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Medicaid › Settlement Agreements

Medicaid is a partnership program between states and the federal government to provide healthcare coverage for lower income individuals, people with disabilities, older people, and certain families with... more +
Medicaid is a partnership program between states and the federal government to provide healthcare coverage for lower income individuals, people with disabilities, older people, and certain families with children.  less -
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

Littler

When Will a Settlement Agreement Preclude a False Claims Act Action?

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A recent District of Columbia federal court ruling reminds employers that a severance agreement containing a release of claims under the False Claims Act does not guarantee dismissal of a suit on those grounds....more

Cozen O'Connor

AG Rokita Recovers $2.9 Million for Medicaid Overbilling

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Indiana AG Todd Rokita announced a settlement with hospital network Parkview Health System, Inc. to resolve allegations that four hospitals in the network (collectively, “Parkview”) violated Indiana’s Medicaid False Claims...more

Foley Hoag LLP - Medicaid and the Law

Medicaid’s Right of Recovery Against Legal Settlements

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The United States Supreme Court recently answered an important question in Medicaid law:  can a state Medicaid plan recover funds from a legal settlement involving a Medicaid beneficiary to pay for that beneficiary’s future...more

Cozen O'Connor

AG Healey Settles with Mental Health Provider Over Alleged False Claims

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Massachusetts AG Maura Healey and the DOJ reached a settlement with outpatient mental health company Pathways of Massachusetts, LLC (“Pathways”) and its former parent company Molina Healthcare, Inc. (“Molina”) to resolve...more

Health Care Compliance Association (HCCA)

Report on Medicare Compliance Volume 31, Number 14. News Briefs: April 2022

Health Care Compliance Association (HCCA) on

Report on Medicare Compliance 31, no. 14 (April 18, 2022) - Michigan gynecologic oncologist Vinay Malviya, M.D., has agreed to pay $775,000 to settle false claims allegations in connection with medically unnecessary...more

Pullman & Comley - Connecticut Health Law

Short Staffing May Still be Hindering Health Care in Connecticut but OIG's Exclusion Authority Remains Alive and Well

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Can a 40-year-old fraud and abuse law that compared to many others is relatively straightforward still get providers into trouble?  Answer: You bet!  In fact, in the first quarter of 2022 alone, the U.S. Attorney for the...more

Health Care Compliance Association (HCCA)

Radiation Therapy Provider Pays $3.6M in CMP Settlement; OIG: 25 CPT Codes ‘Involved’

Health Care Compliance Association (HCCA) on

Report on Medicare Compliance 30, no. 22 (June 14, 2021) - A Colorado radiation therapy provider has agreed to pay $3.569 million in a civil monetary penalty settlement with the HHS Office of Inspector General (OIG). ...more

Cozen O'Connor

Allegedly Lax Sanitary Practices Land Dental Clinics In $2.7 Million False Claims Settlement

Cozen O'Connor on

New York AG Letitia James and the federal Department of Justice acting on behalf of the Department of Health and Human Services reached a settlement agreement with Upper Allegheny Health System (“UAHS”), the operator of...more

Health Care Compliance Association (HCCA)

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

Health Care Compliance Association (HCCA) on

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

Rivkin Radler LLP

Substance Abuse Center And CEO In $6 Million Medicaid Fraud Settlement

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On December 21, New York State Attorney General Letitia James announced a $6 million settlement of a civil healthcare fraud lawsuit against A.R.E.B.A-Casriel, Inc. d/b/a Addiction Care Interventions Chemical Dependency...more

ArentFox Schiff

Investigations Newsletter: Medical Device Manufacturer Settles Improper Payment Allegations for $18 Million

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Medical Device Manufacturer Settles Improper Payment Allegations for $18 Million - Merit Medical Systems Inc. (MMSI), a Utah-based medical device maker, will pay $18 million to settle allegations that it engaged in a...more

ArentFox Schiff

Acute Care Hospital Agrees to Pay $50 Million to Settle Alleged Stark Law and Anti-Kickback Statute Violations

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Acute Care Hospital Agrees to Pay $50 Million to Settle Alleged Stark Law and Anti-Kickback Statute Violations - On September 9, 2020, the Department of Justice (“DOJ”) announced that Wheeling Hospital Inc. (“Wheeling...more

Health Care Compliance Association (HCCA)

Report on Medicare Compliance Volume 29, Number 15. News Briefs: April 2020 #2

Health Care Compliance Association (HCCA) on

Report on Medicare Compliance 29, no. 15 (April 20, 2020) - Maury Regional Medical Center in Tennessee has agreed to pay $1.7 million to settle false claims allegations over MS-DRG coding, the U.S. Attorney’s Office for...more

Baker Donelson

Justice Department Recovers $3 Billion in 2019 from False Claims Act Cases – $2.6 Billion Related to Health Care Industry

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This week the Department of Justice reported it recovered $3 billion from False Claims Act cases in 2019. Of that recovery amount, $2.1 billion resulted from whistleblower, or qui tam, actions. In addition, 633 new qui tam...more

Bass, Berry & Sims PLC

Tennessee Nursing Home Chain Reaches “Largest Worthless Services Resolution in Tennessee’s History”

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Government Settles with Several Entities, Individuals - Last week, Vanguard Healthcare and related entities reached a settlement with the Department of Justice (DOJ) for the stated amount of more than $18 million to settle...more

Carlton Fields

Court Finds No Coverage for $42 Million False Claims Act Suit Due To Late Reporting

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A federal court has found no coverage for a $42 million whistleblower settlement due to the insured’s failure to timely report the claim to its carrier. PAMC, Ltd. v. National Union Fire Insurance Company of Pittsburgh, Pa.,...more

Mintz - Health Care Viewpoints

A Tale of Two False Claims Act Settlements Involving EHR Vendors

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Last week the Department of Justice (DOJ) announced a $57 million settlement with electronic health record (EHR) software vendor Greenway Health LLC (Greenway). According to DOJ, Greenway violated the False Claims Act (FCA)...more

Sheppard Mullin Richter & Hampton LLP

In Case Alleging Nationwide Pharmacy Fraud, Kmart Scores Narrow Settlement

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As described in an April 17, 2018 article originally posted on the Sheppard Mullin Richter and Hampton, LLP False Claims Act Defense Blog, Kmart Corporation and the U.S. Department of Justice entered into a False Claims Act...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

King & Spalding

Hospital, Cardiology Group Settle False Claims Act Allegations for $20.75 Million

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As reported previously, Hamot Medical Center (“Hamot”) and Medicor Associates, Inc. (“Medicor”) entered into a preliminary settlement agreement under which they agreed to pay $20.75 million to resolve kickback allegations...more

Jones Day

"Meaningfully Useful" Risk Mitigation Strategies for Providers Following the eClinicalWorks Settlement

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The Health Information Technology for Economic and Clinical Health Act ("HITECH Act") established financial incentives under Medicare and Medicaid for eligible health care providers that adopt, implement, and demonstrate use...more

McDermott Will & Emery

False Claims Act Settlement with eClinicalWorks Raises Questions for Electronic Health Record Software Vendors

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On May 31, 2017, the US Department of Justice announced a Settlement Agreement under which eClinicalWorks, a vendor of electronic health record software, agreed to pay $155 million and enter into a five-year Corporate...more

King & Spalding

DOJ Settles with Nursing Home for Allegations of Worthless Services

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On February 1, 2017, an Iowa nursing facility and residential care facility operator entered into a settlement agreement (the Agreement) with DOJ and the State of Iowa for alleged violations of the False Claims Act for the...more

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