The Department of Justice announced Thursday that Dallas-based hospice provider Provista Health has been ordered to pay $26.3 million for billing Medicare for a range of medically unnecessary Respiratory Pathogen Panel (RPP) tests administered in nursing homes during the pandemic.
On July 18, the United States District Court for the District of Maryland entered default judgments against Provista, Inc., owned by Patrick Britton Herr, and other laboratory companies for violations of the False Claims Act in the amounts listed above.
In a July 2023 complaint, the United States argued that the RPP tests were not medically necessary because the beneficiaries had no symptoms of respiratory illness and the tests were for rare respiratory pathogens.
The complaint also alleges that Britton Haar and Provista submitted claims for RPP tests that were never ordered by a doctor and that were sometimes never performed, including more than 300 claims for nasal swab samples that were allegedly taken from beneficiaries who were already deceased.
Three Sentenced to Prison for Selling Pirated Business Phone Software
The Department of Justice announced that a husband and wife and a third individual have been sentenced to prison for selling tens of thousands of pirated business telephone system software licenses with a retail value of more than $88 million.
Raymond Bradley “Brad” Pierce, 48, a computer systems administrator from Tuttle, Oklahoma, was sentenced Thursday to four years in prison and ordered to pay $4 million in restitution. In June, his wife, Dusty O. Pierce, 46, also of Tuttle, was sentenced to one year and one day in prison and ordered to pay $4 million in restitution.
Jason M. Hines, 44, of Caldwell, New Jersey, was sentenced to 18 months in prison, 18 months of house arrest and ordered to pay $2 million in restitution.
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The trio, who pleaded guilty to wire fraud conspiracy charges in 2023, will also pay restitution of $17 million to Brad Pierce, $10 million to Dusty Pierce and more than $5 million to Hines.
The Pierces conspired with Hines to commit communications fraud in a scheme to create and sell unauthorized Avaya Direct International (ADI) software licenses used to unlock the features of IP Office telephone systems.
Avaya Holdings Corporation, the California-based international business communications company that sold IP Office, also sold software licenses that unlocked IP Office’s features.
Avaya customer service employee Brad Pearce used his system administrator privileges to generate tens of thousands of ADI software license keys that he illegally sold to Hines and other customers, who in turn sold them to resellers and end users around the world.
He also hijacked the accounts of former Avaya employees to get more license keys, then changed the information in the accounts to cover up the whole scheme, while Dusty Pierce acted as accountant for the illegal activities.
Doctor faces years in prison for illegal distribution of controlled substances and health care fraud
A federal jury yesterday convicted a Louisiana doctor of illegally distributing more than 1.8 million doses of Schedule II controlled substances, including oxycodone and morphine, and defrauding health care benefit programs of more than $5.4 million, the Department of Justice announced Tuesday.
According to court documents, Adrian Dexter Talbot, 58, owned and operated Medex Clinical Consultants, which accepted cash payments for controlled substances in Slidell, Louisiana.
Talbot ignored signs that people frequenting Medex were seeking drugs or abusing prescribed medication.
In 2015, while working a full-time job in Pineville, he left pre-signed prescriptions for opioids and other controlled substances at the clinic so people who had never met him could obtain the medication.
In 2016, he hired another doctor to pre-sign prescriptions to be similarly distributed at his Slidell clinic in exchange for depositing cash into Medex’s account.
Talbott falsified patient records to conceal a scheme in which individuals used insurance benefits to fill prescriptions that were written without a proper patient examination or determination of medical necessity, resulting in fraudulent billing of health care benefit programs.
He faces up to 10 years in prison on the health care fraud conspiracy charge and up to 20 years in prison on the other charges.
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