16 physician kickback suits totaling $180M+ in 2023

Here are 16 physician kickback suits Becker's  has reported on in 2023 that totaled more than $180 million in either restitution or cost of the fraud scheme:

1. David Copeland, part owner and sales manager of a pharmacy in Florida selling compounded prescription drugs, was convicted for a $54 million scheme in which he gave physicians who treated Tricare beneficiaries bribes and kickbacks in exchange for prescription referrals. He took them on hunting trips and "expensive dinners" as well. 

2. Alta Vista Healthcare & Wellness Centre, a skilled nursing facility in Riverside, Calif., and its management company, Rockport Healthcare Services, agreed to pay the U.S. and California $3.825 million to resolve physician kickback allegations.

3. Columbia, S.C.-based Bon Secours St. Francis Health System, St. Francis Hospital and St. Francis Physician Services agreed to pay $36.5 million to resolve allegations that it made illegal kickback payments to surgeons tied to the volume or value of referrals. 

4. Dallas-based Tenet Healthcare, Detroit Medical Center and Vanguard Health Systems agreed to pay $29.7 million to the federal government to resolve a whistleblower's allegations that they violated the False Claims Act by providing kickbacks to referring physicians.

5. A former New Hampshire physician pleaded guilty to healthcare fraud for his role in a $1.9 million Medicare fraud scheme. Steven Powell, MD, who now lives in Alpharetta, Ga., pleaded guilty to signing orders for durable medical equipment that he knew were used to submit fraudulent claims to Medicare. Dr. Powell was paid kickbacks for signing the orders. 

6. James Ellner, MD, and his practice and ASC will pay $625,000 to resolve whistleblower allegations that they violated the False Claims Act. Between May 1, 2015, and Dec. 31, 2019, Dr. Ellner and his Woodstock, Ga.-based pain management practice, Georgia Pain Management, and his ASC, Samson Pain Center, allegedly submitted false claims to Medicare and Tricare for services that were not reimbursable under federal healthcare programs.

7. Paul Koch, MD, the former owner of a chain of Rhode Island ophthalmology practices, has agreed to pay $1.1 million to settle kickback allegations. Between January 2013 and December 2017, Dr. Koch, Koch Eye Associates and Claris Vision allegedly paid kickbacks to referring optometrists whose patients wanted laser-assisted cataract surgery.

8. Alexander, Ark.-based physician Joe David May, MD, pleaded guilty and was sentenced to 102 months in prison for his role in a $12 million scheme to defraud Tricare. Dr. May played a role in a fake prescription-drug assembly line. He rubber stamped 226 prescriptions, costing Tricare more than $4.63 million, for people he did not know nor treat. 

9. Former physician Jeffrey Campbell and nurse practitioner Mark Dyer were sentenced to prison following conviction on committing healthcare fraud, money laundering and unlawfully distributing controlled substances. The two providers fraudulently billed for physical therapy services by using management codes indicating the services were performed by a physician to receive higher reimbursement, when they were actually performed by a non-physician and non-physical therapist. They were also ordered to pay a $1.1 million fine. 

10. Matteson, Ill.-based physician Ajibola Ayeni, MD, was ordered to pay more than $25 million for more than 4,000 violations of the False Claims Act. Dr. Ayeni owned a home visiting physician company where he knowingly submitted claims for Medicare payments for services not rendered, medically unnecessary services and services that were upcoded. A whistleblower suit was filed in 2013 and the government intervened in 2017, according to a news release. 

11. Michael Villarroel, MD, a Navy physician, pleaded guilty to a $2 million scheme where he defrauded the Navy by faking or exaggerating injuries to get reimbursements intended to help service members recovering from traumatic injuries. From 2012 to at least December 2015, Dr. Villarroel admitted he conspired to commit wire fraud. He claimed to have reviewed medical records and verified disabilities consistent with the injuries for the claims to be processed, often falsely stating he interviewed the claimant. 

12. Margate, N.J.-based Brian Sokalsky, DO, pleaded guilty for his role in a $5 million scheme to defraud payers by submitting claims for medically unnecessary prescriptions. Dr. Sokalsky authorized prescriptions for former pharmaceutical sales representative Matthew Tedesco in June 2017. In exchange for the authorization, Mr. Tedesco referred approximately 30 patients to Dr. Sokalsky's new medical practices. 

13. Justin LaMonda, MD, a physician based in Moberly, Mo., pleaded guilty to a $537,322 fraud scheme, admitting he used his father's name to falsely bill Medicare and Medicaid. Dr. LaMonda admitted he and his father agreed to bill Medicare and Missouri Medicaid for services performed by Dr. LaMonda as if they had actually been performed by Dr. LaMonda's father, who was also a physician.

14. A jury convicted pain physician Frederick Gooding, MD, for a $5 million healthcare fraud scheme. Dr. Gooding, president and CEO of Gooding Medical Corp., based in Wilmington, Del., was initially indicted in 2019 of Medicare fraud. Now, he is convicted of 11 counts of healthcare fraud. Dr. Gooding billed Medicare for medically unnecessary procedures that he didn't perform or have equipment for, including spinal injections. He submitted fraudulent claims from 2015 to 2018.

15. Hudson, Ohio-based physician Deepak Raheja, MD, was sentenced to prison and must pay $2.2 million after pleading guilty to his role in a pharmaceutical kickback scheme. Between February 2011 and July 2016, Dr. Raheja and his co-conspirators increased prescriptions for Nuedexta, a drug manufactured to treat the neurological condition pseudobulbar affect, in exchange for money and other items of value.

16. Kishor Vora, MD, owner of Owensboro (Ky.) Heart and Vascular and Owensboro Medical Practice, paid $931,500 to settle a Medicare fraud case for referring patients for genetic testing in exchange for an estimated $335,700 in kickbacks.

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