Providers
All 16 in KY
PIONEER HEALTH GROUP LLC
NPI 1023691599, organization, Louisa, KY, Family Medicine, Addiction Medicine
1
Evidence tier
adjudicated in a public enforcement record
- Adjudicated (civil judgment) per an HHS-OIG enforcement record dated July 27, 2026.
- No Medicaid payments in the last 12 observed months.
score 90 of 100, rank 474, $0 at stake
National provider registry
From the CMS NPPES Registry, refreshed daily.
| Name | PIONEER HEALTH GROUP LLC |
| Type | Organization |
| Status | Active |
| NPI issued | May 3, 2021, last updated May 3, 2021 |
| Practice location | 125 S MAIN CROSS ST, Louisa, KY 41230-1065, 606-639-0938 |
| Authorized official | VICTOR ORLOV (Director of Credentialing) |
| Specialties | Family Medicine, Addiction Medicine (207QA0401X, primary) |
In this area
16 providers in Lawrence County, KY carry an indicator in the public record, with $72.8M at stake between them. The most common is more hours than a day holds, on 13 of them, followed by named in an enforcement record on 2. 2 are tier 1: documented action, then payment.
| tier | provider | at stake | why |
|---|---|---|---|
| 1 | PIONEER HEALTH GROUP LLC Louisa, KY, ranked 47 | $2.9M |
|
| 1 | PIONEER HEALTH GROUP LLC Louisa, KY, ranked 639 | $0 |
|
| 3 | MCKENZIE HEALTH CARE, LLC Louisa, KY, ranked 3271 | $0 |
|
| 4 | MATTHEW PIERZALA Louisa, KY, ranked 8667 | $2.3M |
|
| 4 | SARA MARTIN Louisa, KY, ranked 9205 | $514K |
|
| 5 | SARAH CAMPBELL Louisa, KY, ranked 9886 | $5.6M |
|
| 5 | TRACEY JOHNSON Louisa, KY, ranked 10640 | $15.6M | |
| 5 | JESSICA RIDDLE Louisa, KY, ranked 10648 | $13.0M |
Recent enforcement in KY
All releasesDepartment of Justice and HHS-OIG releases for this state, newest first. Each opens in a new tab.
DOJIndictedAug 27, 2026
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.
DOJChargedJun 23, 2026
5 Individuals and 2 Companies Charged as Part of Department of Justice National Health Care Fraud Takedown
Seven defendants were charged in four cases with schemes including billing Kentucky Medicaid for peer support and psychoeducation services that were fraudulent, unauthorized, or not rendered using providers' NPIs, using a DEA number to order controlled substances in others' names, credentialing a company with Medicare and billing for services not rendered using a doctor's NPI, and stealing controlled substances from hospitals and falsely documenting administration.
DOJCivil settlementJun 23, 2026
Civil Settlements Reached as Part of Department of Justice National Health Care Fraud Takedown
Three Home and Community Based Waiver providers and their owners, who had shared financial interests, referred Medicaid waiver beneficiaries for attendant care services and billed Medicaid for attendant care hours that were not fully provided or not provided at all.
DOJCivil judgmentMay 15, 2026
Operators of Day Treatment Program for Children Agree to $15.2 Million Civil Judgment to Resolve Medicaid Fraud Allegations
The Government alleged that from August 2022 through June 2025 the Recovery Centers sought Medicaid payments for time children spent on education, recreation, and lunch breaks at the Aspire Day Program and that Recovery Center of Kentucky falsely represented clinician qualifications to obtain higher reimbursements.
DOJSentencedApr 24, 2026
Former Sober Home Owner and Operator Sentenced for Kickback Conspiracy and Health Care Fraud
Jordan solicited and received kickbacks in exchange for referring urine drug testing from her sober home company to three labs, and Serenity Keepers billed Medicaid for peer support services not provided by licensed peer support specialists, with Williams reporting that residents received six hours of peer support services per day knowing that was not true.
Referral packet
The packet is a draft for a reviewer. It reads every public record behind this case, states what the records show with a citation for each finding, names the regulation each finding relates to, and lists the ordinary explanations to rule out first. It never asserts intent.