Find Corporate Waste

Category: Healthcare Fraud

  • Brooklyn Adult Day Care Operators Accused in $38M Medicaid Kickback and False-Billing Scheme

    Brooklyn Adult Day Care Operators Accused in $38M Medicaid Kickback and False-Billing Scheme

    Federal prosecutors have charged eight defendants in an alleged $38 million Medicaid fraud scheme involving two Brooklyn social adult day care centers: APNA Adult Daycare and Ashiana Social Adult Daycare, according to the New York Post⁠.

    The reported indictment alleges that Medicaid recipients were paid cash kickbacks to enroll, recruiters were paid to bring in beneficiaries, and the centers then billed New York Medicaid for services that were not actually provided. Prosecutors also reportedly allege fake sign-in sheets, Pakistan-based billing support, and shell-company transfers labeled as “gifts,” “dividends,” “medicine,” or “laddu.”

    For Find Corporate Waste, the relevance is the public-funds mechanism: Medicaid claims allegedly tied to false attendance, kickback-driven enrollment, and non-rendered services.

    That is the same fraud structure FCW tracks across taxpayer-funded health care programs, including provider eligibility, billing integrity, ownership/control relationships, and public-payment exposure.

    The case also fits a broader enforcement pattern. DOJ previously announced guilty pleas in a $68 million Brooklyn adult day care fraud scheme⁠ and charged two Queens men in an alleged $120 million adult day care and pharmacy fraud scheme⁠. 

  • Arkansas Lab and Owners Pay $30M Over Alleged Kickback-Fueled Testing Scheme

    Arkansas Lab and Owners Pay $30M Over Alleged Kickback-Fueled Testing Scheme

    An Arkansas pathology lab and its owners agreed to pay $30 million to resolve federal allegations that their business model turned physician referrals and add-on testing into a taxpayer-funded billing pipeline.

    The settlement covers Advanced Pathology Solutions PLLC, APS MSO LLC, and current and former owners Kevin Hannah, Donell Burkett, and Daniel Hunter Pledger⁠. According to the Justice Department, APS operated “lean labs” with gastroenterology practices across the country and allegedly provided financial benefits to those practices in exchange for exclusive referrals of pathology specimens to APS’s North Little Rock laboratory.

    Federal prosecutors also alleged APS caused special stains and confirmatory testing to be ordered automatically before a pathologist determined whether the tests were medically necessary.

    In essence, the government alleged extra testing was built into the process first, while medical necessity came second.

    The settlement also resolves claims that APS and CEO Kevin Hannah paid volume-based commissions to Richard Sorgnard⁠ to induce referrals for epidermal nerve fiber density testing. The United States contended the commissions equaled 4% of collections from referred ENFD testing.

    The case originated from three whistleblower lawsuits filed under the False Claims Act⁠. As part of the resolution, APS entered into a five-year Corporate Integrity Agreement with HHS-OIG⁠ requiring compliance reforms, training, auditing, and review of physician referral relationships.

    For Find Corporate Waste⁠, the settlement shows how federal health care fraud can hide inside ordinary-looking referral networks, lab protocols, and billing defaults. When financial incentives shape where specimens go and testing is added before necessity is established, taxpayers are left paying for a system designed around revenue rather than care.

  • North Carolina Woman Charged in Immigration and VA Disability Fraud Case

    North Carolina Woman Charged in Immigration and VA Disability Fraud Case

    The DOJ announced that Britney Sherene Curry, 26, of Charlotte, North Carolina, was indicted in the Western District of Missouri for conspiracy to commit immigration fraud, false statements under oath on immigration documents, unlawfully procuring citizenship, mail fraud, and wire fraud.

    According to the DOJ, Curry is a Jamaican national who entered the United States on a six-month B-2 visa in 2015 and allegedly never left. Prosecutors claim she paid a third party to arrange a fraudulent marriage with a U.S. citizen to obtain immigration benefits. The DOJ alleges Curry and her husband first met on the day of the marriage and never lived together.

    The alleged scheme later reached federal benefit payments. After becoming a lawful permanent resident, Curry joined the U.S. Army, applied for naturalization, and later received VA disability compensation. Prosecutors allege she claimed her husband as a dependent for VA disability purposes, increasing her monthly benefit, despite allegedly never living with him and not seeing him after she enlisted.

    The case was investigated by DHS-OIG, ICE Enforcement and Removal Operations, USCIS, VA-OIG, and Army CID. The DOJ noted that VA disability payments passed through Treasury Payment Operations in Kansas City, Missouri.

    The indictment is only an accusation, and Curry is presumed innocent unless proven guilty.

    For Find Corporate Waste, the case is another reminder that federal benefit programs depend on truthful eligibility claims. Whether the program is immigration, veterans benefits, PPP, PRF, or federal contracting, the core issue is the same: public money moves when applicants certify facts that agencies rely on. When those facts are allegedly false, taxpayer funds become recoverable exposure.

  • Circle Medical to Pay $3.325M Over Alleged False Healthcare Claims

    Circle Medical to Pay $3.325M Over Alleged False Healthcare Claims

    San Francisco-based Circle Medical Care of California, Circle Medical Technologies, Inc., and Chief Medical Officer Dr. Nicole Tsang, D.O., agreed to pay $3,325,000 to resolve allegations that they submitted false claims to federal healthcare programs and California commercial insurers.

    According to the DOJ⁠, Circle operates an online telehealth platform offering mental health and primary care services through contract providers, including nurse practitioners and physician assistants. The government alleged that from January 1, 2018 through May 31, 2025, Circle submitted claims using the names and NPI numbers of rendering providers who did not actually provide or supervise the services billed. The claims allegedly involved programs including Medicare, Medicaid, and TRICARE.  

    The settlement allocates $475,000 to the United States and $2.85 million to California. The matter began as a qui tam whistleblower case filed by Jason Vellen, who will receive $80,750 from the federal recovery and $997,500 from California.  

    This case fits the broader Find Corporate Waste focus on healthcare payment integrity: claims data, provider identifiers, supervision rules, and federal program billing requirements can expose recoverable taxpayer losses. 

  • Ahold Delhaize USA to Pay $40M Over Allegedly Inflated Pharmacy Prices

    Ahold Delhaize USA to Pay $40M Over Allegedly Inflated Pharmacy Prices

    Ahold Delhaize USA Inc.⁠, the parent company behind supermarket pharmacy brands including Giant, Hannaford, Stop & Shop, Food Lion, and others, has agreed to pay $40 million to resolve False Claims Act allegations involving prescription drug pricing.

    According to the DOJ⁠, Ahold Delhaize allegedly reported inflated “usual and customary” prices on claims submitted to Medicare Part D, Medicaid, and TRICARE. Prosecutors said the company operated prescription savings programs that offered discounted prices to enrolled customers, but allegedly failed to report those discounted prices as the pharmacies’ usual and customary prices.

    That distinction matters because usual and customary prices can operate as ceiling prices in federal health care reimbursement formulas. The government alleged that by reporting higher prices, Ahold Delhaize caused federal health care programs to pay more than they should have paid on pharmacy claims.

    Of the $40 million settlement, $32.9 million represents the federal share, with the remainder going to participating states.

    The case began as a whistleblower action filed by Lawrence LaBenne, a Pennsylvania pharmacist at an Ahold Delhaize supermarket.

    He will receive $6,083,587 from the federal recovery.

    The settlement is another example of how pricing representations, claim-level billing data, and insider knowledge drive many False Claims Act recoveries.

    For Find Corporate Waste⁠, the case fits the broader enforcement pattern: federal programs rely on accurate certifications and truthful claim data, and public money can be recovered when those representations are allegedly false.

  • Brooklyn Clinic Manager Convicted in $8M Medicare Fraud Scheme

    Brooklyn Clinic Manager Convicted in $8M Medicare Fraud Scheme

    A federal jury convicted Olga Popovych, a New York clinic manager, for her role in an $8 million Medicare fraud scheme, according to the DOJ.  

    Prosecutors said Popovych managed several physical therapy clinics that paid cash kickbacks to ambulette drivers who brought Medicare patients to the clinics. The DOJ said she was personally involved in paying the kickbacks and falsifying medical records to claim that physical therapists treated patients when they were not actually present.  

    Between 2018 and 2020, Medicare paid the clinics more than $8 million. Trial witnesses also testified that Popovych used coded text messages to discuss kickbacks and took steps to conceal the scheme after suspecting law enforcement was watching the clinics.  

    The jury convicted Popovych of conspiracy to commit health care fraud, conspiracy to make false statements relating to health care matters, four counts of health care fraud, and three counts of making false statements relating to health care matters.

    She faces up to 10 years for each health care fraud conviction and up to 5 years for each false-statement conviction. A federal judge will determine the sentence under the U.S. Sentencing Guidelines and other statutory factors.  

    The case was investigated by HHS-OIG and the FBI.

    Anyone with inside knowledge of kickback arrangements, false billing, fabricated medical records, or patient-recruitment schemes involving federal health care programs may have information relevant to public-fraud enforcement.

    Find Corporate Waste protects confidential sources and helps preserve the right to report fraud.

  • $56.5M Settlement Targets Medicare Diagnosis Codes Scheme

    $56.5M Settlement Targets Medicare Diagnosis Codes Scheme

    Community Care Health Network LLC, doing business as Matrix Medical Network, DPN USA, doing business as HealthFair, and Shahriah “James” Ekbatani agreed to pay $56.5 million to resolve False Claims Act allegations over unsupported Medicare Advantage diagnosis codes, the DOJ announced.

    Matrix will pay $36.5 million, HealthFair will pay $5 million, and Ekbatani will pay $15 million.

    The DOJ alleged the defendants caused Medicare Advantage Organizations to submit false or invalid diagnosis codes to CMS, increasing risk-adjusted taxpayer payments.

    Matrix allegedly used in-home assessments to report unsupported conditions. HealthFair allegedly used mobile assessment buses to report unsupported diagnoses under Ekbatani’s direction.

    The whistleblowers will receive major awards. Former Matrix employee Nancy Cahill will receive $7.3 million. Former HealthFair chief medical officer Dr. Robert Oristaglio Jr. will receive $3.6 million.

    Insiders with knowledge of unsupported diagnosis coding, chart-review pressure, mobile assessments, or Medicare Advantage billing failures may have information relevant to public-fraud enforcement.

    Find Corporate Waste helps protect insiders while exposing fraud, waste, and abuse in taxpayer-funded programs.

  • Oglethorpe Pays $32M Over Medicare Overpayment Allegations

    Oglethorpe Pays $32M Over Medicare Overpayment Allegations

    Oglethorpe Inc. and three top executives agreed to pay $32 million to resolve False Claims Act allegations tied to Medicare overpayments at behavioral health facilities.

    According to the DOJ, Oglethorpe, its founder Robert Cohen, CEO John Picciano, and COO James O’Shea allegedly failed to return overpayments that the company’s own consultants had identified.

    The alleged overpayments involved Medicare beneficiaries admitted to Ridgeview Behavioral Hospital, Georgetown Behavioral Hospital, and The Woods at Parkside, despite allegedly not qualifying for inpatient psychiatric care.

    The case stands out because Oglethorpe had already entered a 2021 Corporate Integrity Agreement after an earlier FCA settlement. Following alleged violations, the defendants agreed to a 10-year exclusion from Medicare, Medicaid, and all federal health care programs beginning in July 2026.

    The lawsuit was filed by four former Oglethorpe employees under the FCA’s whistleblower provisions. Their relator share has not yet been determined.

  • Brooklyn Clinic Owner Convicted in $52M Health Care Fraud and Kickback Scheme

    Brooklyn Clinic Owner Convicted in $52M Health Care Fraud and Kickback Scheme

    A federal jury in the Eastern District of New York convicted Tony Brown-Arkah, 78, owner of American Medical Centers, a Brooklyn clinic that purported to provide substance abuse treatment, for his role in a $52 million health care fraud, narcotics, and kickback scheme.

    According to the Department of Justice, Brown-Arkah’s clinic illegally prescribed Suboxone, a Schedule III narcotic used to treat opioid use disorder, while allowing drug diversion activity to operate around the clinic. Witnesses testified that patients were directed to sell prescriptions outside the facility, including to a van near the clinic.

    The DOJ said many patients received prescriptions signed by a nurse practitioner in Florida who did not see or speak with them. Patients were also subjected to medically unnecessary testing, while Medicare and Medicaid were billed for services that were not provided or not legitimate.

    Brown-Arkah was also convicted of paying patient kickbacks and receiving laboratory kickbacks tied to unnecessary testing referrals. Prosecutors said he used a shell company and sham contract to conceal the payments.

    The case reflects the DOJ’s continued focus on health care fraud involving addiction treatment, laboratory testing, controlled substances, and federal program billing.

    DOJ Press Release — Clinic Owner Convicted for $52M Health Care Fraud, Illegal Narcotics Distribution, and Kickback Scheme

    DOJ Health Care Fraud Unit

    Find Corporate Waste — False Claims Act

  • Minnesota Medicaid Fraud Takedown Charges 15 Defendants in Alleged $90M Scheme

    Minnesota Medicaid Fraud Takedown Charges 15 Defendants in Alleged $90M Scheme

    The DOJ announced a major Minnesota health care fraud takedown on May 21, 2026, charging 15 defendants in alleged schemes involving more than $90 million in intended loss.

    The charges target owners of child care centers, autism-service providers, housing-support operators, and other Medicaid-linked providers accused of exploiting public programs designed for vulnerable children, disabled adults, seniors, and low-income families.

    According to the DOJ, the largest case involves Minnesota’s Early Intensive Developmental and Behavioral Intervention program, known as EIDBI, which provides services for people under 21 with autism spectrum disorder.

    Two defendants were charged in connection with an alleged $46.6 million scheme involving kickbacks to parents, medically unnecessary autism diagnoses, and billing for autism services that were not actually provided.

    The growth of the program is staggering. The DOJ said EIDBI claims rose from more than $600,000 in 2018 to more than $400 million by 2025. That kind of explosion is exactly why health care fraud enforcement increasingly depends on data analytics, billing-pattern review, and cross-agency scrutiny.

    The takedown also includes first-of-their-kind criminal prosecutions involving Minnesota’s Integrated Community Supports and Individualized Home Supports programs. In the ICS case, prosecutors allege a defendant billed Medicaid for services that were not provided as represented, including for a vulnerable recipient who required 24-hour care and was later found deceased. In the IHS case, two defendants allegedly concealed financial interests in more than 20 residences while billing Medicaid for services tied to adults with disabilities.

    The DOJ also charged eight defendants in alleged Housing Stabilization Services fraud totaling approximately $15.7 million. That program was created to help people with disabilities, seniors, and people with mental health or substance-use disorders find and maintain housing. But prosecutors said low barriers to entry and minimal documentation requirements made the program vulnerable to fraud. Minnesota eventually shuttered the program on October 31, 2025, after fraud concerns overwhelmed its integrity.

    This announcement is not just about Minnesota. The DOJ also announced funding for 15 new Trial Attorney positions to expand Medicaid fraud enforcement nationwide. The department said these prosecutors will support existing strike forces in states including California, Florida, New York, and Texas, while also expanding rapid-response enforcement across the country.

    For Find Corporate Waste, the message is clear: Medicaid fraud is not a paperwork problem. It is a taxpayer-integrity problem. These programs exist to serve people with serious needs, but weak controls, loose provider entry standards, shell-provider structures, and explosive billing growth can turn public benefits into private revenue machines.

    The DOJ also emphasized that its Health Care Fraud Section’s Data Fusion Center used advanced data analytics to identify and support the Minnesota cases. That matters. Public records, provider data, corporate filings, exclusion lists, addresses, ownership patterns, billing spikes, and program-growth anomalies can reveal serious fraud signals long before a prosecution is announced.

    This is the kind of enforcement environment where public-interest data mining matters. Find Corporate Waste tracks fraud, waste, abuse, and False Claims Act enforcement because taxpayers deserve to know how public money is being spent, who is exploiting weak oversight, and our country will not survive the looting of our government for personal gain.