Department of Justice & HHS Announce Record Recoveries in 2011

On February 14, 2012, the Department of Health and Human Services (HHS) and the Department of Justice (DOJ) published a Report (a copy of which can be found here) touting recoveries of “[a]pproximately $4.1 billion stolen or otherwise improperly obtained from federal health care programs” in fiscal year 2011. This announcement was accompanied by a […]

2011: The Year for Health Care Fraud Prosecutions

Federal prosecutions for health care fraud are on the rise.  Statistics gathered for a recent study show that the U.S. Department of Justice has already commenced 903 health care fraud prosecutions in 2011.  Last year, federal prosecutors launched a total of 731 such cases.  If this pace continues, 2011 will see an 85% increase in […]

Medicare Fraud Strike Force Charges 91 Individuals for Over $295 Million in False Billing

On Wednesday, the Department of Health and Human Services (“HHS”) and the Department of Justice (“DOJ”) issued a joint press release which reported the filing of charges against 91 individuals in eight cities for the submission of over $295 million in false billings to the Medicare program.  The charges were the culmination of investigations by Medicare […]

Pitfalls of an Inventory Case in Criminal Prosecution

Two recent Medicaid and Medicare fraud prosecutions from the New York County District Attorney’s Office and the United States Attorney for the Eastern District of New York both allege that the defendant pharmacists and their respective pharmacies submitted false claims to Medicaid and Medicare for services not rendered.  That is, prescriptions were billed, but not […]

CMS Reports $162 Million In Medicare Overpayments in First Three Months of 2011

Based on a recent report released by CMS, its Medicare Fee-for-Service Recovery Audit Program recovered $162 million in Medicare overpayments during the period of January through March 2011. This is a substantial increase in the amount of money recovered by the Recovery Audit Program (RAP) in that $162 million is more than double the amount […]

OIG Finds Various State’s False Claims Acts, Including New York’s, To Be Noncompliant

The term “qui tam” comes from the latin phrase qui tam pro domino rege quam pro se ipso in hac parte sequitur, which means “[he] who sues in this matter for the king as [well as] for himself.”  In our legal system, qui tam actions are brought by private individuals, or whistleblowers, with knowledge of […]

O&A Attorneys to Speak at the 2011 AAB Annual Meeting

Jeffrey J. Sherrin, Kurt E. Bratten and Charles C. Dunham, IV, will be speaking at the American Association of Bioanalysts‘ 2011 Annual Meeting and Educational Conference. The AAB’s Annual Meeting and Educational Conference is being held in Austin, Texas and runs from May 12 – 14, 2011. On May 12th, Kurt E. Bratten will be […]

O&A’s Expanding Healthcare Fraud and Abuse Unit

Several years ago, O’Connell and Aronowitz formed a Healthcare Fraud and Abuse Unit as an adjunct to its well-established health law practice. The Healthcare Fraud and Abuse Unit focuses on all fraud and abuse issues, both civil and criminal, that impact health care providers.  Recently, the unit was expanded with the addition of Richard A. […]

OIG Fraud and Abuse Testimony Highlights Medicaid and Medicare Fraud Strike Forces, and Greater Use of Exclusionary Remedies for Officers and Management

On Wednesday March 2, 2011, several members of the Office of Inspector General (“OIG”) within the U.S. Department of Health and Human Service (“HHS”), including Inspector General Daniel R. Levinson, headed to Capitol Hill to testify before several House and Senate Committees on the topic of the OIG’s efforts to combat Medicare and Medicaid fraud […]