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False Claims Act (FCA) Required Documentation

Perkins Coie

New CMS Rule Requires Extrapolation of Medicare Advantage RADV Audit Findings

Perkins Coie on

The Centers for Medicare and Medicaid Services (CMS) published its final rule regarding the Medicare Advantage (MA) Risk Adjustment Data Validation (RADV) program in early February 2023. Among other matters, the final rule...more

Rivkin Radler LLP

NJ Pathology Practice Settles Alleged FCA Violations for $2.4 Million

Rivkin Radler LLP on

On December 7, the U.S. Department of Justice (DOJ) announced that it had reached a Settlement Agreement with Princeton Pathology Services P.A., a New Jersey pathology practice, regarding Princeton Pathology’s alleged...more

Health Care Compliance Association (HCCA)

Report on Medicare Compliance Volume 30, Number 2. News Briefs: January 2021 #2

Report on Medicare Compliance 30, no. 2 (January 18, 2021) - Recovery audit contractors (RACs) may soon be auditing positron emission tomography (PET) for initial treatment strategy in oncologic conditions for compliance...more

Stinson LLP

Recent Case Highlights Risks of Paying Physicians for Routine Duties - Signed writing required, informal documentation may not be...

Stinson LLP on

Payments to physicians, even for routine, necessary duties, may cause referrals to the entity making the payments to be "prohibited referrals" under the Stark Law. This means the hospital or other entity should not have...more

Manatt, Phelps & Phillips, LLP

Health Update - September 2015

Latest Healthcare False Claims Act Roundup and Top 3 Best Practices to Reduce Exposure - As the legal landscape in healthcare becomes increasingly complex, healthcare companies that receive federal program funds face...more

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