Find Corporate Waste

Tag: Medicare Fraud

  • 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

  • California Doctor Convicted in $45M Botox Medicare Fraud Scheme

    California Doctor Convicted in $45M Botox Medicare Fraud Scheme

    A federal jury in the Central District of California convicted Dr. Violetta Mailyan, 45, of Glendale, California, for her role in a $45 million Medicare fraud scheme built around Botox billing. According to the DOJ, Mailyan submitted claims for Botox injections that were either never provided, medically unnecessary, cosmetic in nature, or unsupported by the medical records required for Medicare reimbursement. 

    The DOJ said the investigation began after the Health Care Fraud Section’s Data Analytics Team flagged Mailyan as an extreme Medicare outlier: she had been paid more for Botox injections than any other doctor in the country.

    At one point, she had received more than $24 million over four years, roughly six times more than the next highest comparison group, all of whom were neurologists.  

    The details are staggering. Prosecutors said Mailyan billed Medicare for Botox treatments while she was vacationing in Cabo, Maui, Las Vegas, Pennsylvania, and New York. She also allegedly billed for a Medicare beneficiary who was incarcerated in federal prison and submitted over $19 million in claims for injections supposedly performed on days when her clinic was closed.  

    According to trial evidence, Mailyan backdated claims, fabricated patient consent forms, altered medical records after receiving a grand jury subpoena, and tried to make it appear that patients suffered from chronic migraines requiring treatment. The jury convicted her of nine counts of wire fraud and three counts of obstruction. Sentencing is scheduled for September 10, 2026. 

    The forfeiture findings tell the rest of the story: a Tesla Model X, a Tesla Cybertruck, more than $251,000 in bank funds, brokerage accounts valued at over $7.3 million, and four California properties with estimated equity above $7.3 million were found subject to forfeiture as fraud proceeds. 

    This case shows that investigators must follow abnormal billing patterns, outlier providers, ownership trails, and public data signals before the money disappears.

    The DOJ’s new Fraud Division and Health Care Fraud Strike Force are now openly leaning into analytics, and that shift matters. Find Corporate Waste exists to follow that trail.

    If you have information about government funds being misused, inflated, concealed, or routed through questionable claims, now is the time to come forward.

  • Michigan Home Health Owner Convicted in $1.6M Medicare Fraud Scheme

    Michigan Home Health Owner Convicted in $1.6M Medicare Fraud Scheme

    A federal jury in the Eastern District of Michigan convicted Ruby Scott, a Michigan nurse and owner of Delta Home Health Care LLC, for a $1.6 million Medicare fraud scheme involving illegal kickbacks, stolen patient records, and false home health billing.

    According to the DOJ, Scott paid a discharge nurse at a Detroit hospital to identify Medicare patients and send their confidential records to Delta without the patients’ knowledge.

    From 2018 through 2021, Scott allegedly used those records to bill Medicare for home health services. The DOJ said she paid the nurse more than $130,000 through CashApp, PayPal, checks, and cash, including roughly $300 per patient when Delta successfully billed Medicare.

    Prosecutors said Scott falsely represented that doctors had certified patients as eligible for home health care, including that they were homebound, even though no doctor had evaluated those patients for Delta’s services. In some cases, Scott allegedly used real doctors’ identities to fabricate evaluations. One witness testified that a patient for whom Delta received thousands of dollars in Medicare payments never received services from Scott’s company.

    Delta also failed to maintain patient files for more than one-third of the patients it billed Medicare for. Medicare paid Delta more than $1.2 million for those patients alone. The DOJ said Scott caused approximately $1.6 million in losses to Medicare.

    The jury convicted Scott of five counts of health care fraud, conspiracy to defraud the United States and pay illegal health care kickbacks, and four counts of paying illegal health care kickbacks. She is scheduled to be sentenced on September 24, 2026.

    For Find Corporate Waste, this case shows how public health care dollars can be drained through kickbacks, fake medical necessity, stolen patient information, and false billing records. Medicare fraud is not victimless. Every false claim takes money from taxpayers, legitimate providers, and patients who depend on the system

  • Takeda to Pay $13.6M Over False Claims Act Allegations Tied to Physician Payments

    Takeda to Pay $13.6M Over False Claims Act Allegations Tied to Physician Payments

    Takeda Pharmaceuticals U.S.A. Inc. has agreed to pay $13,670,921 to resolve False Claims Act allegations involving improper payments to physicians who prescribed Trintellix, an antidepressant medication marketed for major depressive disorder. The Department of Justice said the alleged conduct caused false claims to be submitted to Medicare and other federal health care programs.  

    The settlement centers on the federal Anti-Kickback Statute, which prohibits offering or paying anything of value to induce referrals or prescriptions covered by Medicare, Medicaid, TRICARE, and other federal health care programs.

    DOJ alleged that from January 2014 through October 2020, Takeda paid improper remuneration to health care providers, including speaker honoraria and meals at high-end restaurants, to encourage prescriptions of Trintellix.  

    According to the government, Takeda selected certain providers for its Trintellix speaker bureau and gave them paid speaking opportunities with the intent that those payments and related benefits would influence prescribing decisions.

    The DOJ also alleged that some prescribers attended multiple programs on the same topic, received meals and drinks, and gained no real educational value from repeated attendance.  

    The case is important because it shows how False Claims Act liability can arise even when the drug itself is legitimate and the prescription may appear ordinary on paper. The issue is not simply whether a medication was dispensed. The issue is whether federal health care dollars were tainted by payments, perks, or side benefits that improperly influenced medical judgment.

    Assistant Attorney General Brett Shumate said that the DOJ remains committed to pursuing False Claims Act violations arising from illegal kickbacks, warning that such conduct can undermine patient trust and increase drug costs for taxpayers. The Eastern District of California, HHS-OIG, and the Defense Criminal Investigative Service also participated in the investigation.  

    This settlement also fits into DOJ’s broader enforcement posture. The release specifically ties the case to the Administration’s Task Force to Eliminate Fraud and the National Fraud Enforcement Division, both aimed at fraud, waste, and abuse in federal programs. DOJ emphasized that False Claims Act enforcement remains central to recovering taxpayer dollars and holding wrongdoers accountable.

    The Takeda settlement is another example that shows how federal fraud may not always look like a fake business or a forged invoice. Sometimes it involves more sophisticated schemes like a polished compliance program, a speaker event, a catered dinner, or a repeat “educational” session that quietly changes prescribing incentives.

    Find Corporate Waste exists to help taxpayers, whistleblowers, and concerned insiders spot the patterns others miss.

    If you have information about improper billing, kickbacks, false certifications, pandemic relief abuse, or corporate conduct that may have caused taxpayer money to be wasted, we want to hear from you. Federal fraud often hides behind paperwork that looks clean on the surface. The more people come forward, the harder it becomes for corporations to treat public money like private profit.

  • HealthSplash Owner Convicted in $1 Billion Medicare Fraud Conspiracy

    HealthSplash Owner Convicted in $1 Billion Medicare Fraud Conspiracy

    A federal jury in the Southern District of Florida convicted Brett Blackman, owner of HealthSplash, Inc., for his role in a Medicare fraud conspiracy involving more than $1 billion in fraudulent claims.

    According to the Department of Justice, Blackman operated through HealthSplash and Power Mobility Doctor Rx, LLC, also known as DMERx, an internet-based platform used to generate doctors’ orders for durable medical equipment and prescriptions.

    The DOJ said those orders falsely claimed that physicians had examined and treated Medicare beneficiaries, while in reality doctors were allegedly paid to sign paperwork with little or no meaningful patient interaction.

    As part of this fraud scheme, the DOJ described a broader fraud pipeline involving marketers, foreign call centers, telemedicine companies, pharmacies, durable medical equipment suppliers, and paid doctors.

    Medicare beneficiaries were pushed toward unnecessary orthotic braces and other items, while the paperwork moved through DMERx so suppliers could bill Medicare and other federal health care programs.

    DOJ said suppliers and pharmacies submitted more than $1 billion in claims, with Medicare and other insurers paying more than $450 million.

    Blackman was convicted of conspiracy to commit health care fraud and wire fraud, conspiracy to pay and receive health care kickbacks, and conspiracy to defraud the United States.

    Why This Matters

    This case shows how federal health care fraud can hide behind clean paperwork, corporate layers, software systems, and technical compliance language.

    A signed doctor’s order does not always mean a real medical exam happened, and a billing record does not always mean the service was necessary.

    For Find Corporate Waste, the lesson is clear: taxpayer money often moves through systems that look legitimate until the relationships, incentives, and eligibility rules are examined more closely. Health care fraud is not always obvious from the surface. It may require connecting billing records, ownership structures, provider relationships, exclusion data, and government payment databases.

    If you have seen suspicious billing, questionable federal payments, corporate abuse, or government money flowing to entities that may not have followed the rules, Find Corporate Waste wants to hear from you.

    Tips, documents, and public records can help expose fraud, recover taxpayer money, and hold bad actors accountable.

  • FCW Welcomes DOJ FOCUS Initiative to Combat Waste, Fraud, and Abuse With Data Science

    FCW Welcomes DOJ FOCUS Initiative to Combat Waste, Fraud, and Abuse With Data Science

    The Department of Justice’s Civil Division has announced the new FOCUS initiative, short for Fraud Oversight through Careful Use of Statistics. The initiative is aimed at data miners who use public government records to identify potential False Claims Act cases. Find Corporate Waste has developed a sophisticated methodology for addressing Medicare Fraud committed during the COVID-19 Pandemic.

    DOJ Is Recognizing What Serious Data Miners Already Know

    For years, traditional whistleblower cases have often depended on insiders: employees, contractors, billing staff, compliance officers, or executives who saw misconduct from the inside.

    Under the leadership of Acting Attorney General Todd Blanche, the federal government now appears to be recognizing that some fraud patterns can also be found by carefully analyzing public records, payment data, provider databases, and regulatory rules.

    DOJ made clear that it welcomes data miners, but not sloppy work. The Department says it will prioritize data miners who can explain their methodology, validate their findings, understand the relevant program rules, and identify legally sufficient False Claims Act matters.  That is exactly the standard serious public-record investigators should want.

    FCW Welcomes the FOCUS Initiative

    At Find Corporate Waste, we welcome the FOCUS initiative because it encourages a disciplined approach to public-data fraud detection.

    The point is not to accuse every recipient of federal funds of wrongdoing, rather the FOCUS is to identify situations where public records raise a serious, documentable question about whether federal money was obtained or retained in violation of program rules.

    That requires matching payment data to eligibility rules, compliance obligations, provider identifiers, corporate records, exclusion data, licensing data, and other government sources.

    Why PRF Data Deserves Careful Review

    One area FCW plans to continue reviewing is the Provider Relief Fund, commonly known as PRF.

    The PRF was created to support healthcare providers during the COVID-19 emergency. Public PRF data identifies providers that received and accepted payments and agreed to the applicable Terms and Conditions. HRSA has stated that public PRF data reflects providers who received one or more payments, attested to receiving at least one payment, and agreed to the related Terms and Conditions.  

    That attestation piece is important.

    When a provider accepts federal relief money and agrees to Terms and Conditions, the question becomes whether the recipient was actually eligible, whether the money was properly retained, and whether any later reporting or compliance obligations were satisfied.

    How the Medicare Opt-Out Database Fits In

    FCW also plans to use the Medicare Opt-Out Affidavits database as part of its review process.

    The CMS opt-out dataset identifies providers who have decided not to participate in Medicare. CMS states that the dataset includes information such as provider NPI, specialty, address, and opt-out effective dates.  

    That database is useful because PRF payments were connected to healthcare providers operating within federal healthcare programs and subject to specific eligibility and compliance rules.

    If public PRF records appear to overlap with Medicare opt-out records, that does not automatically prove fraud. But it does create a legitimate line of inquiry worth reviewing.

    The key is timing, identity, and rule application.

    Data Mining Is Not Guesswork

    The strongest False Claims Act cases are built on public records.

    The goal is to determine whether a public-data anomaly is just an innocent mismatch, a clerical issue, or a real compliance problem involving federal funds.

    That distinction matters. It protects honest providers. It also helps the government focus on cases that are actually worth pursuing.

    Why This Matters for Taxpayers

    COVID-era relief programs moved enormous sums of federal money very quickly. Many recipients used those funds properly. Others may not have.

    The False Claims Act exists because public money comes with rules. When companies or providers accept federal funds, they do not get to ignore the conditions attached to those funds.

    The DOJ’s FOCUS initiative sends a clear message: public data can help uncover fraud, but only when it is used responsibly.

    FCW’s Position

    FCW welcomes DOJ’s FOCUS initiative and supports a high standard for data-driven False Claims Act work.

    Public records are an untapped way to identify waste, fraud, and abuse that would otherwise remain obscure and buried.

    Think You Have Information About Federal Healthcare Fraud?

    If you worked for a provider, billing company, healthcare contractor, clinic, management company, or related entity that received federal funds during the COVID-19 period, your information may matter.

    FCW reviews public records and potential False Claims Act leads involving federal healthcare payments, relief funds, and government program compliance.

    Whistleblowers play a major role in protecting taxpayer money. In many cases, relators who bring successful False Claims Act cases may be eligible to receive a share of the government’s recovery.

    If you have credible information about federal funds being obtained, retained, or reported improperly, FCW can help evaluate whether the facts may warrant attorney review.

    Find Corporate Waste exists to help turn public records into accountability.

  • Michigan Health Care Provider Ordered to Pay $334,807 to Settle False Claims Act Allegations

    Michigan Health Care Provider Ordered to Pay $334,807 to Settle False Claims Act Allegations

    In the Eastern District of Michigan, M&Y Care, LLC, a Michigan-based home health provider, has agreed to pay $334,807.20 to resolve allegations that it defrauded the Medicare and Medicaid programs by billing for services rendered by unqualified staff.

    According to the Department of Justice, M&Y Care caused the United States Government to be billed for services provided by unqualified staff. Using the incorrect CPT code, G0156, which refers to a home health aide, they defrauded the federal government for services at a reimbursement rate higher than the non-skilled rate to which their employees were entitled.

    The misconduct came to light thanks to a False Claims Act lawsuit filed under the law’s qui tam provisions. The investigation was prompted by a whistleblower complaint under the False Claims Act (FCA), showing the critical role private citizens play in holding corporations accountable for wasting our money.

    At Find Corporate Waste, we applaud this outcome and the whistleblower who made it possible. Every time a company siphons money from Medicare or Medicaid, they are not just defrauding a system—they are stealing from the sick, the elderly, and the taxpayer.

    We are committed to ensuring that fraud like this doesn’t go unanswered.

    If you have information about misconduct involving government programs or contracts, visit our page on how whistleblowers protect public funds. You might be the reason the next $300,000 gets returned to the American people.

    • Indian National Charged with Falsely Claiming U.S. Citizenship to Vote in 2024 Election

      An Indian national faces two federal charges for allegedly falsely claiming U.S. citizenship on a Minnesota voter certificate to cast a ballot in the 2024 general election.

    • Health Care Fraud Can Carry a Life Sentence When Patients Die

      Did you know? Federal health care fraud can carry a life sentence when the fraud results in a patient’s death. Under 18 U.S.C. § 1347, knowingly and willfully executing—or attempting to execute—a scheme to defraud a health care benefit program can ordinarily result in up to 10 years in federal prison. But the penalties escalate…

    • Pennsylvania Medical Supplier Billed $1.3B in Five Months, DOJ Says

      ND Medical Solutions allegedly submitted $1.3 billion in fraudulent claims within five months and transferred insurance proceeds overseas.

    • Mount Sinai Reaches DOJ Agreement Amid False Claims Act Investigation

      Mount Sinai Health System has reached an agreement with the Justice Department resolving a federal investigation into its provision of gender-transition procedures to minors. Under the agreement, Mount Sinai will stop providing puberty blockers, cross-sex hormones and surgical procedures to minors. The health system will also pay a monetary penalty and dedicate $2 million to…

    • Complete Health Pays $14.1M Over Inflated Medicare Advantage Diagnoses

      Complete Health allegedly pushed unsupported mental health and substance-dependence diagnoses that increased Medicare Advantage payments. A former risk-adjustment executive will receive nearly $2.5 million for exposing the scheme.

    • Boston Eye Practice to Pay $3.9M Over Unsupported Medicare Billing

      Ophthalmic Consultants of Boston will pay nearly $3.9 million to resolve allegations that it improperly billed Medicare and MassHealth for office visits performed alongside eye injections.

    • Abusive Michigan Day Care Owner Billed Medicare for Dead Patients

      New Beginnings Adult Center owner Yolanda Matthews admitted billing Medicare more than $539,000 for nonexistent psychotherapy, including claims for hospitalized and deceased patients

    • NYC Correction Officers Among Defendants in $3M Fake Check Scheme

      Current and former NYC government employees allegedly helped deposit more than $3 million in fraudulent checks, generating over $500,000 in proceeds.

    • Dallas Lab and Founders Pay $24M Over COVID Testing Claims

      Magnolia Diagnostics, its owners and investors will pay $24 million to resolve allegations involving medically unnecessary respiratory testing billed to Medicare.

    • Brooklyn Adult Day Care Owner Gets 57 Months for $3.2M Medicaid Fraud

      Prime Life owner Eric Zhu was sentenced to 57 months in prison for billing Medicaid $3.2 million for adult day care services never provided.

  • California Couple Guilty in $16M Hospice Fraud Scheme

    California Couple Guilty in $16M Hospice Fraud Scheme

    Two California residents have pleaded guilty in a scheme to defraud Medicare of nearly $16 million by operating fake hospice companies and laundering the proceeds.

    Karpis Srapyan of Winnetka, California, admitted to helping orchestrate the false claims, which were routed through four fake hospice companies he and others controlled. The scam used falsified documents, fraudulent leases, and stolen identities to gain access to federal funds.

    Generated image

    Susanna Harutyunyan, also of Winnetka, pleaded guilty to laundering money on behalf of her husband and co-conspirators. She helped move millions through fraudulent bank accounts and spent taxpayer money on personal luxuries—including a BMW.

    Other defendants have already been sentenced or are awaiting sentencing, with penalties ranging up to 20 years in prison. One participant has already received a 12-year sentence.

    Find Corporate Waste is committed to uncovering schemes that drain public funds.

    Hospice fraud exploits the suffering of vulnerable American families, while wasting taxpayer money. The False Claims Act exists as the main remedy for recovering wasteful, abusive, and fraudulent spending.

    If you have knowledge of healthcare providers submitting false claims to Medicare or Medicaid, you can act.

    Whistleblowers are entitled to a portion of any recovered funds and play a critical role in protecting public trust.

    Becoming a relator is a serious decision.

    Find Corporate Waste is here to help guide you through the process. If you have firsthand knowledge about fraudulent Medicare billing or sham healthcare operations, we urge you to reach out and help restore integrity to our healthcare system.

  • DOJ-HHS Launch New Initiative to Combat Healthcare Fraud

    DOJ-HHS Launch New Initiative to Combat Healthcare Fraud

    July 2, 2025

    Washington, D.C.


    In a decisive move to enhance the fight against healthcare fraud, the U.S. Department of Justice (DOJ) and the Department of Health and Human Services (HHS) have taken significant action. They have launched the DOJ-HHS False Claims Act Working Group.

    This strategic alliance formalizes long-standing cooperation between the two agencies.

    It also shows how the False Claims Act (FCA) is used. This law protects federal healthcare programs from fraud, waste, and abuse.

    The Working Group will concentrate enforcement in seven key areas:

    • Medicare Advantage fraud, such as upcoding and inflated risk scores
    • Drug and device pricing manipulation, such as undisclosed rebates and improper discount arrangements
    • Access to care violations, including non-compliant provider networks
    • Kickback schemes, involving drugs, medical devices, and durable medical equipment
    • Defective medical devices that compromise patient safety
    • Electronic Health Records abuse, such as system manipulation to boost Medicare billing
    • Data-driven investigations, powered by cross-agency analytics and audit findings

    The new Working Group encourages whistleblowers to report false claims involving federal healthcare dollars related to specific enforcement priorities.

    At Find Corporate Waste, we spotlight whistleblower-driven accountability.

    If you become a relator under the False Claims Act, your role would expose fraud and recover taxpayer dollars.

    Becoming a relator is a serious decision.

    If you have inside information on healthcare contracts or schemes, we’re here to assist you.

    Report Fraud
  • California Man Pleads Guilty in $16 Million Medicare Hospice Scam

    California Man Pleads Guilty in $16 Million Medicare Hospice Scam

    In a striking example of Medicare fraud, a California man has pleaded guilty to laundering over $4.6 million in connection with a massive hospice fraud scheme that bilked Medicare out of nearly $16 million.

    Mihran Panosyan, 46, of Winnetka, admitted to orchestrating a complex money laundering operation designed to hide the proceeds of fraudulent Medicare claims submitted by sham hospice companies.

    The scheme involved three major components:

    1. Co-defendants used the stolen identities of foreign nationals to create and operate fictitious hospice providers. They maintained fraudulent passports, bank accounts, and financial instruments to support the illusion of legitimate foreign ownership.
    2. Hospices submitted fake Medicare claims for services supposedly provided to patients who were neither terminally ill nor aware they were enrolled in hospice care.
    3. Panosyan shuffled the money between shell companies, sham hospice accounts, and bank accounts linked to the stolen identities, using the funds to pay private school tuition and to cover personal expenses.

    Panosyan pleaded guilty to one count of money laundering and will be sentenced to up to 20 years on September 8, 2025. His co-defendent, Petros Fichidzhyan, has already pleaded guilty and has been sentenced to 12 years in prison.

    Find Corporate Waste tracks abuses like these to ensure that schemes targeting taxpayer funds are shut down. Fraud like this must be addressed, so if you know of a company or individual exploiting federal contracts or benefits, we encourage whistleblowers to contact us.