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 August 10, 2026. These are public records of charges, pleas, sentences and settlements, not findings by Verity.

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
DOJSentencedJul 8, 2026TN

Memphis Gynecologist Sentenced to 20 Years in Prison for Adulterating Medical Devices and Health Care Fraud

Kumar used adulterated and unlabeled single-use and improperly reprocessed reusable hysteroscopy devices in more than 15,000 hysteroscopy with biopsy procedures and billed Medicare and Medicaid for the procedures.

$41.0M allegedMedicare, Medicaid, private insurance2 providers in Verity
DOJSentencedJun 24, 2026TN

Celina Pharmacy Owner Sentenced for Opioid Distribution/Health Care Fraud

The majority owner of two pharmacies conspired to unlawfully dispense controlled substances despite red flags of abuse and diversion, submitted false claims to Medicare Part D and TennCare, and paid patient co-payments, cash, and "Monkey Bucks" to increase prescription volume.

$1.4M orderedMedicare, Medicaid1 provider in Verity
DOJChargedJun 23, 2026TN

Clarksville Physician Charged with Health Care Fraud Related to Controlled Substance Prescribing Scheme

Aquino owned and operated North Clarksville Medical Center and for more than five years prescribed medically unnecessary controlled substances, totaling more than 1.08 million pills and doses, that were not issued for a legitimate medical purpose in the usual course of professional practice, causing losses of approximately $335,621.73 to health care benefit programs.

$336K allegedMedicare, Medicaid1 provider in Verity
DOJIndictedJun 23, 2026TN

Gordonsville Physician Indicted on Health Care Fraud and Controlled Substance Charges

Moss owned and operated Gordonsville Clinic and prescribed medically unnecessary controlled substances, totaling more than 5.6 million pills and doses over more than eight years, that were not issued for a legitimate medical purpose in the usual course of professional practice.

Medicare, Medicaid2 providers in Verity
DOJSentencedJun 11, 2026TN

Multi-Million-Dollar Prescription Fraud Scheme Results In Prison Sentence For Three East Tennesseans

Defendants altered and forged pharmacy drug formularies signed by pain clinic providers and paid cash kickbacks to obtain them, and submitted the resulting claims through United Apothecary's Riddle Drugs pharmacies to drug plans, pharmacy benefit managers, and Medicare Part D for reimbursement, and separately paid kickbacks to out-of-state marketers for signed prescriptions.

$8.7M alleged$4.8M orderedMedicare, private insurance
DOJPleaded guiltyMay 7, 2026TN

Brentwood Woman Pleads Guilty to Defrauding Taxpayers Out of $6.9 Million

An optometric physician used her practice to submit false claims to Medicare, TennCare, and Federal Employees Health Benefits Programs for wound care products she had not purchased or used, splitting single-use products and directing staff to create false records for dates with no appointments.

$11.0M allegedMedicare, Medicaid, private insurance1 provider in Verity
DOJCivil settlementApr 28, 2026TN

U.S. Attorney's Office Reaches $300,000 False Claims Act Settlement with Clarksville Clinic Over Allegations of Improperly Coded TRICARE Claims

The clinic billed TRICARE for two units of a billing code per day per beneficiary when only one unit was allowed, and billed two different codes for certain services when only one code was payable, a practice referred to as unbundling.

$300K orderedTRICARE2 providers in Verity
DOJCivil settlementMar 30, 2026TN

American Health Companies, dba American Health Partners, Agrees to Pay Over Two Million Dollars to Resolve False Claims Act Liability Involving a Tennessee Nursing Home

The United States and Tennessee alleged that AHC Lewis County billed Medicare and TennCare for grossly substandard and/or worthless nursing home services, including failures in wound care, infection control, fall protection, prevention of weight loss and loss of range of motion, and overprescribing of antipsychotic medications, between 2019 and 2024.

$2.1M orderedMedicare, Medicaid1 provider in Verity
DOJConvictedMar 13, 2026TN

Federal Jury Convicts Three Women For Conspiracy To Commit Wire Fraud Related To Rocky Hill Pharmacy

The defendants conspired to defraud health benefit programs, including Medicare and TennCare, by altering healthcare provider prescriptions without authorization and submitting claims for payment for the added medications.

Medicare, Medicaid, private insurance3 providers in Verity
DOJConvictedJan 8, 2026TN

Federal Jury finds Memphis Physician Guilty of Adulterated and Misbranded Medical Devices and Health Care Fraud

From 2019 to 2024, Kumar submitted and caused his employees to submit fraudulent claims to Medicare and Medicaid for hysteroscopy with biopsy procedures that were not medically necessary and conducted with adulterated and misbranded devices.

$41.0M allegedMedicare, Medicaid, private insurance2 providers in Verity
DOJCivil settlementNov 18, 2025TN

Memphis Doctor to Pay $375,296.90 to Settle Fraudulent Billing Allegations

A Memphis nephrologist was alleged to have falsely billed Medicare for end-stage renal disease treatment visits to dialysis patients that he never actually performed.

$375K orderedMedicare1 provider in Verity
DOJPleaded guiltySep 11, 2025TN

Clay County Pharmacy Investigation and Prosecution Ends in Guilty Pleas

Pharmacy owners and pharmacists dispensed large volumes of controlled substances without legitimate medical purpose, submitted false claims for medically unnecessary controlled substance combinations to Medicare Part D and TennCare, and paid kickbacks, copayments, cash, and "Monkey Bucks" to recruit and retain patients.

$1.4M orderedMedicare, Medicaid1 provider in Verity
DOJIndictedJun 30, 2025TN

Hendersonville Doctor and Her Office Manager Husband Indicted as Part of the Department of Justice's 2025 National Health Care Fraud Takedown

Zhang, a medical doctor, and Mei, who billed, submitted approximately $20 million in claims to Medicare and Blue Cross Blue Shield between 2017 and 2025 for inpatient hospital physician services that were never provided, including for patients who were in nursing homes or deceased and for services exceeding twenty-four hours in a day.

$20.0M alleged$6.0M orderedMedicare, private insurance1 provider in Verity
DOJIndictedJun 30, 2025TN

Three West Tennessee Residents Charged in Connection with Over $28 Million in Alleged Health Care Fraud

Three defendants were charged with conspiracy to commit health care fraud and wire fraud for billing the Federal Employees' Compensation Fund through SarJo Pharmacy for medications that were not based on valid prescriptions and were not dispensed to injured United States Postal Service claimants.

$28.7M allegedprivate insurance1 provider in Verity
DOJSentencedJun 27, 2025TN

Lab Owner, Marketing Company Owner, and Doctor All Sentenced in Multi-Million Dollar Medicare and Medicaid Kickback Conspiracy

Laboratory owner paid illegal kickbacks to marketing companies that recruited elderly and low-income beneficiaries for genetic tests approved by telemedicine doctors paid $20 per order, and billed Medicare and Medicaid over $129 million for the tests.

$129.0M alleged$495K orderedMedicare, Medicaid2 providers in Verity
DOJSentencedApr 23, 2025TN

Memphis Woman Sentenced in Healthcare Fraud Scheme and Schemes to Defraud COVID-19 Relief Program

Cannady fraudulently billed Cigna Insurance for 24 hours a day of home healthcare when she knew the patients had only received 8 or 12 hours a day, and submitted six fraudulent PPP and EIDL applications containing false information for four businesses she controlled.

$540K orderedprivate insurance3 providers in Verity
DOJSentencedApr 14, 2025TN

Ashland City Doctor Sentenced to 3 Years for Conspiracy to Commit Health Care Fraud

Manning signed doctor orders and prescriptions for durable medical equipment, topical creams, and cancer genetic tests for telemedicine companies based on brief or no patient conversations in exchange for kickbacks and bribes, causing the submission of false and fraudulent claims to Medicare.

$41.1M alleged$20.6M orderedMedicare1 provider in Verity
DOJIndictedFeb 28, 2025TN

Acting United States Attorney Fondren Announces Federal Indictment Against Gynecologist for Sexually Abusing Patients, Adulterating Medical Devices for Reuse on Patients, and Healthcare Fraud

Kumar conducted medically unnecessary gynecologic procedures using reused or improperly reprocessed single-use medical devices and billed Medicare and Medicaid as if the procedures were medically necessary and as if a new or properly reprocessed device had been used.

Medicare, Medicaid1 provider in Verity
DOJIndictedDec 23, 2024TN

Jamestown Pharmacist Arrested and Charged with Health Care Fraud and Aggravated Identity Theft in a Multi-Million Dollar Health Care Fraud Scheme

Hall submitted false claims to Medicare, Medicaid, TRICARE, and Blue Cross Blue Shield for prescriptions for drugs that were medically unnecessary, not actually dispensed, or not ordered by a physician or other healthcare provider, and used other people's identification without authorization to obtain reimbursement.

$6.0M alleged$6.5M orderedMedicare, Medicaid, TRICARE, private insurance2 providers in Verity
DOJCivil settlementDec 23, 2024TN

Food City Agrees To Pay Over $8 Million To Settle False Claims Act Allegations Related To Opioid Dispensing

From Jan. 1, 2011, through Dec. 31, 2018, 24 Food City store pharmacies dispensed opioids and other controlled substances that were medically unnecessary, lacked a legitimate medical purpose or medically accepted indication, and/or were not dispensed pursuant to valid prescriptions, resulting in false claims to federal healthcare programs.

$8.6M orderedMedicare, Medicaid, TRICARE
DOJCivil settlementDec 23, 2024TN

Food City Agrees to Pay over $8M to Settle False Claims Act Allegations Related to Opioid Dispensing

From Jan. 1, 2011, through Dec. 31, 2018, 24 Food City store pharmacies dispensed opioids and other controlled substances that were medically unnecessary, lacked a legitimate medical purpose or medically accepted indication, and/or were not dispensed pursuant to valid prescriptions, resulting in false claims to federal health care programs.

$8.6M orderedMedicare, Medicaid, TRICARE, private insurance
DOJIndictedNov 4, 2024TN

Rocky Hill Pharmacy And Its Owners Indicted For Conspiring To Submit False Pharmacy Claims, Making False Statements, And Aggravated Identity Theft

The indictment alleges that the pharmacy's co-owners altered or forged prescriptions in support of claims for reimbursement to various drug plans, made false statements, and used the names and NPI numbers of another person without lawful authority.

Medicaid, private insurance3 providers in Verity
DOJConvictedNov 1, 2024TN

Lab Owner and Marketing Company Owner Both Found Guilty in Multi-Million Dollar Medicare and Medicaid Fraud Scheme

Defendants entered into sham contracts and paid illegal kickbacks in exchange for laboratory genetic tests obtained from elderly and low-income federal health care program beneficiaries and approved by telemedicine doctors who were paid kickbacks, resulting in over $100 million billed to Medicare and Medicaid.

$100.0M allegedMedicare, Medicaid2 providers in Verity
DOJConvictedOct 25, 2024TN

Tennessee Business Owner Convicted of $35M Fraud Scheme

Kestner, owner and operator of the Pain MD pain clinic network, pressured nurse practitioners and physician assistants to administer and bill approximately $35 million in medically unnecessary back injections billed as Tendon Origin Insertion injections to opioid-dependent patients.

$35.0M allegedMedicare, private insurance
DOJComplaint filedSep 11, 2024TN

United States Files Suit Against Pain Institute of Nashville, Michael Cox, Debbie Cox, and Related Entities

The complaint alleges that since at least 2014 the pain clinics and the Coxes knowingly submitted or caused to be submitted false claims for diagnostic testing services, including urine drug screens, allergy tests, and psychological tests, that were not medically necessary.

Medicare4 providers in Verity
DOJSentencedAug 1, 2024TN

Mt. Juliet Woman Sentenced for Long-Running Theft from Federal Health Care and Disability Programs

Caraballo used a stolen identity to apply for and obtain Social Security Disability Insurance payments and Medicare benefits for over a decade, with Medicare paying her health care expenses based on false claims.

$576K alleged$576K orderedMedicare
DOJCivil settlementJul 17, 2024TN

Kindred and Related Entities Agree to Pay $19.428 Million to Settle Federal and State False Claims Act Lawsuits Alleging Ineligible Claims for Hospice Patients

Kindred at Home and related hospice entities knowingly submitted false claims and retained overpayments for hospice services provided to patients who were not terminally ill and therefore ineligible for hospice benefits, and SouthernCare New Beacon paid remuneration to a consulting physician to induce hospice referrals.

$19.4M orderedMedicare, Medicaid, TRICARE
DOJCivil settlementJul 17, 2024TN

Kindred and Related Entities Agree to Pay $19.428M to Settle Federal and State False Claims Act Lawsuits Alleging Ineligible Claims for Hospice Patients

Kindred at Home and related hospice entities allegedly knowingly submitted false claims and retained overpayments for hospice services provided to patients who were not terminally ill and thus ineligible for hospice benefits, and SouthernCare New Beacon allegedly paid remuneration to a consulting physician to induce hospice referrals.

$19.4M orderedMedicare, Medicaid
DOJSentencedJul 9, 2024TN

Pain Clinic Owners Sentenced For Role In Operating Pill Mills In Tennessee And Florida

Tipton and co-defendants owned and operated pain clinics in Tennessee and Florida that distributed over 11 million tablets of oxycodone, oxymorphone, and morphine generating over $21 million in revenue, and Tipton pleaded guilty to conspiracy to launder money and two counts of conspiracy to defraud the United States and pay healthcare kickbacks.

$21.0M alleged2 providers in Verity
DOJSentencedJun 27, 2024TN

Podiatrist Sentenced for $4M Foot Bath Fraud Scheme

A podiatrist who owned a podiatry clinic and two pharmacies prescribed and dispensed medically unnecessary foot bath medications and caused his pharmacies to submit nearly $4 million in claims to Medicare and TennCare.

$4.0M allegedMedicare, Medicaid1 provider in Verity
DOJIndictedJun 27, 2024TN

National Health Care Fraud Enforcement Action Results In 193 Defendants Charged And Over $2.75 Billion In False Claims

Six defendants were charged by indictment with submitting, or causing the submission of, fraudulent claims to the Department of Labor Division of Energy Employees Occupational Illness Compensation Program for home health and skilled nursing services that were not actually rendered.

4 providers in Verity
DOJChargedJun 27, 2024TN

Middle District of Tennessee Charges Four Individuals Responsible for $15 Million in False Medicare Billing as Part of National Health Care Fraud Takedown

Four defendants were charged with selling and buying doctors' orders procured through kickbacks and billing Medicare for medically unnecessary genetic tests, durable medical equipment, and medications through DME companies and pharmacies.

$15.0M allegedMedicare
DOJConvictedMar 18, 2024TN

Podiatrist Convicted of $4M Foot Bath Fraud Scheme

A podiatrist prescribed and dispensed medically unnecessary foot bath medications through his in-house pharmacies and caused nearly $4 million in claims to Medicare and TennCare, chosen based on anticipated reimbursement rather than medical necessity.

$4.0M allegedMedicare, Medicaid2 providers in Verity
DOJCivil settlementJan 4, 2024TN

Memphis-Based Methodist Le Bonheur Healthcare and Methodist Healthcare-Memphis Hospitals Pay $7.25 Million to Settle Allegations that They Violated the False Claims Act

Methodist caused the submission of false claims to Medicare resulting from improper financial arrangements with the West Clinic, including kickbacks paid as part of its affiliation to induce referrals of Medicare beneficiaries.

$7.3M orderedMedicare3 providers in Verity
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