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 August 4, 2026. These are public records of charges, pleas, sentences and settlements, not findings by Verity.
The Fraud Division Announces Charges Against 19 Defendants for Medicaid Home Health Aid Schemes
Nineteen defendants, including owners and employees of home care companies, home health aides, and Medicaid recipients, were charged with submitting claims for home care services that were not provided, including claims for hours when purported aides were incarcerated, hospitalized, working other jobs, or traveling overseas.
Two Doctors, Physician’s Assistant Charged With Unlawfully Distributing Controlled Substances Via Voicemail “Refill Line”
From January 2020 through March 2025 the defendants allegedly operated a voicemail refill line that allowed patients to receive refills of Schedule II controlled substance prescriptions, namely oxycodone and amphetamine, without interacting with a licensed prescriber, and submitted prescriptions in another medical professional's name to deceive pharmacies.
Scranton Woman Charged With Conspiracy To Commit Bank Fraud With Funds Derived From Federal Health Care Programs
Beaubrun is alleged to have stolen and appropriated checks intended by Entity #1 for various payees, including funds derived from Medicare and Medicaid, and endorsed them to herself, causing a loss of over $300,000.
Ahold Delhaize USA Inc. to Pay $40M for Allegedly Reporting Inflated Drug Prices on Claims to Federal Healthcare Programs
Ahold Delhaize's in-store retail pharmacies operated prescription savings programs offering discounted prices but failed to report those discounted prices as their "usual and customary" prices on claims to Medicare Part D, Medicaid and TRICARE, causing those programs to pay inflated amounts.
Ahold Delhaize USA Inc. to Pay $40M for Allegedly Reporting Inflated Drug Prices on Claims to Federal Healthcare Programs
Ahold Delhaize supermarket pharmacies operated prescription savings programs offering discounted prices but failed to report those discounted prices as their "usual and customary" prices on claims to Medicare Part D, Medicaid, and TRICARE, causing those programs to pay inflated amounts.
Florida Man Pleads Guilty In Health Care Fraud And Kickback Scheme Involving “Foot Baths”
Suess and codefendants acquired control of pharmacies and billed health insurance for medically unnecessary prescription drug combinations known as "foot baths" using prechecked templated order forms obtained at health fairs, paid kickbacks for those orders, and obstructed the investigation with a false marketing services agreement.
Consent Judgment Entered Against Bucks County Company Resolving Allegations of False Claims for Billing Group Art Classes in Assisted Living and Adult Day Facilities as Occupational Therapy
The United States alleged Segal Arts and its owner submitted or caused the submission of Medicare claims for one-on-one occupational therapy services that were not provided, having instead provided group arts-and-crafts sessions to beneficiaries at assisted living and similar facilities.
Aetna Agrees to Pay $117.7 Million to Resolve Allegations that it Violated the False Claims Act by Submitting or Failing to Correct Inaccurate Diagnoses for Medicare Advantage Enrollees
Aetna submitted or failed to withdraw inaccurate and untruthful diagnosis codes for its Medicare Advantage enrollees, including through a chart review program and morbid obesity codes inconsistent with recorded BMI, to increase payments from CMS.
Founders/Owners of Hertel & Brown Physical and Aquatic Therapy Each Sentenced to Six Years in Prison and Fined $250,000 for Wire and Healthcare Fraud Conspiracy
Hertel and Brown led a conspiracy at Hertel & Brown Physical and Aquatic Therapy that used unlicensed technicians to treat patients while billing insurers as if licensed physical therapists provided the treatment, billed more treatment time than the clinics were open, and tampered with patient schedules to make group treatment appear to be one-on-one treatment.
Business Owner Sentenced to More Than Five Years in Prison for Fraud and Money Laundering Schemes
Yeghiazaryan committed fraud offenses targeting government programs using shell companies and false identities, including participating in a scheme to defraud Medicaid and pandemic relief programs, and money laundering.
Bucks County Home Care Company and Its Owners and Managers Charged in Alleged Health Care Fraud Scheme
Favorite Home Care, LLC and its owners and managers billed Medicaid and a Medicaid Managed Care Organization for home health services that were not rendered, completing electronic visit verification calls attesting to providing services when they were not present with the client.
Physician Sentenced to 14 Years for Illegal Distribution of Opioids and Health Care Fraud Conspiracies
Anand conspired to submit false and fraudulent claims to Medicare, OPM, Independence Blue Cross, and Anthem for "Goody Bags" of medically unnecessary prescription medications dispensed by his in-house pharmacies, and conspired to distribute oxycodone outside the usual course of medical practice, including prescriptions written by unlicensed medical interns on pre-signed blank prescriptions.
Owner of Facility for Intellectually Disabled Adults Pleads Guilty to Health Care Fraud
Oliver-Hollis, an enrolled Medicaid provider operating Serenitycare LLC under Pennsylvania's Home and Community-Based Services Waiver Program, failed to sufficiently staff homes housing intellectually disabled adults and submitted weekly claims falsely representing proper staffing between 2018 and 2023.
United States Intervenes and Sues ProMedica Health System, Inc. and Its Affiliates for Providing Grossly Substandard Nursing Home Services
The United States alleged that four nursing homes owned and controlled by ProMedica provided non-existent or grossly substandard skilled nursing facility care from 2017 to 2023, failed to develop or follow individualized care plans, and in some cases falsely documented in resident medical records that care had been provided when it had not.
United States Intervenes and Sues ProMedica Health System, Inc. and Its Affiliates for Providing Grossly Substandard Nursing Home Services
The United States alleged that four nursing homes owned by ProMedica provided non-existent or grossly substandard skilled nursing facility care, failed to develop or follow individualized care plans, and falsely documented in resident medical records that care had been provided when it had not.
Superseding Indictment Against Pittsburgh Health Care Facility Owner Adds Charges of Social Security Fraud and Concealing Material Facts Related to Health Care Matters
As owner of SerenityCare LLC, Oliver-Hollis schemed to overbill Pennsylvania Medicaid in connection with services provided to residents with intellectual disabilities, and misused Social Security benefits as a representative payee.
Bensalem Woman Charged in Home Care Fraud Kickback Scheme That Caused Loss to Medicaid of Nearly $1.1 Million
Patel is alleged to have received kickbacks to refer home care patients to home care agencies, forged doctor signatures on eligibility certification forms, and used individuals' personal information without their knowledge to bill Medicaid for home care services never provided.
Ohio Based Nonprofit and Affiliated Nursing Homes Agree to Pay $3.61M to Resolve False Claims Act Liability
The nonprofit, its management affiliate, and three affiliated nursing homes billed Medicare and Medicaid for grossly substandard skilled nursing services between 2016 and 2018, including failures in infection control, staffing, resident care plans, unnecessary medications, and unsafe or unsanitary conditions.
Pittsburgh-Area Nursing Home Companies Ordered to Pay More Than $15 Million in Restitution for Health Care Fraud
Companies operating two nursing homes falsified staffing information provided to the Pennsylvania Department of Health and CMS to show the facilities were in compliance with the conditions of participation in Medicare and Medicaid and to evade penalties.
Business Owner Pleads Guilty to Fraud and Money Laundering Schemes
The defendant pleaded guilty to conspiracy, health care fraud, wire fraud and money laundering, admitting he used shell companies and false identities to defraud government programs including the SBA Economic Injury Disaster Loan program, the Pandemic Unemployment Assistance Program, and Medicaid.
Philadelphia Man Pleads Guilty to Defrauding the Government of More Than $1 Million in SNAP, Medicaid Benefits
Sessoms used stolen and fictitious identities and Social Security numbers, along with fraudulent identification and birth certificates, to file false applications for SNAP and Medicaid benefits and sold the fraudulently acquired SNAP cards, causing a total government loss of $1,063,633.
Former Owner Of York Pain Management Practice Sentenced To 42 Months For Health Care Fraud, Money Laundering, And Theft Of Public Money
Yentzer agreed with others to defraud Medicare by submitting medically unnecessary urine drug tests for chronic opioid patients at clinics he controlled, laundered the proceeds for personal benefit, and obtained over $191,000 in HHS COVID-19 provider relief funds after the clinics closed.
Genetic Testing Marketing Companies Genexe, LLC and Immerge, Inc. and Two Executives Agree to Pay $6 Million to Resolve Allegations of Fraudulent Medicare Claims
Genexe, Immerge, Green, and Gross allegedly participated in schemes that caused Medicare to pay claims for genetic testing that was medically unnecessary and procured through kickbacks, paying independent contractors to collect swabs from beneficiaries and paying providers for test orders while receiving a portion of laboratory Medicare reimbursements.
Physician Convicted at Trial for Illegal Distribution of Opioids and Healthcare Fraud Conspiracies
Anand conspired to submit false and fraudulent claims to Medicare, OPM health plans, Independence Blue Cross, and Anthem for "Goody Bags" of medically unnecessary prescription medications dispensed by his in-house pharmacies, required patients to take them to receive controlled substance prescriptions, conspired to distribute oxycodone outside the usual course of professional practice using blank pre-signed prescriptions written by unlicensed medical interns, and transferred approximately $1.2 million of proceeds into an account in his father's name.
Harrisburg Woman Sentenced To 41 Months in Prison for Health Care Fraud And Bank Fraud Charges
Mbaya, president of a home health care agency, submitted fraudulent Medicaid claims for services that were not provided or were inflated, and submitted falsified records to four financial institutions to obtain loans and lines of credit.
Philadelphia Mental Health Clinic and Its Psychiatrist Owner Agree to Pay $900,000 to Resolve False Claims Act Lawsuit for Alleged Medicaid Fraud
Defendants allegedly billed Medicaid for medication management appointments that were shorter than the required 15 minutes and falsely recorded start and end times in patient files, including overlapping times for multiple patients.
Seven Defendants Charged In Health Care Fraud And Kickback Scheme Involving “Foot Baths”
Seven defendants allegedly conspired to bill health insurances for medically unnecessary prescription drug combinations known as "foot baths" routed through Sterling Pharmacy, paid kickbacks for referral of signed foot-bath order forms, used another physician's NPI without knowledge, and obstructed the investigation with false backdated records.
Harrisburg Woman Pleads Guilty To Health Care Fraud And Bank Fraud Charges
Mbaya, president of a home health care agency, submitted fraudulent Medicaid claims for services that were not provided or inflated claims and submitted falsified records to four financial institutions to obtain loans and lines of credit.
Generic Pharmaceutical Company Pays $25 Million to Resolve False Claims Act Liability for Price-Fixing of Generic Drugs
The government alleged that between May 1, 2013 and December 31, 2015, Teva paid and received compensation prohibited by the Anti-Kickback Statute through arrangements on price, supply, and allocation of customers with other pharmaceutical manufacturers for two generic drugs, pravastatin and tobramycin.
Lehigh Valley-Area Doctor Agrees to Pay $45,000 to Resolve False Claims Act Liability
Ailawadi caused the submission of false claims by billing EGD procedures using CPT Code 43239 without the reduced service modifier 52 when the duodenum was deliberately not examined.
Hollidaysburg Couple Sentenced For Conspiracy To Defraud The United States And Health Care Fraud Conspiracy
John H. Johnson conspired with Rodney L. Yentzer to bill health insurance programs for urine drug tests through pain management practices, including a pass-through arrangement with a Critical Access Hospital that paid $900 per test in kickbacks, and he and Paula Z. Johnson conspired to evade his restitution payments to the United States by funneling money to them through the practice's payroll and other payments.
Philadelphia Woman Sentenced to 20 Months in Prison for Conspiring to Defraud Medicaid
Kredens conspired with companies purportedly supplying home-based personal assistance services by paying Medicaid recipients cash instead of providing services and recruiting people to be employed on paper so the companies could bill Medicaid managed care organizations for services not rendered.
Penn Highlands Healthcare to Pay $735,000 to Settle False Claims Act Allegations
The United States alleged that from July 1, 2009 through June 30, 2012 Penn Highlands DuBois violated the Stark Law by paying $420,000 in improper compensation to referring physician Gary Ott and to a physician employed by his practice for employment services allegedly performed before the agreement went into effect, and submitted claims to Medicare and Medicaid resulting from those violations.
Florida Man Sentenced to 10 Years in Prison and Ordered to Pay More Than $97 Million in Restitution for Participation in Multiple Health Care Fraud and Kickback Schemes
Hurt conspired to commit health care fraud and to pay and receive kickbacks through schemes involving medically unnecessary compounded medication prescriptions billed to TRICARE, CHAMPVA and other insurers and cancer genomic testing billed to Medicare through Ellwood City Medical Center and laboratories he owned.
Pittsburgh Health Care Facility Owner Indicted on 33 Counts, Including Fraud, Money Laundering, and Making False Statements Related to Health Care Matters
As owner of SerenityCare LLC, Oliver-Hollis schemed to overbill Pennsylvania Medicaid by submitting false and fraudulent claims regarding the care and staffing provided to residents with intellectual disabilities, causing an overpayment in excess of $2 million.
United States Files Lawsuit Alleging Medicaid Fraud by Philadelphia Mental Health Clinic and Its Owner
The United States filed a civil complaint alleging that Nueva Vida and its owner billed Medicaid for psychiatric medication management appointments and other services that did not occur as billed, including med checks billed as at least 15 minutes when less time was spent and services for patients who were hospitalized elsewhere.
Hollidaysburg Couple Pleads Guilty To Conspiracy To Defraud The United States And Husband Pleads Guilty To Health Care Fraud
A physician and his business partner billed health insurance programs for urine drug tests through pain management practices and a pass-through arrangement with a Critical Access Hospital that paid $900 per test in kickbacks, and the physician and his wife conspired to evade his court-ordered restitution payments by funneling money to them through the practice payroll and other payments.
Physician Pays $95,000 to Resolve Allegations of Genetic Testing Fraud
A physician referred more than 400 patients for medically unnecessary genetic tests paid for by Medicare based on brief telemedicine consultations or no consultation, with no medical relationship with the patients.
Medical Doctor To Pay $60,000.00 To Resolve Civil Liability For Alleged Violations Of The False Claims Act
Between April 2015 and December 2015, Dr. Baddick prescribed the opioid medication Subsys to patients who did not have a cancer diagnosis without a legitimate medical purpose outside the usual course of professional practice, then billed Medicaid and Tricare for the visits associated with those prescriptions.
Former Delaware Specialty Pharmacy Chief Marketing Officer Agrees to Six-Year Exclusion from Federal Healthcare Programs for Allegations of Kickback and False Claims Act Violations
The former Chief Marketing Officer of a specialty pharmacy agreed to a six-year federal health care program exclusion to resolve allegations that she orchestrated a scheme to routinely waive Medicare and TRICARE patient copays without regard to financial hardship and to provide gifts, dinners, and free administrative and clinical support services to physicians to induce patient referrals.