News & Analysis as of

Hospice Enforcement Actions

The Volkov Law Group

Gentiva Pays $19.4 Million for False Claims Act Violations Involving Hospice Care

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Gentiva, the renamed former Kindred at Home, agreed to pay $19.4 million to resolve claims that its predecessor company, Kindred at Home and related companies, violated the False Claims Act by retaining overpayments for...more

Polsinelli

Health Care Fraud and Abuse 2023 Year in Review

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Introduction - Polsinelli proudly introduces the Health Care Fraud and Abuse 2023 Year in Review, a comprehensive examination of the evolving landscape surrounding the False Claims Act (“FCA”) and fraud & abuse enforcement...more

Husch Blackwell LLP

How One Hospice Owner Got Convicted of Healthcare Fraud and How You Can Avoid That Fate

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The owner of a Louisiana hospice was indicted and then convicted of healthcare fraud. How did that happen? In this episode of Hospice Insights: The Law and Beyond, Husch Blackwell's Meg Pekarske and Jonathan Porter talk about...more

Health Care Compliance Association (HCCA)

[Virtual Event] Healthcare Enforcement Compliance Conference - November 7th - 9th, 8:55 am - 3:30 pm CST

Hear directly from the enforcement community - Want to gain insight into properly monitoring, detecting, investigating, and managing violations? Join us virtually at HCCA’s Annual Healthcare Enforcement Compliance...more

Husch Blackwell LLP

Hospice Audit Series | Turning the Screws: UPIC Enforcement Tactics and What They Mean for Your Hospice

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Unified Program Integrity Contractor (UPIC) audits are on the rise, and the UPICs are embracing the full array of enforcement tools at their disposal. In this episode, Husch Blackwell’s Meg Pekarske and Bryan Nowicki discuss...more

Health Care Compliance Association (HCCA)

[Event] Kansas City Regional Healthcare Compliance Conference - September 17th, Lenexa, KS

Our one-day Regional Compliance Conferences provide attendees with a forum to interact with local compliance professionals, share information about your compliance successes and challenges, and create educational...more

Health Care Compliance Association (HCCA)

[Virtual Event] 2021 25th Annual Compliance Institute - April 19th - 22nd, 9:30 am - 4:35 pm CDT

The Compliance Institute is celebrating 25 years! Join us for the Compliance Institute's 25th anniversary, April 19-22, 2021. This year, HCCA is excited to celebrate over two decades of compliance excellence with our...more

Husch Blackwell LLP

Enforcement Relief: What New Regulatory Reforms Could Mean for Hospices

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The Trump Administration has shown an interest in regulatory reform with the goal of reducing the burden on regulated parties such as hospices. This has recently come to the forefront as part of the administration’s efforts...more

Morgan Lewis - Health Law Scan

Mere Differences of Judicial Opinion Emerge to Muddle Healthcare Providers False Claims Act Exposure for Mere Differences of...

In the Care Alternatives False Claims Act (FCA) appeal, a panel of the US Court of Appeals for the Third Circuit on March 4 reversed the summary judgment granted to hospice provider Care Alternatives at the district court,...more

Polsinelli

DOJ Cuts Bait in High-Profile Statistical Sampling FCA Case

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On Thursday, AseraCare, a national hospice care provider, announced that it had settled a long-standing Medicare billing dispute with the DOJ, a case that has garnered nationwide attention in healthcare since 2008. At issue...more

Bass, Berry & Sims PLC

Healthcare Fraud & Abuse Annual Review 2019

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Bass, Berry & Sims is pleased to announce the release of the 2019 edition of its Healthcare Fraud & Abuse Annual Review. Compiled by the firm’s Healthcare Fraud Task Force, the Review is an in-depth and comprehensive analysis...more

Epstein Becker & Green

Health Care Continues to Drive False Claims Act Recoveries: Thought Leaders in Health Law Video Series

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$3 billion recovered under the False Claims Act (“FCA”). That’s what the US Department of Justice (“DOJ”) reported collecting in FY2019. The health care and life sciences industries accounted for $2.6 billion of the total...more

Sheppard Mullin Richter & Hampton LLP

Hospice False Claims: AseraCare Lost A Battle But Has Helped Win The War

Last week, the 11th Circuit Federal Court of Appeals reversed summary judgment given to AseraCare in its hospice false claims case, setting up more litigation on the question whether AseraCare’s certifications were made in...more

Robinson+Cole Health Law Diagnosis

Eleventh Circuit Endorses Objective Falsehood Standard for False Claims Cases Concerning Physician Judgment of Hospice Eligibility

In a 3-0 decision issued September 9, 2019, the U.S. Court of Appeals for the Eleventh Circuit affirmed a three-year-old district court ruling in United States v. AseraCare, Inc. that a Medicare claim for hospice services...more

King & Spalding

AseraCare Saga Illustrates the Importance of Internal Compliance

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On September 9, 2019, the Eleventh Circuit issued a highly anticipated opinion addressing the critical question of when Medicare claims for reimbursement (in this case, claims for hospice care) can be considered “false” under...more

Troutman Pepper

Eleventh Circuit Says Difference Of Opinion Does Not Establish Falsity In False Claims Act Case

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On September 9, in a setback for AseraCare but an overall win for hospice providers, the Eleventh Circuit affirmed a Northern District of Alabama decision to grant a new trial in a False Claims Act (FCA) case against...more

Carlton Fields

US v. AseraCare: Eleventh Circuit Holds That Contradictory Clinical Judgments Alone Cannot Trigger FCA Liability

Carlton Fields on

In a long-awaited decision, the Eleventh Circuit concurred with the lower court’s standard for determining falsity under the False Claims Act (FCA) — reasonable disagreement between medical experts alone is not enough to...more

Hogan Lovells

Eleventh Circuit Confirms: Mere Difference of Opinion Between Physicians Does Not Establish Falsity Under the False Claims Act

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More than two years after the Northern District of Alabama granted summary judgment in a False Claims Act (FCA) case in favor of AseraCare Inc., holding that “contradiction based on clinical judgment or opinion alone cannot...more

Bricker Graydon LLP

Recent hospice settlements highlight where things can go wrong

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Two recent settlements highlight important Medicare hospice program requirements and the need to remain vigilant about compliance with Medicare program rules....more

Bricker Graydon LLP

Hospice news update

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Hospice audits - In late 2017, the Centers for Medicare and Medicaid Services (CMS) expanded its targeted probe and educate (TPE) audit program to include hospices....more

Bass, Berry & Sims PLC

Healthcare Fraud & Abuse Review 2017

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A LOOK BACK... A LOOK AHEAD - While the uncertainty associated with legislative efforts to repeal the Patient Protection and Affordable Care Act (PPACA) dominated most of the headlines for the healthcare industry last year,...more

Bass, Berry & Sims PLC

Healthcare Fraud and Abuse Review 2016

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Bass, Berry & Sims is pleased to announce the release of its fifth annual Healthcare Fraud and Abuse Review 2016. The Review, compiled by the firm’s Healthcare Fraud Task Force, is an industry-leading guide to healthcare...more

Manatt, Phelps & Phillips, LLP

Corporate Investigations and White Collar Defense - August 2016

Spotlight on the False Claims Act - Why it matters: This month, we review a recent Ninth Circuit case that allowed a qui tam relator’s action against various Medicare Advantage organizations to proceed, holding that the...more

Poyner Spruill LLP

Hospice EndNotes - December 2015

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Winds of Change Blowing Across the Hospice Landscape - Recent Medicare developments indicate that end-of-life health care providers can expect to face continuing change in an already dynamic sector. These latest turns...more

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