PODCAST: Williams Mullen's Benefits Companion - SECURE 2.0 Act - More Relief for Plan Administrators
Recent Tenth Circuit Decision in John Q Hammons Fall Following SCOTUS’ Decision in Siegel v. Fitzgerald Could Result in Significant Refunds for Certain Chapter 11 Debtors
Nuts and Bolts of a Repayment Investigation: Keys to Conducting Investigations Under the 60-Day Repayment Rule
Hospice Audit Series: The Latest Developments and Strategies for Success in the Ever-changing Audit Landscape
• Reasonable disagreement among clinicians, by itself, does not result in a false claim. • Clinical judgment must be objectively false to constitute an FCA violation. • A clinical judgment may only be objectively false...more
On June 26, 2019, the United States District Court for the Northern District of Ohio granted a motion to dismiss a qui tam lawsuit against HCR ManorCare Inc. and its subsidiaries, including Heartland Hospice Services, LLC...more
On December 11, 2018, the United States announced that it has elected to intervene in a False Claims Act (FCA) lawsuit filed against Sutter Health and its affiliated entity Palo Alto Medical Foundation (PAMF) alleging that...more
Key Points: - Learn the latest case law developments regarding what evidence the government or the relator must establish to prove that the defendant “recklessly” interpreted a statute or regulation in violation of the...more
A settlement was reached on August 23, 2016, in U.S. ex rel. Kane v. Healthfirst, Inc., et al., No. 11 CIV. 2325 (ER) (SDNY), a little over one year after the judge in that case issued the first judicial interpretation of the...more
With Halloween looming, a discussion of skeletons that may be lurking in a health care provider’s closet is timely. Many of our previous posts, as well as the monthly Qui Tam Updates published by our Health Care Enforcement...more
Trends & Analysis: ..We have identified 15 health care–related qui tam cases that were unsealed since our last Qui Tam Update. Of those, 12 were filed from 2012 to the present. All but two cases had been pending more...more
The court’s interpretation complicates the already difficult task providers face in having sufficient time to assess and quantify potential overpayments. An August 3 decision in United States v. Continuum Health Partners...more
On August 3, 2015, a federal judge in the Southern District of New York ruled that the United States’ and state of New York’s complaints in intervention can move forward against a group of hospitals, under the federal False...more
The Centers for Medicare & Medicaid Services (CMS) recently announced a one-year delay in finalizing the long-awaited and closely watched rule addressing the 60-day deadline to return Medicare and Medicaid overpayments (the...more