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 June 23, 2026. These are public records of charges, pleas, sentences and settlements, not findings by Verity.

DOJChargedJun 23, 2026VA

U.S. Attorney’s Office announces charges against three defendants in the Eastern District of Virginia as part of national health care fraud takedown

Three defendants were charged with fraudulently billing Medicaid for mental health services that were not provided and with submitting false claims to Medicare through a straw-owned durable medical equipment company.

$50.7M allegedMedicare, Medicaid3 providers in Verity
DOJSentencedJun 5, 2026VA

Medicaid service providers sentenced for false statements resulting in overbilling

Wright and Winfield instructed CCR employees to falsely claim in progress notes that children received therapeutic day treatment services from 2:00pm to 7:00pm, including providing prefilled progress note templates, resulting in overbilling to Medicaid.

Medicaid
DOJCivil settlementApr 27, 2026VA

Tri-Area Community Health Agrees to Pay $513,000 to Resolve Medicare Billing Allegations

Tri-Area Community Health billed Medicare for Annual Wellness Visits provided by pharmacists without appropriate physician supervision that were billed under the names of physicians not involved with the visits.

$514K orderedMedicare
DOJSentencedMar 17, 2026VA

Six Sentenced in Healthcare Fraud Conspiracy that Stole $10 Million from Medicaid Over Six-Year Period

Six defendants conspired to submit false claims to Virginia Medicaid on behalf of 1st Adult N Pediatric Healthcare Services for nursing and personal care services that were not provided, including falsifying records and paying parents or guardians of patients for blank, signed nursing notes.

$10.0M alleged$10.0M orderedMedicaid3 providers in Verity
DOJIndictedMar 11, 2026VA

Victim Advisory- Divine Youth Case Updates

Divine Youth Counseling submitted more than $11 million in fraudulent Medicaid claims for Crisis Stabilization and Mobile Crisis services by falsely claiming two mental health professionals provided Team Treatment services and paid more than $470,000 in kickbacks in the form of hotel rooms for Medicaid recipients.

$11.0M allegedMedicaid3 providers in Verity
DOJSentencedJan 9, 2026VA

Pain Clinic Owner Sentenced, L5 Medical Holdings to Pay Nearly $5 Million in Restitution

Barnes and L5 Medical Holdings operated pain clinics that billed Medicare and Virginia Medicaid for patient interactions with non-medical professionals and under providers who had not seen the patient, and ordered the maximum amount of urine drug tests insurance would pay for regardless of medical need, along with illegally prescribing Suboxone and opioids.

$5.1M orderedMedicare, Medicaid, private insurance1 provider in Verity
DOJConvictedDec 15, 2025VA

Federal jury convicts North Chesterfield man for billing Medicaid for services he did not provide

Boykins, a Qualified Mental Health Professional authorized to bill Medicaid for Mental Health Skill-Building Services, caused his employers to submit false Medicaid claims for services he did not provide, including on dates he was outside the United States.

Medicaid
DOJCivil settlementNov 25, 2025VA

Adult residential group homes operator settles healthcare fraud claims

Sola, Inc. billed Virginia Medicaid for skilled and other nursing services for its group home residents that exceeded the total number of hours worked by its nurses as reported on nurses' time sheets.

$641K alleged$2.0M orderedMedicaid
DOJPleaded guiltySep 16, 2025VA

Three More Plead Guilty In 1st Adult N Pediatric Healthcare Fraud Case

Owners and employees of a Medicaid-enrolled home health agency conspired to submit false claims to Medicaid for nursing and personal care services that were not provided, including paying patients' family members for blank signed nursing notes that were filled out to support the claims.

Medicaid3 providers in Verity
DOJPleaded guiltySep 16, 2025VA

Roanoke Home Health Care Attendant Pleads Guilty to Health Care Fraud

Dowdy submitted fraudulent timesheets and billed Medicaid for 1,970.5 hours of personal home health care and respite services that were not rendered to two Medicaid recipients.

$25K alleged$25K orderedMedicaid
DOJIndictedSep 11, 2025VA

Media Advisory- Chesapeake Regional Medical Center (CRMC) Case Updates

CRMC was charged with conspiracy to defraud the United States and health care fraud related to its billing to insurance companies for Dr. Javaid Perwaiz's performance of surgeries and other procedures at its facility, including unnecessary hysterectomies, elective inductions before 39 weeks without medical justification, and sterilizations of Medicaid patients without consent forms signed 30 days in advance.

$18.5M allegedMedicaid, private insurance1 provider in Verity
DOJPleaded guiltySep 8, 2025VA

Owners of 1st Adult N Pediatric Healthcare Pled Guilty

Owners and employees of a Medicaid-enrolled home health agency conspired to submit false claims to Medicaid for services not provided, including falsifying records and paying parents or guardians of patients for blank, signed nursing notes used to support billing.

Medicaid3 providers in Verity
DOJPleaded guiltyAug 27, 2025VA

Maryland Woman Pleads Guilty to Conspiracy to Commit Healthcare Fraud

The defendants conspired to submit false claims to Medicaid for nursing services that were not provided or were in excess of services provided, including paying parents or guardians of patients for blank, signed nursing notes and falsifying records to support the claims.

Medicaid3 providers in Verity
DOJSentencedAug 27, 2025VA

Danville Woman Sentenced for Health Care Fraud

Farrish submitted and approved fraudulent timesheets claiming 9,819 hours of personal care attendant services from her estranged husband that were never performed, causing a loss to Virginia Medicaid of $116,536.

$117K alleged$117K orderedMedicaid
DOJCivil settlementAug 11, 2025VA

Richmond psychotherapist convicted of healthcare fraud to pay over $1M

A licensed clinical social worker submitted at least $335,824.31 in fraudulent claims to Virginia Medicaid and Medicare for services that were not rendered, including billing for more than 16 hours of services in one day and using billing codes for more complex services than provided, supported by false psychotherapy progress notes.

$336K alleged$1.2M orderedMedicaid, Medicare1 provider in Verity
DOJSentencedJul 8, 2025VA

Former Chief Operating Officer of Pain Care Centers Sentenced

The former chief operating officer of L5 Medical Holdings, doing business as Pain Care Centers, helped conceal illegal prescribing and healthcare fraud at the clinics, including directing medical decisions by non-medical staff, using doctors' prescribing credentials for patients they had not seen, and implementing drug testing policies that inflated bills to medical insurers.

Medicaid, private insurance1 provider in Verity
DOJChargedJun 30, 2025VA

U.S. Attorney Erik S. Siebert announces charges as part of DOJ’s national health care fraud enforcement action

Six defendants were charged with schemes including billing Medicare and Medicaid for FDA-unapproved ozone injections falsely billed as nerve blocks and for ultrasound guidance not used, overcharging Medicaid for environmental modifications by hiding profit margins in subcontractor costs, billing Medicaid for group home services when recipients were absent, submitting claims to CareFirst BlueCross BlueShield using physicians' NPIs for services not provided or prescribed, and tampering with a Pyxis machine by substituting fentanyl and Versed syringes.

$5.2M allegedMedicare, Medicaid, private insurance5 providers in Verity
DOJSentencedJun 11, 2025VA

Doctor at L5 Pain Clinic Sentenced to 40 Months in Prison, Ordered to Pay $35,000 Fine and $200,000 in Forfeiture

Dixon pre-signed blank prescriptions for Schedule II opioids at L5 pain clinics, shared his controlled substance identification number with unqualified providers, approved and signed patient files for patients he had not treated to obtain insurance payments, and failed to report a pattern of health care fraud.

$235K orderedMedicaid, private insurance1 provider in Verity
DOJSentencedMay 23, 2025VA

Three people sentenced to prison for scheme to bill Medicare for millions of dollars in unnecessary medical equipment

Three people created and operated a durable medical equipment supplier, NOVA DME, that concealed its true owner from Medicare and billed Medicare approximately $13.5 million for unnecessary and unwanted equipment based on unvetted leads from foreign co-conspirators, laundering proceeds through a shell company.

$13.5M alleged$2.3M orderedMedicare1 provider in Verity
DOJSentencedMar 12, 2025VA

Hampton man sentenced to over nine years in prison for defrauding Virginia Medicaid and Virginia Unemployment

Burch targeted Medicaid recipients to enroll in consumer directed personal and respite care services, used the personal identifying information of recipients and purported personal care attendants to submit and approve fraudulent timesheets for services never provided, and also submitted fraudulent unemployment applications using PCAs' identities.

$937K alleged$953K orderedMedicaid
DOJPleaded guiltyFeb 25, 2025VA

Danville Woman Pleads Guilty to Health Care Fraud

Farrish claimed 9,819 hours of personal care attendant services purportedly provided by her estranged husband that were never rendered, submitting fraudulent timesheets and causing a Medicaid loss of $116,536.

$117K allegedMedicaid
DOJIndictedJan 8, 2025VA

Chesapeake hospital indicted for healthcare fraud involving unnecessary surgical procedures

A federal grand jury indicted Chesapeake Regional Medical Center for healthcare fraud and conspiracy, alleging it granted and renewed privileges to Javaid Perwaiz despite knowing of his prior privilege termination for unnecessary surgeries and felony convictions, and billed health care benefit programs for medically unnecessary surgeries, pre-39-week elective inductions, misclassified inpatient surgeries, and sterilizations without valid consent forms.

$18.5M allegedMedicare, Medicaid, TRICARE, private insurance1 provider in Verity
DOJSentencedJan 7, 2025VA

Pharmacy Owner Sentenced to Imprisonment for Health Care Fraud

Yost dispensed cheaper generic medications while billing government health care programs for more expensive brand name drugs, billed for medications not dispensed, and rebilled returned medications without reversing the original charges.

$1.3M alleged$1.3M orderedMedicare, Medicaid, TRICARE, private insurance1 provider in Verity
DOJCivil settlementJan 2, 2025VA

Virginia Beach doctor agrees to $625,000 False Claims Act settlement

Saffold and Chesapeake Bay ENT billed federal and state payors for balloon sinus dilations that were not medically necessary, staged procedures to increase reimbursement, and billed endoscopies with sphenoid sinusoscopy under CPT Code 31235 when that service was not performed.

$625K orderedMedicare, Medicaid, TRICARE3 providers in Verity
DOJCivil settlementNov 15, 2024VA

Virginia hospital system agrees to $2.37M False Claims settlement

Inova submitted claims to Medicaid for sterilization and hysterectomy procedures that contained documentation improperly modified by or at the request of one or more Inova employees, resulting in claims containing falsified information.

$1.6M alleged$2.4M orderedMedicaid1 provider in Verity
DOJCivil settlementOct 15, 2024VA

Virginia Contractor Settles False Claims Act Liability for Failing to Secure Medicare Beneficiary Data

AFDS and a subcontractor stored screenshots from CMS systems containing personally identifiable information and potentially personal health information of Medicare beneficiaries on the subcontractor's server without individually encrypting the files, in violation of AFDS' contractual cybersecurity requirements, and AFDS knowingly billed CMS in violation of those requirements.

$307K orderedMedicare
DOJPleaded guiltySep 3, 2024VA

Four defendants plead guilty to defrauding Virginia Medicaid

Defendants signed up Medicaid recipients for consumer directed personal and respite care services and submitted fraudulent timesheets for services that were never provided, causing Medicaid to pay at least $936,950.70.

$937K allegedMedicaid
DOJPleaded guiltyAug 27, 2024VA

Suffolk services provider pleads guilty to healthcare fraud

Guyton billed Virginia Medicaid through her company Synergy Health Systems for personal care, respite, and mental health skill building services using falsified records, forged RN and LCSW signatures on assessments, and inflated time, obtaining approximately $1,320,088.

$1.3M allegedMedicaid4 providers in Verity
DOJConvictedAug 20, 2024VA

Powhatan man convicted of federal healthcare fraud

Davis directed employees of his Medicaid-enrolled company to bill the maximum allowable service units per day for non-reimbursable activities, resulting in billing Medicaid for five hours of therapeutic day treatment when only two or three hours of care were provided.

$218K allegedMedicaid1 provider in Verity
DOJChargedJun 27, 2024VA

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

The Justice Department charged 193 defendants, including 76 licensed medical professionals, in 32 federal districts for participation in health care fraud schemes involving approximately $2.75 billion in intended losses, including amniotic wound graft billing, unlawful distribution of Adderall and other stimulants, distribution of adulterated and misbranded HIV medication, addiction treatment fraud, and telemedicine and laboratory fraud.

$2.8B alleged$231.0M orderedMedicare, Medicaid
DOJSentencedMar 21, 2024VA

Doctor at L5 Pain Clinic Sentenced to 18 Months in Prison, Ordered to Pay Over $200,000

Randall allowed other medical providers at L5's pain clinics to use his DEA registration number to prescribe Suboxone in his name for patients he never saw, and was paid over $300,000 for renting out his DEA credentials and for supposed supervision of nurses.

$300K alleged$205K ordered1 provider in Verity
DOJIndictedJan 9, 2024VA

Nine Indicted in Federal Health Care Fraud Probe

Nine defendants, including owners and employees of a Medicaid-enrolled home health agency, are alleged to have conspired to submit false claims to Medicaid for services that were not provided to patients, including falsifying records and documentation in support of the fraudulent claims.

Medicaid4 providers in Verity
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