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Hospice Medical Necessity

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

Bass, Berry & Sims PLC

Fifth Circuit Affirms Criminal Healthcare Fraud Convictions of Hospice and Home Health Executives

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On March 24, the U.S. Court of Appeals for the Fifth Circuit affirmed the criminal healthcare fraud convictions of two individuals who ran a network of home health and hospice centers in Texas. According to the Fifth Circuit,...more

Husch Blackwell LLP

Hospice Audit Series: The Second Guessing of Billed Hospice Physician Visits

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In today's episode of Hospice Insights: The Law & Beyond, Husch Blackwell’s Meg Pekarske is joined by colleagues Bryan Nowicki and Erin Burns to discuss the recent denial of physician visits. Over the last several months, a...more

Perkins Coie

AseraCare Settlement Ends Medical Judgment False Claims Act Case With a Whimper

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The U.S. Department of Justice (DOJ) has reached a settlement with hospice company AseraCare, closing a 12-year-old saga that carries substantial implications for False Claims Act (FCA) enforcement in cases involving a...more

Baker Donelson

Disagreements over a Medical Judgment Cannot Form the Basis for Liability Under the False Claims Act

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A new federal court decision offers a ray of light to those providers defending false claims actions based on an alleged lack of medical necessity. On September 9, 2019, the United States Court of Appeals for the Eleventh...more

Sheppard Mullin Richter & Hampton LLP

The Eleventh Circuit Remands AseraCare, But Affirms High Hurdle for Proving Falsity

In a highly anticipated opinion in the AseraCare case, issued on September 9, 2019, the Eleventh Circuit Court of Appeals affirmed the district court’s holding that “a clinical judgment of terminal illness warranting hospice...more

Mintz - Health Care Viewpoints

Eleventh Circuit Rules in AseraCare Case that Disagreements in Clinical Judgment, Without Objective Falsity, Do Not Prove Fraud...

On Monday, the U.S. Court of Appeals for the Eleventh Circuit issued its long-awaited and closely watched decision in United States v. AseraCare Inc.. The court ruled that a claim cannot be deemed false under the False Claims...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

FCA Deeper Dive: Objective Falsity and Medical Necessity Cases

The FCA continues to be the federal government’s primary civil enforcement tool for investigating allegations that healthcare providers or government contractors defrauded the federal government. In the coming weeks, we will...more

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