Medicare Fraud News, Breaking Headlines and Insight from the Qui Tam Perspective
From the category archives:
Medical device-maker Kyphon allegedly trained its sales force to coach hospitals how to improperly schedule and bill kyphoplasty as an inpatient procedure. By billing as an inpatient procedure, the hospitals were able to wrongfully obtain additional government health care dollars for inpatient care that was typically a 1- 2-hour day surgery. After two Kyphon exposed [...]
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Nolan & Auerbach, P.A. Managing Partner Marcella Auerbach will speak at the University of Miami 2011 Law Review Symposium on Friday February 18, 2011. Ms. Auerbach will discuss the topic of health care fraud during the opening panel discussion. She will be joined in her health care fraud panel by David Hyman, Richard W. and [...]
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Two St. Louis-based hospital systems have agreed to shell out more than $2.2 million to quiet allegations that they submitted false Medicare claims for routine foot care procedures. Under the terms of the settlement, St. John’s Mercy Health System and St. John’s Health System have agreed to close the foot clinics and to pay the [...]
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While investigating a doctor who reportedly implanted hundreds of potentially medically unnecessary stents, Senate investigators may have stumbled across a troubling nationwide practice that drains funds from government health care programs and needlessly places patients’ lives at risk. In their released report, Senate Finance Committee Chairman Max Baucus (D-Mont.) and Ranking Member Chuck Grassley (R-Iowa) [...]
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Last year, Congress amended the federal False Claims Act to close a “finders’ keepers” loophole, which had permitted health care providers to keep Medicare and Medicaid overpayments. Earlier this year, as part of the Health Care Reform Legislation, Congress set a 60-day time limit for providers to return these overpayments. Specifically, Section 6402 of the [...]
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Recently, Nolan & Auerbach, P.A. Partner Joseph E. B. “Jeb” White was a guest lecturer during the opening session of the George Washington University Healthcare Corporate Compliance Program. This one-of-a-kind program provides a comprehensive corporate compliance education for current or aspiring corporate compliance officers. For the eighth time, Mr. White was the lone speaker from [...]
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“Where there’s smoke, there’s usually fire.” Law enforcement applies this age-old adage when it focuses investigative efforts on suspicious activity. However, according to a recently released HHS-OIG report, the Centers for Medicare & Medicaid Services (CMS) and its contractors have not been zeroed in on health care providers who have repeatedly submitted incorrect bills to [...]
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A Southern California hospital, El Centro Regional Medical Center, has agreed to pay $2.2 million to settle an FCA qui tam action, alleging that the hospital fraudulently inflated its charges to Medicare patients to obtain larger reimbursements from the federal health care program. Specifically, the whistleblower alleged that the hospital submitted false Medicare claims for [...]
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HHS-OIG released the results of an audit it conducted looking into Medicare Parts A and B services billed with dates of service after the beneficiaries’ death. Based on its findings, it estimates that Medicare shelled out over $8.2 million in overpayments for Medicare Part B claims with dates of service after the beneficiaries’ deaths. Under [...]
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Earlier this week, the federal government unveiled proposed regulations to crack down on Medicare and Medicaid fraud by empowering government officials with the power to stop payments as soon as credible fraud allegations are made. Currently, improper health care payments continue to pour out of the federal government coffers, even when credible allegations have been [...]
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