The OMIG Releases Annual Report for 2013: A Year of Record Recoveries

The New York State Office of the Medicaid Inspector General (OMIG) has released its 2013 Annual Report (“Report”). The OMIG announced that it has recovered a record $879 million in Medicaid overbillings for 2013.  More than $226 million of Medicaid overbillings were identified through audit activities. According to the Report, over the last three years, […]

The Rise of the Worthless Services Theory in Federal False Claims Act (Whistleblower) Cases – A Look to the Future

The theory of “worthless services” has yet again been tried by whistleblowers in the federal False Claims Act context, this time resulting in a large settlement with the federal government.  We saw this argument made previously in Ashber v. Momence, which we discussed in a prior article here.  Now, Extendicare Health Services Inc., and its […]

An Ever Widening Gap: Circuit Split on the Applicable Pleading Standard for the False Claims Act

Many areas of the False Claim Act are subject to legal interpretation and have been subject to Circuit splits, sometimes resulting in rulings from the Supreme Court.  In the United States, there are thirteen federal circuit courts that provide intermediate appellate review of the federal district courts in several states.  The decision by a circuit […]

Attention Medicaid and Medicare Providers: US DOJ Sues Providers for Failing to Return Overpayments Within 60 Days

On June 27, 2014, in the case of United States ex rel. Kane v. Healthfirst, Inc., et al., No. 11-2325 (S.D.N.Y.), the United States Department of Justice (USDOJ), via the United States Attorney’s Office for the Southern District of New York, sued several Medicaid providers under the federal False Claims Act for failing to return […]

Proposed Rule to Extend and Amend the Exception to Donate Electronic Health Records Items and Services

The Office of Inspector General for the Department of Health and Human Services (OIG) and the Centers for Medicare and Medicaid Services (CMS) published on April 10, 2013 proposed rules to extend and amend the Electronic Health Records (EHR) donation exceptions under the Anti-Kickback Statute and Stark Law, respectively. The proposed rules would extend the […]

Medicaid Provider Gets His Second Day In Court, Wins $7.7 Million Verdict Against His Accusers

A Brooklyn dentist who alleged that his career was ruined by a New York State Attorney General’s Office Medicaid Fraud Control Unit (MFCU) investigation has won a $7.7 million verdict against two of then-Attorney General Eliot Spitzer’s staff members. According to court papers filed by Dr. Leonard Morse’s attorney, available here, the dentist was pursued […]