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Physician Medicare Reimbursements Hospitals False Claims Act (FCA)

Health Care Compliance Association (HCCA)

Report on Medicare Compliance Volume 30, Number 8. News Briefs: March 2021

Report on Medicare Compliance 30, no. 8 (March 1, 2021) - According to a CMS spokesperson, “CMS has not yet determined when Targeted Probe and Educate reviews will resume.” Meanwhile, “CMS continues to temporarily pause...more

McDermott Will & Emery

Third Circuit Perpetuates Tuomey’s Controversial Stark Law “Volume or Value” Standard

McDermott Will & Emery on

The US Court of Appeals for the Third Circuit endorsed two controversial interpretations of the Stark Law’s “volume or value” standard, known as the correlation theory and the practice “loss” theory in U.S. ex rel. J. William...more

Dorsey & Whitney LLP

Relator Failed to Sufficiently Plead its FCA Action by Relying on Big Data Alone, Resulting In Big Dismissal

Dorsey & Whitney LLP on

In early August, the U.S. District Court for the Western District of Texas granted a hospital system’s motion to dismiss a False Claims Act case that illustrates the increasing intersections in FCA litigation between data...more

Foley & Lardner LLP

Health Care Company Asks U.S. Supreme Court to Find False Claims Act Unconstitutional

Foley & Lardner LLP on

If one appellant has its way, the False Claims Act (FCA) would be gutted by way of its qui tam provisions struck down as unconstitutional by the United States Supreme Court. That is the position taken by Intermountain Health...more

Holland & Knight LLP

Healthcare Law Update: September 2018

Holland & Knight LLP on

Regulation - CMS Contemplating Telemedicine Changes - The Centers for Medicare & Medicaid Services (CMS) recently published what it described as a "major proposed rule" that covers a number of topics that could have...more

Morrison & Foerster LLP

The Difficulty Of Challenging FCA Fine As Excessive

Last month, in U.S. ex rel. Drakeford v. Tuomey, No. 13-2219, (4th Cir. July 2, 2015), the Fourth Circuit affirmed a False Claims Act verdict against a nonprofit hospital in Sumter, South Carolina. In an area of the law where...more

Faegre Drinker Biddle & Reath LLP

These Doctors Work Hard – Over 24 Hours a Day

Sir Arthur Conan Doyle might have called it “The Case of the Doctors Who Work More than 24 Hours a Day.” Unfortunately for the physician group in question, Sir Arthur wasn’t the author; the federal court for the Northern...more

Benesch

The Halifax $85 Million Lesson: Compensation Arrangements Between Hospitals and Physicians Must Be Reviewed

Benesch on

The Department of Justice (“DOJ”) announced another multi-million dollar settlement of alleged False Claims Act violations on March 11, 2014. Specifically, Halifax Hospital Medical Center and Halifax Staffing, Inc. agreed to...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

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