Government Contracting Health Consumer Protection

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MACRA’s Advancement of EHR Interoperability and Telehealth

This is the fourth and final post in our series on the Medicare Access and CHIP Reauthorization Act (MACRA). Pub.L. No. 114-10. We’ve previously covered the repeal of the Sustainable Growth Rate (SGR) in our April 20th post,...more

Health Care E-Note - March 2015

In This E-Note: - Health Care Reform in America: The Good, The Bad and The Ugly - The Federal False Claims Act - Violations of Conditions of Payment or Conditions of Participation? - State Regulatory...more

California’s Insurance Fraud Prevention Act: 3 unsettled issues the health sector should understand

California’s Insurance Frauds Prevention Act, Ins. Code §§ 1871 et seq. (IFPA), is an unusual false claims statute. It allows “interested persons” (aka whistleblowers or relators) to file false claims lawsuits based on the...more

Too Big to Exclude; Too Much Wrongdoing to Ignore

A 2007 audit initiated by a Medicare Program Safeguard Contractor (PSC) discovered that a North Carolina provider had a high incidence of inpatient billings for patients who did not stay in the hospital overnight. The PSC's...more

New Jersey False Claims Act Is Not Retroactive

Qui tam claims by whistleblowers or relators are most commonly brought under the federal False Claims Act for 15-30% of whatever funds the Government recoups from Medicare fraud as an example. Yet, some states have legislated...more

U.S. ex rel. Stephen Paranich v. Sorngard, Irwin Leasing Corp

Physician as Whistleblower on Notice:Unnecessary Additional Information seen by Government as Self-Motivated Desire to be...

Physician as whistleblower or relator in a qui tam claim, pursuant to the False Claims Act, responded too vigorously to a limited Government subpoena by unnecessary and intensive internal investigations viewed by the...more

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