News & Analysis as of

Medicare Hospitals Fraud

McGuireWoods LLP

Medical Device Legal News with Sam Bernstein: Episode 11

McGuireWoods LLP on

A former DePuy Synthes sales representative is arrested for allegedly defrauding a hospital into submitting claims for products not actually used in surgery; A number of additional clinics enter into settlements to resolve...more

Smith Gambrell Russell

How A Hospital Can Assure That It Will Be Required To Pay Punitive Damages

Smith Gambrell Russell on

During the federal fiscal year ending in September, 2022, the Department of Justice collected more than $1.7 billion in False Claims Act (FCA) settlements and judgments involving fraud in Medicaid, Medicare Advantage (MA)...more

Health Care Compliance Association (HCCA)

Report on Medicare Compliance Volume 29, Number 25. News Briefs: July 2020

Report on Medicare Compliance 29, no. 25 (July 13, 2020)  -  Ophthalmic Consultants PA in Sarasota, Florida, agreed to pay $4.8 million to settle false claims allegations that it billed Medicare and other federal payers...more

ArentFox Schiff

Investigations Newsletter: 34 Individuals Charged in $258 Million Medicare and Medicaid Fraud Schemes

ArentFox Schiff on

34 Individuals Charged in $258 Million Medicare and Medicaid Fraud Schemes - Twenty-six individuals in the state of California, fourteen of whom were doctors or medical professionals, and eight individuals in Arizona and...more

Bass, Berry & Sims PLC

FCA Deeper Dive: Pleading the Alleged Fraud Scheme

Bass, Berry & Sims PLC on

The FCA continues to be the federal government’s primary civil enforcement tool for investigating allegations that healthcare providers or government contractors defrauded the federal government. In the coming weeks, we are...more

Mintz - Health Care Viewpoints

Another Court Agrees That A Difference Of Opinion On Medical Necessity Is Insufficient to Show Falsity Under the False Claims Act

Last month, the U.S. District Court for the District of Utah joined the AseraCare court and others in finding that a relator cannot successfully allege violations of the False Claims Act (“FCA”) based on a purported lack of...more

BakerHostetler

The Deeper Dive: C-Suite to Prison Pipeline

BakerHostetler on

In recent years, the U.S. Department of Justice (DOJ) has been criticized for failing to prosecute executives for fraud, particularly in the financial sector. In response, the DOJ has begun to more heavily emphasize...more

King & Spalding

OIG Report Recommends Increased Scrutiny of Over 1000 Laboratories With Questionable Billing for Medicare Part B Clinical...

King & Spalding on

According to a recently released report by the HHS Office of Inspector General (OIG), over 1,000 labs had unusually high billing for Medicare Part B Clinical Laboratory Services for dates of service in 2010. Increased...more

Faegre Drinker Biddle & Reath LLP

Halifax Health Gets In More Hot Water

You probably didn’t think Florida’s Halifax Health could make its situation any worse. After all, only two months ago Halifax agreed to pay $85 million to settle just the first half of a Medicare fraud case. That still...more

Faegre Drinker Biddle & Reath LLP

Kentucky Hospital Pays $41 Million To Settle Fraud Charges

Yesterday Kentucky’s largest hospital, King’s Daughters Medical Center, in Ashland, announced its agreement to pay $40.9 million to settle charges that it committed Medicare and Medicaid fraud by billing for coronary...more

Mintz - Health Care Viewpoints

Serial Relator Getting the Boot?

This past Friday, hospital company HCA Holdings, Inc. asked a federal court judge to dismiss a False Claims Act (FCA) suit filed by whistleblower and former employee, Stephen McMullen. Mr. McMullen worked for an...more

Perkins Coie

CMS Adopts New “2 Midnights” Presumption For Inpatient Hospital Admissions

Perkins Coie on

On August 2, 2013, the Centers for Medicare and Medicaid Services (CMS) issued an advance copy of its final rulemaking that adopts a new approach to evaluating the medical necessity of inpatient hospital admissions. ...more

The Volkov Law Group

Hospitals And Fraud Enforcement

The Volkov Law Group on

The HHS Office of Inspector General has targeted hospitals for fraud enforcement. It is one of the OIG’s most important initiatives because of the impact it could have on reducing health care costs....more

King & Spalding

Judge Approves Two-Year Delayed Prosecution of WakeMed

King & Spalding on

A Federal district court judge issued a February 8, 2013 order granting a delayed prosecution against Raleigh, NC-based WakeMed Health and Hospitals for allegedly submitting false inpatient bills to Medicare. The...more

King & Spalding

OIG: Cardiac Catheterization Arrangement Between Hospital and Physicians Not Subject to Sanctions

King & Spalding on

On January 7, 2013, HHS OIG published a favorable advisory opinion on a management arrangement between a hospital and a cardiology group related to the provision of certain cardiac catheterization services at the hospital. ...more

15 Results
 / 
View per page
Page: of 1

"My best business intelligence, in one easy email…"

Your first step to building a free, personalized, morning email brief covering pertinent authors and topics on JD Supra:
*By using the service, you signify your acceptance of JD Supra's Privacy Policy.
- hide
- hide