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sophiamostel: Springhill Care Group : 2012 U.S. Healthcare: UCR or '$99,750 Ear Wax Fraud'? Aetna Wants Court to Stop Hospital's UCR Billing On Dec 7, 2011, Aetna filed a lawsuit against two PPO surgeons and one out-of-network (OON) hospital, in the District Court, Harris County, Texas. Aetna lawsuit seeks to recover damages and attorneys' fees and for court temporary injunction to stop the OON hospital's UCR billing and PPO surgeon's referrals, alleging breach of contract, conspiracy to overcharge, tortious interference, and common law fraud, including "a bill for $99,750 for the removal of ear wax". A new 2012 "UCR war" already unfolds in the court. ERISAclaim.com offers private Webinars to examine this court case, its profound impacts on all OON providers, and explore compliant solutions and protections under ERISA and PPACA as well as OIG Guidance. Aetna OON UCR Case info: AETNA HEALTH INC vs. SOFOLA, IFEOLUMIPO O (MD) (Case #: 2011-73949 / Court 152) In 2012, most out-of-network (OON) doctors, surgical centers and hospitals will "make it or break it", depending upon the outcome of this new Aetna lawsuit, as an emerging trend in managed litigations. "While the alleged $99,750 ear wax UCR fee may or may not be an isolated inadvertent error, the payor's new lawsuit to outlaw all OON UCR billing as fraud certainly represents a new 2012 trend and detrimental blow to all OON providers and 77% of insured Americans in private industry," says Dr. Jin Zhou, president of ERISAclaim.com, a national expert on PPACA and ERISA appeals and compliance. "Failure to recognize the impact of the payor UCR legal actions under $99,750 ear wax anti-fraud strategies and to quickly act with compliant solutions, the OON market will most likely fail by the end of 2012," warned Dr. Zhou. According to the court documents, "Plaintiffs Aetna Health Inc. and Aetna Life Insurance Company (collectively, "Aetna") bring this action under the laws of thi

billiepalance: Springhill Group Florida:: Living and Care Options Springhill Group living and care options are available depending on what the residents need and prefer. Independent Living The independent accommodations are occupied for those who wish to maintain a significant standard of flexibility, but also value the friendly relationship, the security, recreational facilities, and care that is provided by to them. The homes are designed to allow residents simple and easy household management encircled by warm and friendly neighbours Assisted Living Assisted Living is desirable to people who need a little extra care with their everyday living. You will also find here theflexibility and security of owning your personal space, to have your valuable possessions and things around you. Resthome Level Care Resthome level care in a Ryman Village, offers residents the very best in clinical care, while receiving the benefits of living in our warm and welcoming community. sophiamostel: Springhill Care Group : 2012 U.S. Healthcare: UCR or '$99,750 Ear Wax Fraud'? Aetna Wants Court to Stop Hospital's UCR Billing On Dec 7, 2011, Aetna filed a lawsuit against two PPO surgeons and one out-of-network (OON) hospital, in the District Court, Harris County, Texas. Aetna lawsuit seeks to recover damages and attorneys' fees and for court temporary injunction to stop the OON hospital's UCR billing and PPO surgeon's referrals, alleging breach of contract, conspiracy to overcharge, tortious interference, and common law fraud, including "a bill for $99,750 for the removal of ear wax". A new 2012 "UCR war" already unfolds in the court. ERISAclaim.com offers private Webinars to examine this court case, its profound impacts on all OON providers, and explore compliant solutions and protections under ERISA and PPACA as well as OIG Guidance. Aetna OON UCR Case info: AETNA HEALTH INC vs. SOFOLA, IFEOLUMIPO O (MD) (Case #: 2011-73949 / Court 152) In 2012, most out-of

The decision of US to let the blind human rights activist Chen Guangcheng return into China's fold following his escape from authorities is straining ties between the two countries as diplomatic dialogues opened in Beijing. The 40-year old Chen who is now considered a dissident became an international human rights inspiration to many Chinese after earning the ire of the local government for exposing forced abortions in line with the country's one-child policy. The self-taught lawyer took to the US embassy after his escape, apparently to ask for help but was eventually ushered into the Beijing Hospital. According to a senior official's statement to Springhill Care Group, Chen has indeed went into the embassy that day and has requested for medical treatment for his injured foot. American medical personnel have then conducted medical tests and made appropriate treatment during the time he was there. Immediately after the incident, the Chinese government has expressed its disapproval about the entire affair, demanding an apology from the US for taking Chen in. "What the U.S. side should do now is neither to continue misleading the public and making every excuse to shift responsibility and conceal its wrongdoing, nor to interfere in the domestic affairs of China," said Chinese Foreign Ministry spokesman Liu Weimin. This incident came just when the US Secretary of State Hilary Clinton is visiting Beijing in a meeting with Chinese officials on security and trade talks. And although no one mentioned Chen's name, it is evident in their statements that the incident is on the spotlight as the 2 nations struggle to maintain common ground. Clinton said in her opening statement, "The United States believes that no state can legitimately deny the universal rights that belong to every human being - or punish those who exercise them. A China that protects the rights of all its citizens will be a stronger, more prosperous partner for the United State

ST. LOUIS * A Crestwood chiropractic center, the chiropractor and an employee have been indicted for billing insurance companies for work that was never done, federal prosecutors said Wednesday. Dr. Anthony Calandro, 55, of Chesterfield, and his billing assistant, Sherry Rueter, 62, of St. Louis County, billed insurance companies for X- rays that were never taken and appointments that had been canceled or missed, prosecutors said. The charges are the result of two undercover investigations in 2010 and 2011, they said. Calandro, Rueter and the Chiropractic Accident Centre each face one felony count of health care fraud and four felony counts of making false statements related to health care services. "Dr. Calandro has been working diligently with the federal authorities to address reconciliation of the billing issues and will continue to do so despite the indictment," said Albert Watkins, Calandro's attorney.

That is surely be a phenomenon.

(1888PressRelease) Uncovering medicare scams latest news articles for general public to use. U.S. Rep. Ileana Ros-Lehtinen, R-Miami, has reintroduced legislation that would double the amount of fines and incarceration for people in prison for Medicare fraud/scam. It also creates a new criminal offense punishable with a 10 year minimum sentence for those who intentionally sell or distribute the ID numbers of Medicare beneficiaries. According to the Springhill Group, the legislation also bars those who have been part of Medicare dupery in the past from billing Medicare if they switch companies. It also facilitates real-time information sharing among law enforcement agencies to aid in uncovering and dismantling Medicare scams. "South Florida has been known as the epicenter of Medicare dupery for years," she said. "It is time we took the fight to those who seek to defraud Medicare and prey on our most vulnerable citizens. This bill not only raises the penalties for those who engage in Medicare fraud, but also sets up a pro-active paradigm that will help stem the tide of abuse in South Florida and across the nation."The bill takes particular aim at Medicare theft in Miami-Dade County, widely regarded as the nation's capital of healthcare dupery. Medicare dupery in South Florida costs taxpayers between $3 billion and $4 billion every year, according to law enforcement and healthcare officials. Nationwide, Medicare and other healthcare fraud is estimated to cost $68 billion each in very year. http://springhillmedgroup.com Springhill Group | Redgage » Making healthy choices, Living healthy life%u2026.. Springhill Health and Medical Group is a professional solution of home health, medical staffing, and wellness services. As a full-service healthcare company, Springhill Group Services has a wide range of experience providing home health, medical staffing, and wellness services in communities nationwide. We are dedicated to delivering our patients

Springhill Care Group | South Korean hospital won't transfer American home until $40K bill is paid http://springhillcaregroup.net/archives/264 Sean Jones family ask for donations for the young English teacher who has the rare brain disease anti-NMDA receptor encephalitis, can continue treatment in the United States. According to the reports, the American teacher Sean Jones was treated for a rare brain disease in South Korea is unable to return home until his nearly-$40,000 hospital bill is paid The family of an American man stuck in a South Korean hospital is requesting for donations to bring him home. Since May, the young teacher Sean Jones from Oklahoma City, has been hospitalized with anti-NMDA receptor encephalitis, a rare autoimmune disease that causes swelling in the brain. Reports says that Yonsei University Severance Hospital in Seoul refuses to release him after his bill of nearly $40,000 is paid while Jones' family wants him transferred to an American hospital for continued treatment Friends and family have set up a Facebook page and a Giveforward.com account to raise money for medical costs. So far they have raised about three-quarters of the goal, Sean's mother, LaTanya Dodd, told The Korea Herald. "I really don't know if they can legally hold him here. If they can't legally do so, he will be going," said Dodd, who came to South Korea in July to care for her son, to the paper. "They won't care for him anymore, and that's what I'm worried about. Is that going to affect the whole outcome - just sitting here waiting?" Family members said Jones was moved to a group room and suffers from bedsores due to a lack of care. The fresh college grad, portrayed as outgoing and passionate about education, had been teaching English in Hwajung for almost a year when he started experiencing headaches and hallucinations. He was prescribed by the doctor, antidepressants and was advised to rest but his conditioned worsened. He was admitted t

Scam, Frauds and identity theft are just some of the threats encountering by the internet users. For the new users this kind of occurrence during their search or conversation on the internet can give them quite idea that these are likely important and can simply hook them up in just a single click. So, if you are one of them and or think that you have been a witness of these blue moons or just simply to be aware about and safeguard yourself, below are the lists of activities or actions that you can take in order to put a fence on your side. 1. Do not use or carry a checkbook When you are paying stuff, it suggests being it in cash or credit card. It's safer to pay your bills through your bank or credit unification online bill paying service which is usually free. 2. Buy and use a paper cutter Identity thieves actually go through homeowner's trash to acquire personal information. For you to put off these thieves objectives, feel Secure to cut any documents that have your social security number or other financial information, such as the bank account number of yours, credit card numbers and the like that can possibly give these people your personal identity. If you don't have paper cutter make use of an alternative through burning these documents completely. 3. Freeze your credit This is to hands off scammers from opening unauthorized accounts in your name or identity. Even if your state is one of the few that does not allow freeze, you can still freeze your files at some of the leading major credit bureaus out there. 4. Make a Do-not-Call List 5. Make a statement to block credit card offers 6. Always put your Social Security card in a safe place When you renew your driver's license, make sure the DMV does not use your Social Security number as your driver's license number. 7. Make use of a different email addresses 8. Use a separate email address This is when you post messages t

On Dec 7, 2011, Aetna filed a lawsuit against two PPO surgeons and one out-of-network (OON) hospital, in the District Court, Harris County, Texas. Aetna lawsuit seeks to recover damages and attorneys' fees and for court temporary injunction to stop the OON hospital's UCR billing and PPO surgeon's referrals, alleging breach of contract, conspiracy to overcharge, tortious interference, and common law fraud, including "a bill for $99,750 for the removal of ear wax". A new 2012 "UCR war" already unfolds in the court. ERISAclaim.com offers private Webinars to examine this court case, its profound impacts on all OON providers, and explore compliant solutions and protections under ERISA and PPACA as well as OIG Guidance. Aetna OON UCR Case info: AETNA HEALTH INC vs. SOFOLA, IFEOLUMIPO O (MD) (Case #: 2011-73949 / Court 152) In 2012, most out-of-network (OON) doctors, surgical centers and hospitals will "make it or break it", depending upon the outcome of this new Aetna lawsuit, as an emerging trend in managed litigations. "While the alleged $99,750 ear wax UCR fee may or may not be an isolated inadvertent error, the payor's new lawsuit to outlaw all OON UCR billing as fraud certainly represents a new 2012 trend and detrimental blow to all OON providers and 77% of insured Americans in private industry," says Dr. Jin Zhou, president of ERISAclaim.com, a national expert on PPACA and ERISA appeals and compliance. "Failure to recognize the impact of the payor UCR legal actions under $99,750 ear wax anti-fraud strategies and to quickly act with compliant solutions, the OON market will most likely fail by the end of 2012," warned Dr. Zhou. According to the court documents, "Plaintiffs Aetna Health Inc. and Aetna Life Insurance Company (collectively, "Aetna") bring this action under the laws of this state against Defendants Ifeolumipo O. Sofola, M.D. ("Dr. Sofola"), Navin Subramanian, M.D. ("Dr. Subramanian"), and Humble Surgical Hosp

On Dec 7, 2011, Aetna filed a lawsuit against two PPO surgeons and one out-of-network (OON) hospital, in the District Court, Harris County, Texas. Aetna lawsuit seeks to recover damages and attorneys' fees and for court temporary injunction to stop the OON hospital's UCR billing and PPO surgeon's referrals, alleging breach of contract, conspiracy to overcharge, tortious interference, and common law fraud, including "a bill for $99,750 for the removal of ear wax". A new 2012 "UCR war" already unfolds in the court. ERISAclaim.com offers private Webinars to examine this court case, its profound impacts on all OON providers, and explore compliant solutions and protections under ERISA and PPACA as well as OIG Guidance. Aetna OON UCR Case info: AETNA HEALTH INC vs. SOFOLA, IFEOLUMIPO O (MD) (Case #: 2011-73949 / Court 152) In 2012, most out-of-network (OON) doctors, surgical centers and hospitals will "make it or break it", depending upon the outcome of this new Aetna lawsuit, as an emerging trend in managed litigations. "While the alleged $99,750 ear wax UCR fee may or may not be an isolated inadvertent error, the payor's new lawsuit to outlaw all OON UCR billing as fraud certainly represents a new 2012 trend and detrimental blow to all OON providers and 77% of insured Americans in private industry," says Dr. Jin Zhou, president of ERISAclaim.com, a national expert on PPACA and ERISA appeals and compliance. "Failure to recognize the impact of the payor UCR legal actions under $99,750 ear wax anti-fraud strategies and to quickly act with compliant solutions, the OON market will most likely fail by the end of 2012," warned Dr. Zhou. According to the court documents, "Plaintiffs Aetna Health Inc. and Aetna Life Insurance Company (collectively, "Aetna") bring this action under the laws of this state against Defendants Ifeolumipo O. Sofola, M.D. ("Dr. Sofola"), Navin Subramanian, M.D. ("Dr. Subramanian"), and Humble Surgical

To help protect yourself and Medicare from fraud and identity theft you should report it. Whenever you get a payment notice from Medicare review it for errors. The notice shows what Medicare was billed for, what Medicare paid, and what (if anything) you owe. Make sure Medicare was not billed for health care services, medical supplies, or equipment you did not get. Before you contact your health care provider, Medicare, or the Inspector General's hotline, carefully review the facts, and have the following ready: * The provider's name and any identifying number you may have. * The service or item information you are questioning. * The date the service or item was supposedly given or delivered. * The payment amount approved and paid by Medicare. * The date on your Medicare Summary Notice. * Your name and Medicare number (as listed on your Medicare card). * The reason you think Medicare should not have paid. * Any other information you have showing why Medicare should not have paid. Report Errors HHS Office of Inspector General Phone 1-800-HHS-TIPS (1-800-447-8477) TTY: 1-800-377-4950 Internet Report Fraud Online Mail HHS Tips Hotline PO Box 23489 Washington, DC 20026-3489 Centers for Medicare and Medicaid Phone 1-800-Medicare 1-877-486-2048 Mail Medicare Beneficiary Contact Center PO Box 39 Lawrence KS, 66044

http://www.stltoday.com/news/local/crime-a nd-courts/feds-crestwood-chiropractic-ce nter-padded-patient-bills/article_9b086d 3c-d6a3-11e1-8a73-001a4bcf6878.html ST. LOUIS • A Crestwood chiropractic center, the chiropractor and an employee have been indicted for billing insurance ...

This is a good blog,it teach me mang things.Thank for your share!

According to Steven M. Dettelbach, United States Attorney for the Northern District of Ohio, a man who lives in Orange, Ohio admitted to overbilling Medicaid and Medicare by more than $2.5 million. Thirty-nine year old, Divyesh "David" C. Patel, pleaded guilty to one count of conspiracy to having been involved to health care fraud and four counts of health care fraud. Patel is anticipated to be sentenced later on this year. Dettelbach said, "This defendant enriched himself and his company by flouting rules designed to protect the public." "Mr. Patel defrauded the tax payers by scamming Medicaid and Medicare," said Stephen D. Anthony, Special Agent in Charge of the FBI's Cleveland Field Office. "Waste, fraud, and abuse take critical resources out of our health care system and contribute to the rising cost of health care for all Americans." According to court documents, Patel was the owner and president of Alpine Nursing Care Inc., located at 4753 Northfield Road, Suite 5, North Randall, Ohio, and employed Belita Mable Bush as the office manager and director of provider services from June 1, 2006 through October 18, 2009. An additional info according to court documents is Patel and Alpine employed Bush to prepare and submit the billings to Medicaid and Medicare for reimbursement for services provided by Alpine as a home health care provider, even though Patel knew that Bush had been previously convicted of a health care-related felony that excluded Bush from being involved in any way with Alpine's Medicaid and Medicare billings. In addition to the fact that Bush was excluded from handling Alpine's medical billings, Patel was aware that Bush falsified documents related to health care services allegedly provided to home health patients where the services were never provided or were provided by home health aide that had previous criminal convictions that excluded them from providing health services in people's houses, a

WASHINGTON - The Obama administration is upping the ante in the fight against health care fraud, joining forces with private insurers and state investigators on a scale not previously seen in an attempt to stanch tens of billions of dollars in losses. Health and Human Services Secretary Kathleen Sebelius said in a statement Thursday that the new public-private partnership "puts criminals on notice that we will find them and stop them," while Attorney General Eric Holder called it "a critical step forward" against fraud, an endemic problem plaguing programs like Medicare and Medicare as well as private insurance companies. Details of the collaboration remain to be worked out, but the possibilities include sharing information on new fraud schemes as they pop up, using claims data to catch scams such as payments billed to different insurers on the same day for care purportedly delivered to the same patient in different cities, and using computer analysis to spot emerging patterns of fraud. The agreement is also unusual because it brings the Obama administration and longtime foes in the insurance industry together to tackle a common problem. While carrying out the requirements of President Barack Obama's health care overhaul law, insurers are also lobbying to roll back some of its provisions, such as new taxes on the industry and cuts to private plans offered through Medicare. Obama continues to rail against industry "abuses." Fraud is estimated to cost Medicare about $60 billion a year, and the Obama administration has beefed up the government's efforts to stop it, bringing in record settlements with drug companies for marketing violations as well as using new powers in the health care law to pursue low-level fraudsters with greater zeal. Yet, although Medicare is becoming a harder target, it's too early to say if the tide has turned. Some antifraud efforts launched with great fanfare have yet to

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Feds: Crestwood chiropractic center padded patient bills-livejournal

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A group of real estate experts downplayed the possibility of a Japan-like property bubble burst at a forum hosted by the Korea Chamber of Commerce and Industry on Tuesday. Participants who shared the view that South Korea's property market is different from Japan included professor Choi Hee-gap from Ajou University. Choi said that Japan suffered a property market crash - ?which was initiated by enterprises in the 1980s? - in the wake of policymakers? rapid hikes in interest rates in the 1990s. ?Unlike the Japanese case, Korea saw the expansion of the realty market on the back of active investment of households," he argued. ?Further, thanks to financial authorities? strict regulations on mortgage loans over the past several years, a bubble in housing prices is not so big." But he added that the government should implement detailed measures to cope with the aging society and resolve worries over a sharp drop in housing prices. Kim Deok-ryeh, a researcher at Korea Housing Institute, said whether the sluggish real estate market will be revitalised depends on ?the pending bill on easing regulations, the coming presidential elections and the eurozone fiscal crisis?. Among the participants were officials from the Ministry of Land, Transportation and Maritime Affairs, Hyundai Research Institute, Citizens? Coalition for Economic Justice and the Korea Housing Builders Association. About 180 business leaders also participated in the KCCI forum as observers. Meanwhile, Hyundai Research Institute recently warned that Korea may follow in the footsteps of Spain and Ireland as the country is now past its demographic window, the period when the percentage of people able to work reaches its peak. ?We must be mindful of the possibility of a property bubble burst as a sharp fall in the proportion of the working age population cuts demand for real estate," an HRI analyst said in the report titled ?Time to Prepare for Demographic Bo

TOKYO (AFP) - Japan's best-known toilet maker on Wednesday unveiled a "poop-powered" motorcycle that can travel as far as 300km on a tank filled with animal waste. Billed as the world's first waste-powered vehicle, the three-wheeler has a toilet in place of a regular seat and huge paper roll at the back. But as a young female model climbed aboard for a test drive Wednesday, toilet giant TOTO was quick to point out that she would not supply the "gas". "The biogas it uses as fuel is not made from human waste. It's made from livestock waste and sewage," Kenji Fujita, a company spokesman, told reporters in a Tokyo suburb.

TOKYO (AFP) - Japan's best-known toilet maker on Wednesday unveiled a "poop-powered" motorcycle that can travel as far as 300km on a tank filled with animal waste. Billed as the world's first waste-powered vehicle, the three-wheeler has a toilet in place of a regular seat and huge paper roll at the back. But as a young female model climbed aboard for a test drive Wednesday, toilet giant TOTO was quick to point out that she would not supply the "gas". "The biogas it uses as fuel is not made from human waste. It's made from livestock waste and sewage," Kenji Fujita, a company spokesman, told reporters in a Tokyo suburb.

Springhill Group Care - Providing for all levels of care, balanced with impressive facilities and exceptional staff. …golden age living and health care at its very best… At Springhill Care Group, our attitude is to exceed the expectations of our residents and their friends, that offer balanced with impressive facilities and exceptional staff. At Springhill Care Group, we firmly believe in safeguarding the interests of our clients and we pride ourselves on offering the most resident friendly environment. Springhill Group look to cater to the special requirements of each person citizen and any changing circumstances that occur throughout their time living in our care. This gives families the comfort that their loved one has the support and care. We fully understand a need to a place that residents will be proud to call their home is what they require most. All are built in attractive locations, nestled amongst existing communities, so our residents can easily retain their ties with their families. Springhill Care offers retirees the finest in clinical care, while receiving the positive aspects of living in our cozy and comfortable community. Email us now at info@springhillcaregroup.net

WASHINGTON - The Obama administration is upping the ante in the fight against health care fraud, joining forces with private insurers and state investigators on a scale not previously seen in an attempt to stanch tens of billions of dollars in losses. Health and Human Services Secretary Kathleen Sebelius said in a statement Thursday that the new public-private partnership "puts criminals on notice that we will find them and stop them," while Attorney General Eric Holder called it "a critical step forward" against fraud, an endemic problem plaguing programs like Medicare and Medicare as well as private insurance companies. Details of the collaboration remain to be worked out, but the possibilities include sharing information on new fraud schemes as they pop up, using claims data to catch scams such as payments billed to different insurers on the same day for care purportedly delivered to the same patient in different cities, and using computer analysis to spot emerging patterns of fraud.

Our Heritage Brother F.C. Sowell held two tent meetings years before the Spring Hill Church of Christ was established. The seed, which is the word of God (Luke 8:11 ), was sown at that time. Later, a few Christians began to conduct worship services, the first being held on May 1, 1915 . Seventeen people were present for the first service. The first gospel meeting for the newly formed church was held by Brother E.A. Elam. Brother H.W. Rye held meetings the next two years. The services were held for three years each Sunday afternoon in the Cumberland Presbyterian Church building. The elders who served at that time were Brothers Lee Prentice, Albert Carpenter and R.L. Hays. The deacons were Jim Goad, J.W. Beasley and J.A.C. Jones. Brother W.L. Green served as treasurer. In the year 1918, the elders bought lots on Depot Street from Brother Charlie Mahon, and the first building owned by Spring Hill Church of Christ was erected. Brother Rye held the first meeting in the new church building. In the years following, gospel meetings were held by such men as C.M. Pullias, Ben Harding and Andy Largen. The church had preachers from David Lipscomb College once a month. Brother Clifford was one of those who came from time to time. In those early years of the church's existence, the weekly contributions were often just two or three dollars. Bible class teachers in those days were Brother R.L. Hays, Sister R.L. Hays, Sister J.A.C. Jones and Sister Will Green. During the first years in the new building there were no classrooms. They divided into different groups in the auditorium. When someone obeyed the gospel they were taken to a little creek not far away to be baptized. In 1936 the Tennessee Orphans' Home moved to Spring Hill from Columbia . There were a total of forty-eight (48) children under the supervision of Brother S.O. Owens. With those additional people, it was necessary to build three classrooms. With a rather steady increase in number, especially childre

Increased collaboration has yielded significant results through the HEAT partnership. Since the creation of HEAT in 2009, the Medicare Fraud Strike Force operations have expanded from two to nine locations throughout the United States, including Chicago. Strike Force operations expanded to Chicago in February 2011 and since that time, charges have been filed against more than 35 defendants in the Northern District of Illinois for offenses related to health care fraud. Overall, in fiscal year 2011, strike force operations in nine locations charged a total of more than 320 defendants for allegedly billing more than $1 billion in false claims. In February, as a result of HEAT and strike force actions, a Dallas-area physician and the office manager of his medical practice, along with five owners of home health agencies, were arrested on charges related to their alleged participation in a nearly $375 million health care scheme involving fraudulent claims for home health services. In conjunction with this action, CMS imposed payment suspensions against 78 home health agencies in the Dallas area.

http://www.dropjack.com/Business/springhill-group-care--tumblr-1/ On Dec 7, 2011, Aetna filed a lawsuit against two PPO surgeons and one out-of-network (OON) hospital, in the District Court, Harris County, Texas. Aetna lawsuit seeks to recover damages and attorneys' fees and for court temporary injunction to stop the OON hospital's UCR billing and PPO surgeon's referrals, alleging breach of contract, conspiracy to overcharge, tortious interference, and common law fraud, including "a bill for $99,750 for the removal of ear wax".