Health Care Providers To Pay Back Almost $2 Million In Medicare Fraud

A number of doctors and medical practices have agreed to pay $1.9 million to settle allegations of fraudulent claims to Medicare and TRICARE, the U.S. Department of Justice announced Thursday.

Newsweek has contacted Curis Healthcare Inc and Alliance Immediate and Primary Care of Chicago out of hours via email for comment.

Why It Matters

Medicare and Medicaid have come into the spotlight in recent weeks as President Donald Trump’s Department of Government Efficiency (DOGE) investigates the health programs’ spending to uncover “fraud, waste and abuse” in the systems.

A Government Accountability Office (GAO) report from 2024 found that $100 billion had been discovered in “improper payments” in 2023 across the Medicare and Medicaid programs. However, the claims that the federal health programs are full of “waste” and “fraud” have been disputed by others.

What To Know

The U.S. Department of Justice shared that those involved have agreed to pay a total of $1,913,808 to resolve alleged “False Claims Act violations arising from their involvement in laboratory kickback schemes.”

Those involved include the doctors Gerald Congdon, M.D., of Pawleys Island, South Carolina, Gbenga Aluko, M.D., of Charlotte, North Carolina, Anup Banerjee, M.D., of Gastonia, North Carolina, and their medical practices, and Omar Hussain, of South Miami, Florida.

It also includes the health care providers Curis Healthcare Inc, of Chicago, Illinois, and Saeed Medical Group Ltd, which is doing business as Alliance Immediate and Primary Care, of Chicago, Illinois.

According to the U.S. Department of Justice, the Anti-Kickback Statute prohibits offering, paying, soliciting, or receiving remuneration to induce referrals of items or services covered by Medicare, TRICARE, the federal health program for those in the U.S. military, and other federally funded health care programs.

The statute is designed to ensure that medical providers’ judgments are not driven by improper financial incentives and instead focused solely on the best interests of their patients.

The settlements resolve allegations that health care providers received kickbacks in return for their referrals to a laboratory in Anderson, South Carolina. A marketer, along with his company, is also involved in the allegations.

The kickbacks allegedly resulted in the submission of “false or fraudulent laboratory testing claims to Medicare and TRICARE in violation of the False Claims Act,” the Department of Justice stated.

The Details

A press release from the Office of Public Affairs listed the following as resolved:

• Dr. Gerald Congdon, Coastal Urgent Care LLC, and Coastal Wellness Center LLC. Dr. Congdon and his medical practices in Pawleys Island and Myrtle Beach, South Carolina, agreed to pay $400,000 to resolve allegations that from May 2016 to November 2021, they received thousands of dollars in remuneration disguised as purported office space rental and phlebotomy payments from the South Carolina laboratory in return for ordering testing.
• Dr. Gbenga Aluko and Eagle Medical Center PC. Dr. Aluko and his medical practice in Charlotte, North Carolina, agreed to pay $250,000 to resolve allegations that from May 2016 to November 2021, they received thousands of dollars in remuneration disguised as purported office space rental, phlebotomy, and toxicology payments from the South Carolina laboratory in return for ordering testing.
• Dr. Anup Banerjee and Gastonia Medical Specialty Clinic P.A. Dr. Banerjee and his medical practice in Gastonia, North Carolina, agreed to pay $206,000 to resolve allegations that from April 2017 to November 2021, they received thousands of dollars in remuneration disguised as purported office space rental and phlebotomy payments from the South Carolina laboratory in return for ordering testing.
• Omar Hussain and Curis Healthcare Inc. Hussain and his marketing company agreed to pay $817,808 to resolve allegations that from April 2020 to August 2021, Hussain and his company received commissions from the South Carolina laboratory as independent contractors based on the volume and value of the Medicare and TRICARE referrals for laboratory testing that they arranged for and recommended.
• Saeed Medical Group Ltd., Omar Hussain, and Curis Healthcare Inc. Saeed Medical Group and Hussain and his marketing company agreed to pay $240,000 to resolve allegations that from April 2020 to August 2021, Saeed Medical Group received thousands of dollars in remuneration in the form of cash payments from Hussain and his company in return for ordering testing from the South Carolina laboratory.

The department noted that the claims resolved by the settlements are only allegations, and there has been no determination of liability.

Newsweek phoned Coastal Urgent Care, the practice of Gerald Congdon, Eagle Medical Center, the practice of Gbenga Aluko, Gastonia Medical Specialty Clinic, the practice of Anup Banerjee, and Keralty Hospital Miami, the practice of Omar Hussain, for comment but was unable to get through to an operator.

What People Are Saying

Acting U.S. Attorney Brook B. Andrews for the District of South Carolina, said: “Integrity must be the standard in our health care system. Kickback schemes divert funds and focus away from patients and their medical needs.”

Special Agent in Charge Steve Jensen of the FBI Columbia Field Office, said: “The public puts immense trust in medical professionals, and disdain for the rule of law damages that trust and erodes their credibility. These settlements should serve as a reminder that the FBI and its partners are committed to holding medical practitioners accountable for kickbacks.”

Special Agent in Charge Kelly Blackmon of the U.S. Department of Health and Human Services Office of Inspector General (HHS-OIG), said: “Kickback schemes undermine medical decision-making and jeopardize the integrity of federally funded health care programs. Our commitment is to safeguard taxpayer-funded health care and the patients who rely on it, and we will rigorously pursue any allegations of False Claims Act violations.”

Special Agent in Charge Christopher Dillard of the Department of Defense Office of Inspector General, Defense Criminal Investigative Service (DCIS) mid-Atlantic Field Office, said: “The trust of the American taxpayer and the well-being of our service members are undermined when laboratories and physicians engage in collusive financial relationships. DCIS will continue to work with our law enforcement partners to bring to justice medical providers who illegally enrich themselves by prioritizing kickbacks over patient care.”

What’s Next

The Department of Justice emphasized that the pursuit of uncovering fraud in Medicare and TRICARE illustrates the government’s goal of “combating health care fraud,” and added that “one of the most powerful tools” in this effort was the False Claims Act.

It seems likely that the government will continue to push the effort to uncover “fraud” in federal health programs, something which DOGE’s Subcommittee on Delivering on Government Efficiency has pledged to do.