327.25 consent judgment, the defendants will make scheduled payments to the United States of at least $385,000 over the next five years. The defendants have also entered into a five-year corporate integrity agreement with the HHS-OIG.

Sheretta Qushawn Joseph, Tallahassee, FL

Issue: Medicaid Fraud
Summary: Sheretta Qushawn Joseph is accused of submitting claims to Medicaid for persons with disabilities for services not rendered. Joseph billed Medicaid for $55,423 in services never provided to recipients, some of whom with disabilities, submitting falsified service logs in excess of the hours of service actually performed.
Resolution: Pending

Steven King, Chief Compliance Officer, Miramar, FL

Issue: Medicare Fraud
Summary: Steven King, 45, of Miramar, was the chief compliance officer of a pharmacy holding company that fraudulently billed Medicare for dispensing lidocaine and diabetic testing supplies that Medicare beneficiaries did not need or want.
Resolution: King was sentenced to four years and six months in prison and ordered to pay $21.7 million in restitution

Henry Geoffrey Watson, M.D, Oakland, CA

Issue: Medicare Fraud and Kickbacks
Summary: He was convicted of three health care kickback schemes from 2013 to 2019:

A conspiracy to refer patients to Amity Home Health Care in exchange for kickback payments.
Accepting kickbacks from an undercover FBI agent posing as a home health agency representative seeking Watson’s agreement to refer his patients to a particular Bay Area home health agency.
Involved in a conspiracy to repeatedly and falsely certify individuals for Medicare-funded home health services that weren’t needed or wanted.
Resolution: Watson’s sentencing hearing is scheduled for February 28, 2024

Alex L. Gloster, MD, New Orleans, LA

Issue: Medicare Fraud
Summary: Gloster pled guilty to health care fraud. Gloster was an independent contractor for several purported telemedicine companies. From approximately September 2017 to August 2019, through the telemedicine companies he signed thousands of doctors’ orders for DME and CGx tests for Medicare beneficiaries he never saw, spoke to, or otherwise treated. Gloster’s orders resulted in over $5.6 million in false and fraudulent claims of which Medicare reimbursed over $2.4 million.
Resolution: Sentencing hearing is January 24, 2024.

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