News & Analysis as of

False Claims Act (FCA) › ICD Codes

Foley & Lardner LLP

Court Calls Underlying Legal Standards “No Model of Clarity” but Allows False Claims Act Case To Proceed Anyway

Foley & Lardner LLP on

Does violating requirements amount to fraud under the False Claims Act (FCA) when the requirements allegedly violated are unclear? There is currently a circuit split and petitions for review pending to the Supreme Court as to...more

Bass, Berry & Sims PLC

Judge Chen’s Message to Medicare Advantage Providers: ICD Guidelines Aren’t Suggestions

Bass, Berry & Sims PLC on

On November 14, Judge Edward Chen in the Northern District of California issued rulings on the pending motions to dismiss in U.S. ex rel. Osinek v. Kaiser Permanente, granting in part and denying in part Kaiser’s motion to...more

Mintz - Health Care Viewpoints

DOJ Files False Claims Act Lawsuit Against Anthem for “One-Sided” Chart Review Practices

Mintz - Health Care Viewpoints on

The Department of Justice (DOJ) recently filed suit against Anthem, Inc. (Anthem) alleging that the Medicare Advantage Organization (MAO) violated the False Claims Act (FCA) when it knowingly failed to delete inaccurate...more

Burr & Forman

2013 Healthcare Year In Review

Burr & Forman on

Bob Dylan's quote from 1964 -- "The Times They Are A-Changin" -- could equally apply to the healthcare industry in 2013. This was the year that the Affordable Care Act ("ACA") came into full public view with the start of the...more

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