Fraud is the making of false representations or engaging in deceptive behavior in order to unlawfully secure financial or personal gain.
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How do the federal sentencing guidelines work in federal fraud cases?
Insurance Commissioner Dave Jones announced yesterday that Sutter Health, which operates over 20 hospitals in northern California, agreed to pay $46 million and change its billing and disclosure of anesthesia charges and...more
As the Healthcare Landscape Shifts, Four Issues Are Critical to Build Effective Market Access Strategies -
In this time of high growth and fast change for the healthcare industry, pharmaceutical, biotechnology and...more
Last year was another busy year in health care fraud enforcement. In 2012, the Office of Inspector General for the Department of Health and Human Services (HHS-OIG) reported total expected recoveries of $6.9 billion from all...more
It is always important to consider how different parts of the government handle voluntary disclosures. The FCPA enforcement initiative has been largely the result of the voluntary disclosure process, and the government...more
The industry should take note of new California anti-fraud laws that have recently gone into effect—and the increasing challenges of compliance in a rapidly transforming industry. Even as lawmakers in Sacramento debate how...more
Your employee handbook likely addresses, in great detail, the do's and don'ts of using the internet while at the office, guidance on HIPAA, and even the company's policy on sexual harassment, but does it provide any...more
To date in 2012, the Department of Justice secured a record $3.3 billion in settlements and judgments in civil cases alleging healthcare fraud against the government under the Federal False Claims Act (“FCA”). The figure,...more
For centuries, health care providers have enlightened patients with the well-known adage: “an ounce of prevention is worth a pound of cure.” A recent set of cases involving a durable medical equipment company and its...more
Sometimes the deck is stacked against you. No matter what you do and how hard you try, you will lose.
In the healthcare area, hospitals, doctors and other service providers have to feel the frustration when it comes...more
At Ashley D. Adams, PLC, we have a well-established track record of success in false claim cases that can make a difference. For both organization defending against false claims charges and individuals pursuing qui tam...more