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ArentFox Schiff

Investigations Newsletter: Ultragenyx to Pay $6 Million To Settle False Claims Act Case

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Ultragenyx to Pay $6 Million To Settle False Claims Act Case - Ultragenyx Pharmaceutical Inc. recently agreed to pay $6 million to settle a qui tam action filed under the False Claims Act (FCA). Ultragenyx manufactures a...more

Health Care Compliance Association (HCCA)

Provider Wins $2M Appeal at ALJ Over Modifier 25, Random Sample

Report on Medicare Compliance 30, no. 11 (March 22, 2021) - A cancer center has won its appeal of $2 million in Medicare claim denials in a case about modifier 25 and the extrapolation of an overpayment. Problems with the...more

Health Care Compliance Association (HCCA)

Report on Medicare Compliance Volume 29, Number 32. News Briefs: September 2020

Report on Medicare Compliance Volume 29, no. 32 (September 14, 2020) -  In an audit of 100 outlier payments, the HHS Office of Inspector General (OIG) said Baylor Scott & White – College Station, a hospital in Texas, didn’t...more

Health Care Compliance Association (HCCA)

Observation Is Attracting Audit Attention; Hours Are a Risk, And Watch Out for the MOON

Report on Medicare Compliance 29, no. 5 (February 10, 2020) -  At least two Medicare administrative contractors (MACs) have set their sights on observation services, and there may be more to come. WPS is auditing...more

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