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Wallace P. Berkowitz, MD, an otolaryngologist based in St. Louis, Mo., has been indicted on one count of healthcare fraud and 19 counts of making false statements related to healthcare mattes, according to a report in The Rolla Daily News.

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Wednesday, 10 February 2010 10:40

W.Va. Clinic Owner Charged With Healthcare Fraud

Cameron J. Justice of Crum, W.Va., owner and president of Justice Medical Complex, with conspiracy to misuse a physicians registration number and aiding and abetting healthcare fraud, according to a report in The Charleston Gazette.

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The Department of Health and Human Services' Office of the Inspector General released its Justification of Estimates for Appropriations Committees report for fiscal year 2011 proposed budget, which included a $40 million increase to continue to support and increase efforts made to combat healthcare fraud.

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Southern New Hampshire Medical Center agreed to pay a $33,400 civil settlement to resolve allegations that it violated the federal False Claims Act by submitting bills to federal healthcare programs for a nursing assistant who had been excluded from these programs, according to a press release from the US Attorney's office (District of New Hampshire).

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Romilla Anwar, MD, of New Providence, N.J., and Anatoly Sunik of Rego Park, N.Y., were sentenced on Jan. 29, 2010, to 30 months and 12 months in prison, respectively, in a Manhattan Federal Court after pleading guilty to healthcare fraud charges, stemming from their operation of a medical fraud mill operating as the Avenue K Medical Clinic, according to a news release from the U.S. Department of Justice.

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1. Initial development of the False Claims Act. The False Claims Act, also known as the “Lincoln Law" after its primary proponent, President Abraham Lincoln, was initially developed during the Civil War. The Act was a response to war profiteering by military contractors who attempted to defraud the government, for example, by sending boxes of sawdust instead of guns or selling the same cavalry horse to the armed forces multiple times. The Act remained in its original form from its initial passage in 1863 until 1943, at which point various amendments de-incentivizing qui tam actions made the statute nearly obsolete. In 1986, the Act was amended again with greater incentives for private citizens to report fraud on the government. The Act has become an increasingly active mechanism to combat fraud and false claims submitted to the federal government ever since. For additional background information, see http://www.all-about-qui-tam.org/fca_history.shtml.

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Attorney General Eric Holder said federal prosecutors charged a record number of people with medical fraud in 2009, but there is still a lot more work to be done, according to a release from the Justice Department.
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Four employees at Three Rivers Infusion and Pharmacy Specialists in Coshocton, Ohio, were arrested in connection with an ongoing investigation into suspected healthcare fraud at the facility, according to a news release from the Ohio Attorney General's office.
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The American Medical Association offered recommendations on immediate actions the Obama administration can take to curb fraud in the healthcare system at a day-long summit sponsored by the federal government, according to an AMA news release.
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Miami-Dade County, Fla., residents Michel De Jesus Huarte, Alyd Dazza, Ricco Dazza, Monika Blacio, Dayron Porrata and Wally Proenza were sentenced for various offenses including conspiracy to commit Medicare fraud, conspiracy to commit money laundering, and aggravated identity theft, which included a maximum sentence of 22 years' imprisonment, according to a Department of Justice news release.
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