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Health Policy

Medicare spending on home health was $12.9 billion in 2006—that’s up 44% since 2002, according to Government Accountability Office (GAO) report released March 13, 2009. Upcoding, by home health agencies, as well as other fraudulent and abusive practices, such as kickbacks and billing for services not rendered, contributed to the rise in Medicare spending for [...]

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New York Hospital Agrees to Settle Qui Tam

by Nolan and Auerbach on March 6, 2009

The Government announced today that a former employee  of Victory Memorial Hospital’s qui tam lawsuit has resulted in a settlement with the United States of at least $2.3 million to resolve claims that the hospital defrauded the Medicare program. The Medicare Fraud settlement covers allegations that Victory Memorial submitted Cost Reports for 1996 and 1997 [...]

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President Obama’s fiscal year 2010 proposed budget estimates that reducing health care fraud, waste and abuse could save the government about $5 billion in a decade’s time. The budget pledges nearly $1.5 billion for its Health Care Fraud and Abuse Control Program (HCFAC), including a $311 million increase in HCFAC funding. The budget takes aim [...]

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South Florida Company Bilks Medicare Out of $170 Million

by Nolan and Auerbach on August 28, 2007

R&I Billing was charged with fraudulently billing Medicare $170 million for infusions of HIV drugs. The scheme worked as follows: “From roughly October 2002 through April 2006, HIV clinics in South Florida serviced by R&I Billing allegedly provided bills to Medicare that indicated patients were being injected with excessive amounts of HIV medications…Based on claims [...]

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