News

Enforcement, updated every day.

Every health care enforcement release from the Department of Justice and the HHS Office of Inspector General, including state attorneys general and Medicaid fraud control units, fetched daily and read into the same schema the detectors use. Each one links to the providers it names when the match is certain, and the newest is dated September 4, 2026. These are public records of charges, pleas, sentences and settlements, not findings by Verity.

DOJIndictedSep 4, 2026MA

Illegal Alien from Georgia Charged for Conspiracy to Launder Proceeds of $1.3B Health Care Fraud Scheme

Gugava purportedly owned ND Medical Solutions LLC, a durable medical equipment company that submitted at least $1.3 billion in fraudulent DME claims to Medicare and other insurers using stolen identities, and he opened bank accounts to deposit and transfer the fraud proceeds to overseas accounts.

$1.3B allegedMedicare, private insurance1 provider in Verity
DOJIndictedSep 4, 2026MA

Georgian National Charged for Conspiracy to Launder Proceeds of $1.3 Billion Health Care Fraud Scheme

Gugava allegedly served as purported owner of ND Medical Solutions, LLC, which submitted at least $1.3 billion in fraudulent durable medical equipment claims to Medicare and private insurers using stolen identities, and he opened bank accounts to deposit and transfer the proceeds overseas.

$1.3B allegedMedicare, private insurance1 provider in Verity
HHS-OIGArrestedAug 28, 2026

A Family Affair: Metairie Nurse Arrested for Medicaid Fraud

Handcock, listed as a Medicaid Direct Service Worker, claimed to have provided services to her son on the same dates and times she was working as an APRN with JeffCare, resulting in $1,282.50 in Medicaid payments.

$1K allegedMedicaid4 providers in Verity
HHS-OIGCivil settlementAug 27, 2026

The Villages Health System LLC Agrees to $541.5M Settlement to Resolve False Claims Act Allegations

The Villages Health System LLC self-disclosed that it caused the submission of false diagnosis codes in order to increase payments received from the Medicare Advantage program.

$541.5M orderedMedicare1 provider in Verity
DOJSentencedAug 27, 2026NC

Charlotte Woman Sentenced for Defrauding the North Carolina Medicaid Program

Jackson and her company submitted over $1.9 million in claims to NC Medicaid for urine drug testing and psychotherapy services that were never performed or already paid, using Medicaid recipients' personal information, and she spent the proceeds.

$1.9M alleged$1.6M orderedMedicaid2 providers in Verity
DOJPleaded guiltyAug 27, 2026MO

Kansas Chiropractor Pleads Guilty to Health Care Fraud

Laser submitted claims to Blue Cross and Blue Shield of Kansas City seeking payment for chiropractic services purportedly rendered on dates when patients had not visited Laser Chiropractic and received no treatment, including billing using the information of an individual who never received treatment.

private insurance1 provider in Verity
DOJPleaded guiltyAug 27, 2026CA

Anaheim Woman Pleads Guilty to Submitting More Than $2.2 Million in Fraudulent Hospice Care Claims to Medicare

Galbraith submitted approximately $2,266,694 in claims to Medicare for hospice services for beneficiaries who did not have a terminal illness with a life expectancy of six months or less, and Medicare paid her company approximately $2,140,606.

$2.3M allegedMedicare1 provider in Verity
DOJIndictedAug 27, 2026KY

Kentucky Medical Biller Indicted for Healthcare Fraud and Money Laundering Charges

Sanders recruited individuals to open behavioral health entities, handled their Kentucky Medicaid credentialing and enrollment, and directed submission of fraudulent Medicaid claims across ten behavioral health providers for services never provided, including for incarcerated, hospitalized, or deceased members, using licensed professionals' NPIs without authorization.

Medicaid
DOJPleaded guiltyAug 27, 2026DC

Behavioral Health Worker Pleads Guilty to Billing D.C. Medicaid for Therapy Sessions That Never Happened

Nassor, a Community Support Worker at a D.C. Medicaid behavioral health provider, conspired with company employees and other community support workers to bill D.C. Medicaid for mental health telehealth services that were never provided or were inflated, including documenting over 701 hours of telehealth across six patients when call records showed roughly 172 minutes.

$250K allegedMedicaid
HHS-OIGCivil settlementAug 26, 2026

The Villages Health System LLC Agrees to $541.5M Settlement to Resolve False Claims Act Allegations

The Villages Health System LLC self-disclosed that it caused the submission of false diagnosis codes to increase payments received from the Medicare Advantage program.

$541.5M orderedMedicare1 provider in Verity
DOJCivil settlementAug 26, 2026TX

Dallas medical clinic to pay $7.5 million to resolve COVID-19 testing overbilling allegations

Aymancare billed the federal government's HRSA Uninsured Program for separate evaluation and management services in addition to COVID-19 specimen collection and testing at pop-up testing sites when no such separate services were performed.

$7.5M orderedMedicare1 provider in Verity
DOJIndictedAug 26, 2026UT

Woman Charged with Health Care Fraud After Submitting False Claims to Utah Medicaid and Receiving Millions in Payout

Clark allegedly submitted fraudulent claims to Utah Medicaid for therapy services that were not rendered, rendered by unqualified and unlicensed providers, or not covered, using the NPI numbers of out-of-state providers, resulting in over $4 million in payments.

$4.0M allegedMedicaid
DOJCivil settlementAug 26, 2026CA

DermTech Inc. to Pay Up to $5M to Resolve Allegations It Submitted False Claims to Medicare for Unreliable Skin Cancer Tests

DermTech Inc. submitted claims to Medicare for skin cancer tests conducted with an unvalidated positive control range and for tests lacking sufficient patient RNA, and did not retract results or adequately refund Medicare.

$5.0M orderedMedicare
DOJCivil settlementAug 26, 2026CA

DermTech Inc. to Pay Up to $5M to Resolve Allegations It Submitted False Claims to Medicare for Unreliable Skin Cancer Tests

DermTech Inc. billed Medicare for skin cancer tests conducted using an unvalidated positive control range and for tests with insufficient patient RNA, and did not retract the results or adequately refund Medicare.

$5.0M orderedMedicare
HHS-OIGIndictedAug 25, 2026

Carr: Owner of Therapy Center Charged with $88k Medicaid Fraud in Fulton County

Maul is alleged to have continued billing Medicaid for services as if a deceased physician directly provided or supervised such services, including by affixing his name and signature to treatment notes dated after his death, receiving over $88,000 from August 2021 to September 2023.

$88K allegedMedicaid2 providers in Verity
DOJCivil settlementAug 24, 2026CA

Medicare Advantage Provider Monogram Health Agrees to Pay $2.4 Million to Settle False Claims Act Lawsuit

Monogram knowingly submitted diagnosis codes in four HCCs that were not clinically accurate, not supported by medical record documentation, and/or did not require or affect patient care, inflating Medicare Advantage beneficiaries' risk scores and causing CMS to make higher capitated payments to Medicare Advantage Organizations.

$2.4M orderedMedicare1 provider in Verity
DOJCivil settlementAug 24, 2026CA

Medicare Advantage Provider Monogram Health Agrees to Pay $2.4M to Settle False Claims Act Suit

Monogram Health knowingly submitted diagnosis codes within four HCCs that were not clinically accurate, not supported by medical record documentation, and/or did not require or affect patient care, inflating Medicare Advantage beneficiaries' risk scores and causing CMS to make higher capitated payments to MAOs.

$2.4M orderedMedicare1 provider in Verity
DOJIndictedAug 24, 2026GA

Southern District of Georgia federal indictments include murder, drug- and firearm-related charges and healthcare fraud

Perry Patalano was indicted for Healthcare Fraud, Theft of Government Money, Property or Records, and Aggravated Identity Theft.

HHS-OIGSentencedAug 20, 2026

Former Owner of Montgomery County-Based Home Care Agency Jailed for Multi-Million Dollar Medicaid Fraud Scheme

The former owner of a home care agency approved kickback arrangements, assigned phony caregivers to clients, and recruited clients as part of a scheme that submitted Medicaid claims for services that were not provided.

$1.8M alleged$1.8M orderedMedicaid1 provider in Verity
DOJIndictedAug 20, 2026NY

Four Members Of The “War Room” Charged In Connection With $12 Million Medicaid Fraud Scheme

Members of a Bronx-based racketeering organization known as the "War Room" fabricated ride data for methadone clinic transportation using a GPS spoofing application, paid Medicaid patients kickbacks in cash and drugs for their enrollment information, provided the fake data to transportation companies that submitted over $12 million in claims to Medicaid, and laundered the proceeds.

$12.0M allegedMedicaid
DOJIndictedAug 20, 2026NY

Four Members of the “War Room” Charged in Connection with $12M Medicaid Fraud Scheme

Four members of a Bronx racketeering organization known as the "War Room" fabricated medical transportation ride data using a ride-tracking app and GPS spoofing, paid Medicaid patients at methadone clinics kickbacks in cash and drugs for their enrollment information, provided the fake data to transportation companies that submitted over $12 million in Medicaid claims, and laundered the proceeds.

$12.0M allegedMedicaid
DOJSentencedAug 20, 2026MA

Former Owner of Telemedicine Companies Sentenced to Two Years in Prison for $110 Million Medicare Fraud Scheme

Through his telemedicine companies, Richardson generated prepopulated durable medical equipment orders signed by doctors and nurses without beneficiary contact and sold them to telemarketers who resold them to DME suppliers that billed Medicare for medically unnecessary equipment.

$110.0M allegedMedicare
HHS-OIGComplaint filedAug 18, 2026

Attorney General Raoul Seeks To Intervene In False Claims Act Lawsuit Against Chicago-Area Medical Practice And Billing Company Over Fraudulent Medicaid Claims

The complaint alleges that a podiatrist terminated from the Illinois Medicaid program, his practices and their billing companies submitted claims for services he performed under the names and NPIs of other physicians, and billed services by new physicians under established providers' NPIs to avoid credentialing, resulting in more than $5 million in false claims paid by Medicare and Medicaid.

$5.0M allegedMedicaid, Medicare, private insurance2 providers in Verity
HHS-OIGComplaint filedAug 18, 2026

United States and State of Illinois File Complaint in Intervention in False Claims Act Lawsuit Against Chicago-Area Medical Practice and Billing Company for Allegedly Submitting Fraudulent Medicare and Medicaid Claims

A Chicago-area medical practice and billing company knowingly submitted fraudulent claims to Medicaid and Medicare, resulting in the payment of more than $5.2 million in false claims.

$5.2M allegedMedicare, Medicaid
HHS-OIGCivil settlementAug 17, 2026

Attorney General James Secures $6 Million from Three Buffalo Nursing Homes for Years-Long Fraudulent Billing Scheme

From July 1, 2016 through December 31, 2020, the three nursing homes submitted false data to the New York Department of Health that inflated the amount of rehabilitative services certain residents needed, artificially increasing their Medicaid reimbursement rates, and reduced rehabilitation services during periods that did not affect those rates.

$9.0M orderedMedicaid, Medicare3 providers in Verity
DOJCivil settlementAug 17, 2026NY

Safire nursing homes agree to pay $9 million to resolve fraudulent Medicare and Medicaid billing allegations

The United States alleged that Safire submitted false claims to Medicare and Medicaid for skilled rehabilitative therapy services that were not reasonable or necessary, not supported by medical records, not documented as provided, or not provided at all, including by scheduling therapy based on insurer reimbursement policies, pressuring therapists and residents, and manufacturing or altering therapy referrals and medical records.

$9.0M orderedMedicare, Medicaid3 providers in Verity
HHS-OIGComplaint filedAug 17, 2026

U.S. Attorney’s Office Files Civil Complaint against Texas Corporation and North Carolina Man for Allegedly Defrauding Medicare

The U.S. Attorney's Office filed a civil complaint against two defendants for an alleged scheme to defraud Medicare.

Medicare
DOJPleaded guiltyAug 14, 2026

Ohio Man Pleads Guilty to Laundering Health Care Fraud Proceeds for Transnational Criminal Organization

Zarbavel opened bank accounts in Northeast Ohio for a Florida-based durable medical equipment company and facilitated the deposit, transfer, and withdrawal of approximately $3.4 million in health care fraud proceeds for a transnational criminal organization that submitted $1.42 billion in false and fraudulent claims to Medicare and other health insurers.

$1.4B allegedMedicare, private insurance1 provider in Verity
DOJPleaded guiltyAug 14, 2026FL

Ocala Mental Health Counselor Pleads Guilty to Aggravated Identity Theft and Wire Fraud

Forsythe used the names and insurance policy information of 22 individuals without their consent to bill two health insurance companies for counseling services she had not provided.

$483K orderedprivate insurance1 provider in Verity
HHS-OIGIndictedAug 13, 2026

Six Medicaid Providers Indicted on Fraud Charges

Six Medicaid providers were indicted for allegedly stealing a combined $558,383 by inflating claims, upcoding, billing for services never provided, and billing while working other jobs or when clients were hospitalized or deceased.

$558K allegedMedicaid4 providers in Verity
DOJConvictedAug 12, 2026FL

Cuban National Convicted of Unlawfully Obtaining US Citizenship After Concealing Healthcare Fraud Scheme

Rodriguez concealed on her naturalization application her participation in a seven-year healthcare fraud conspiracy that resulted in approximately $4.6 million in fraudulent healthcare claims.

$4.6M allegedMedicare
HHS-OIGSentencedAug 12, 2026

Former Brooklyn Bank Manager Sentenced to Prison for Laundering Proceeds of Medicare Fraud for Transnational Criminal Organization

A Brooklyn man was sentenced for conspiring to launder more than $8 million in health care fraud proceeds through a U.S. bank on behalf of a transnational criminal organization.

$8.0M allegedMedicare
DOJConvictedAug 12, 2026TX

Scammer pharmacist guilty in $20 million healthcare kickback scheme

Thomas paid over $2 million in kickbacks to the owner of a Houston clinic in exchange for referrals of DOL-OWCP insured patients prescribed high-reimbursement compounded medications, which his pharmacy then billed to DOL-OWCP, receiving more than $20 million in reimbursements.

$20.0M allegedprivate insurance
HHS-OIGPleaded guiltyAug 11, 2026

International Fugitive Pleads Guilty to Healthcare Fraud Conspiracy and Failure to Appear

Kimble pleaded guilty to conspiracy to defraud the United States and failure to appear after being charged for his role in a $1.2 billion telemedicine and durable medical equipment scheme involving health care fraud and anti-kickback violations.

$1.2B allegedMedicare
DOJCivil settlementAug 10, 2026TN

Celina Pharmacy Owner/Two Pharmacies Agree to Pay $450,000 & Receive Ban on Handling Controlled Substances

The defendants knowingly dispensed controlled substances without valid prescriptions and outside the usual course of professional pharmacy practice, and falsely billed Medicare for prescriptions that were not medically necessary or otherwise eligible for reimbursement.

$450K orderedMedicare, Medicaid2 providers in Verity
HHS-OIGComplaint filedAug 10, 2026

United States Intervenes in False Claims Act Lawsuit Against Colorado Medical Companies

The United States alleges that three Colorado healthcare companies and two individuals engaged in a scheme for nearly a decade to submit fraudulent claims for payment under federal health insurance programs.

Medicare, Medicaid5 providers in Verity
DOJCivil settlementAug 10, 2026MA

Veloxis Pharmaceuticals Agrees to Pay $46 Million to Resolve Criminal and Civil Liability for Kickback Scheme

Veloxis paid kickbacks in the form of lavish meals, alcohol, luxury resort stays, personal gifts and sham consulting payments to transplant health care professionals, and per-patient and per-month payments to specialty pharmacies, to induce prescriptions and purchases of Envarsus XR, causing false claims to federal health care programs and underreporting payments under the Open Payments Program.

$46.0M orderedMedicare, Medicaid, TRICARE
DOJCivil settlementAug 10, 2026MA

Veloxis Pharmaceuticals Agrees to Pay Over $46M to Resolve Criminal and Civil Liability for Kickback Schemes

Veloxis paid kickbacks in the form of lavish meals, alcohol, gifts, trips and resort stays, and purported consulting fees to health care providers, and per-patient and per-month payments to specialty pharmacies, to induce prescriptions and purchases of Envarsus XR, and concealed those payments through falsified expense reports that resulted in underreporting to CMS's Open Payments Program.

$46.0M orderedMedicare, Medicaid, TRICARE
DOJSentencedAug 10, 2026MA

CFO of Boston-Area Spinal Device Company Sentenced to Four Months in Prison for Kickback Scheme

The CFO of SpineFrontier conspired to pay and direct over $540,000 in bribes to surgeons in the form of sham consulting fees to induce them to use SpineFrontier's spinal implant products in surgeries paid for by federal health care programs.

$540K alleged$10K orderedMedicare, Medicaid
HHS-OIGIndictedAug 5, 2026

Nevada Doctor Charged with $95M Wound Care Fraud on Medicare

A federal grand jury indicted a doctor for a $95 million scheme to defraud Medicare by billing for medically unnecessary amniotic wound allografts that he and others applied to elderly Medicare patients.

$95.0M allegedMedicare1 provider in Verity
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