‘Qui Tam Whistleblower’ Category

St. Cloud dental clinic owner Ayman Risha, who is unlicensed in Minnesota but holds a foreign-issued Bachelor of Dental Surgery degree, has been denied a license because the Minnesota Board of Dentistry found he had engaged in dental fraud by making diagnoses and treatment plans that were not medically warranted. The board found that he instructed his staff to:

The Securities and Exchange Commission has sent letters to all six of the major Hollywood studios and to DreamWorks Animation as part of an investigation of the film industry’s potential violations of the Foreign Corrupt Practices Act (FCPA) in their business dealings in China, according the Los Angeles Times.

Paramount Pictures, Twentieth Century Fox, Universal Pictures, Sony...

Medicaid insurance company Coventry Cares has attempted to end its contract with Appalachian Regional Healthcare (ARH). According to the Chicago Tribune, House Speaker Greg Stumbo has said that he believes the company’s actions border on Medicaid fraud and has called for an investigation of Coventry Cares and the company that operates it, Coventry Life and Health Insurance...

Humana, Inc. has disclosed that some of its Florida subsidiaries are under investigation by the U.S. Department of Justice (DOJ) for possible Medicaid and Medicare fraud, according to Bloomberg.  Specifically, Humana revealed that the DOJ investigation involves the coding of Medicaid and Medicare claims and loans to physicians. Earlier this year, the U.S. Attorney’s Office in Miami asked...

After being convicted on various drug charges last October, former pharmacist Peter Victor Ayika has pleaded guilty to charges that he submitted false claims to Medicaid, a number of private insurance providers, and the Federal Employees Health Benefit Program for drugs he did not dispense. He was sentenced to 63 months in prison on the fraud charges alone, as reported by the El Paso...

Rhode Island Attorney General Peter Kilmartin is calling on the public to be partners in fighting Medicaid fraud by reporting incidents of fraud through an online complaint form, reports Providence Eyewitness News. Individuals can report fraud anonymously through the electronic complaint form, submitting it directly to the Attorney General’s Medical Fraud Control and Patient Abuse Unit for...

After a three-week jury trial, Colorado resident Curtis Morris and Arizona resident Richard Kellogg Armstrong have been convicted of filing false claims against the federal government, conspiracy to file false claims against the federal government, and mail fraud. Essentially, the two men were convicted of tax fraud. They will be sentenced in August 2012, according to the Justice...

Edna Iris Torres of West Palm Beach, Florida, has been arrested and charged with Medicaid fraud and grand theft, both second degree felonies. While the total fraud amounted to $28,000, if convicted Ms. Torres could be sentenced to as much as 30 years in prison as well as $20,000 in fines.

According to the Sunshine State News, from May 2007 to February 2011, Torres allegedly submitted...

Woo Jin Yang, Senior Sales Manager of Korea-based Hitachi-LG Data Storage Inc., has agreed to a guilty plea on charges that he participated in a conspiracy to rig bids involving the sale of optical disk drives, according to the Justice Department.

Mr. Yang allegedly conspired to suppress competition by rigging bids for the sale of optical disk drives to Hewlett-Packard Co. from about...

An Alabama physician, Diana K. McCutcheon, has been indicted on charges that she committed insurance and Medicare fraud for filing claims against Medicare and other insurers for non-reimbursable cosmetic skin treatments.

According to The Republic, the 96-count indictment alleges that Dr. McCutcheon billed Medicare and Blue Cross Blue Shield of Alabama for removing age spots, sun...