The New York Court of Appeals recently ruled that the Office of the Medicaid Inspector General (OMIG) has discretion to exclude a physician from New York's medical assistance program (Medicaid) based solely on a consent order...more
The Center for Medicare and Medicaid Services (CMS) recently issued a policy memorandum to state survey agency (SSA) directors regarding the effect of rejecting a Medicare agreement in connection with the acquisition of a...more
On April 26, 2013, the U. S. Department of Justice (DOJ) intervened in a whistleblower case alleging Novartis Pharmaceuticals Corporation (Novartis) knowingly and willfully violated the federal FCA by inducing physicians to...more
The U.S. District Court for the Northern District of California recently denied Contra Costa Regional Medical Center’s (CCRMC) motion to dismiss regarding an alleged violation of the Emergency Medical Treatment and Labor Act...more
A 2007 audit initiated by a Medicare Program Safeguard Contractor (PSC) discovered that a North Carolina provider had a high incidence of inpatient billings for patients who did not stay in the hospital overnight. The PSC's...more