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Medicare fraud

Centers for Medicare & Medicaid Services
National

New Hospice Oversight Aims to Expose Fraud, Protect Patients

April 6, 2026April 4, 2026 - by Maryann Pugh

WASHINGTON, D.C. — Medicare hospice providers could face increased scrutiny under a proposed federal rule that introduces a new scoring system to flag questionable billing and care patterns while expanding …

New Hospice Oversight Aims to Expose Fraud, Protect Patients Read More

Judge
Crime & Safety / Regional

Court Orders Segal Arts to Pay $200,000 in Medicare Fraud Case

March 19, 2026March 19, 2026 - by Zainuddin Harinder

PHILADELPHIA, PA — A federal court has entered a consent judgment requiring Segal Arts, LLC, and its owner, Irina Segal, to pay $200,000 to resolve allegations that they improperly billed …

Court Orders Segal Arts to Pay $200,000 in Medicare Fraud Case Read More
Regional

U.S. Files False Claims Act Case Over Sanexas Billing Scheme

March 17, 2026March 17, 2026 - by Zainuddin Harinder

PHILADELPHIA, PA — Federal prosecutors have filed a civil complaint under the False Claims Act alleging a scheme to improperly bill Medicare for treatments involving an electrical stimulation device and …

U.S. Files False Claims Act Case Over Sanexas Billing Scheme Read More

US Department of Health and Human Services (HHS)
Health / Medical / National

HHS Rolls Out Health Push, Fraud Crackdown, Farm Plan

March 1, 2026March 1, 2026 - by Maryann Pugh

WASHINGTON, D.C. — Federal health officials this week announced a sweeping series of actions ranging from new drug approval guidance and Medicare fraud enforcement to more than $1 billion in …

HHS Rolls Out Health Push, Fraud Crackdown, Farm Plan Read More
Hundred dollar bills
National / Veteran Issues

VA and CMS Target $106 Million in Duplicate Payments Under New Data-Sharing Partnership

July 28, 2025July 28, 2025 - by Maryann Pugh

WASHINGTON, D.C. — In a move aimed at curbing government waste and improving coordination, the U.S. Department of Veterans Affairs and the Centers for Medicare & Medicaid Services announced a …

VA and CMS Target $106 Million in Duplicate Payments Under New Data-Sharing Partnership Read More

Department of Justice
National

Justice Department Unveils Historic Health Care Fraud Takedown, Charging 324 Defendants Nationwide

July 6, 2025July 6, 2025 - by Maryann Pugh

WASHINGTON, D.C. — In an unprecedented national crackdown, the U.S. Department of Justice announced charges last week against 324 defendants — including nearly 100 licensed medical professionals — across 50 …

Justice Department Unveils Historic Health Care Fraud Takedown, Charging 324 Defendants Nationwide Read More
United States Penitentiary
Crime & Safety / Regional

Philadelphia Woman Sentenced to 20 Months for Multi-Scheme Fraud

April 24, 2025April 24, 2025 - by Zainuddin Harinder

PHILADELPHIA, PA — Nyesha D. Paris, also known as Nyesha D. Henderson and Nyesha D. Jackson, was sentenced to 20 months in prison on April 22 for her role in …

Philadelphia Woman Sentenced to 20 Months for Multi-Scheme Fraud Read More

Settlement, fines
Pennsylvania

Genetic Testing Companies and Executives Agree to $6M Settlement Over Alleged Medicare Fraud

April 24, 2025April 24, 2025 - by Maryann Pugh

PHILADELPHIA, PA — Genexe, LLC, its parent company Immerge, Inc., and executives Jason Green and Jason Gross have agreed to pay $6 million to settle allegations of violating the False …

Genetic Testing Companies and Executives Agree to $6M Settlement Over Alleged Medicare Fraud Read More
Settlement, fines
Regional

$900K Medicaid Fraud Settlement Exposes Alleged Exploitation of Vulnerable Patients by Philly Doctor

January 29, 2025January 28, 2025 - by Maryann Pugh

PHILADELPHIA, PA — Dr. Ghodrat Pirooz Sholevar and his company, Nueva Vida Multicultural/Multilingual Behavioral Health, Inc., have agreed to pay $900,000 to settle allegations of Medicaid fraud. The U.S. Attorney’s …

$900K Medicaid Fraud Settlement Exposes Alleged Exploitation of Vulnerable Patients by Philly Doctor Read More
Legal
Crime & Safety / Pennsylvania

$20 Million Fraud Scandal Shocks Philadelphia—Nine Accused in Bold Scheme

December 21, 2024December 20, 2024 - by Zainuddin Harinder

HARRISBURG, PA — Pennsylvania Attorney General Michelle Henry announced charges were filed this week against nine individuals accused of orchestrating a complex $20 million Medicaid and Medicare fraud scheme through …

$20 Million Fraud Scandal Shocks Philadelphia—Nine Accused in Bold Scheme Read More

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