Tag Archives: False Claims Act
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 … Continue reading
False Claims Act: Payment vs. Participation Regulations
In U.S. ex rel. Williams v. Renal Care Group, Inc. (Case No. 11-5779) (October 5, 2012), the Sixth Circuit Court of Appeals reversed a grant of summary judgment in favor of the United States on two main False Claims Act … Continue reading
Legal Hurdles Mount for Lab Corp and Quest
The U.S. Department of Justice (DOJ) and the Federal Trade Commission (FTC) recently released their Annual Report for Fiscal Year 2011 under the Hart-Scott-Rodino Antitrust Act. In brief, the Hart-Scott-Rodino Act allows the DOJ and FTC to block transactions believed to be … Continue reading
HHS OIG Identifies $332 Million in Uncollected Medicare Overpayments
On Friday the Office of Inspector General (“OIG”) of the Department of Health and Human Services (“HHS”) made public a report which revealed that the Centers for Medicare and Medicaid Services (“CMS”) had failed to collect over $332 million in Medicare … Continue reading
The Wild, Wild West of Billing by Out-of-Network Labs and Waivers of Patient Responsibility
O’Connell & Aronowitz attorneys, Jeffrey Sherrin, Kurt Bratten, and Charles Dunham, spoke at a national meeting of clinical laboratories in Las Vegas on May 19, on the complicated issue of referrals to and billing by out- of-network (OON) clinical laboratories, and … Continue reading
OMIG 2012-2013 Work Plan: A Brief Overview
“Fighting Fraud. Improving Integrity and Quality. Saving Taxpayer Dollars.” This phrase appears on each page of the newly released New York State Office of the Medicaid Inspector General (OMIG) State Fiscal Year 2012-2013 Work Plan. On the Executive Summary page, … Continue reading
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 … Continue reading
Federal Qui Tam Complaint Charges LabCorp with Improperly Billing the Medicare System Billions
A federal judge in New York’s Southern District Court recently unsealed a federal qui tam complaint alleging that Laboratory Corporation of America violated the federal False Claims Act by providing kickbacks to UnitedHealthcare in the form of highly reduced prices … Continue reading
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 … Continue reading
Federal Decision Shows Inability to Rely upon CMS Approval
A recent decision by the U.S. District Court for the Middle District of Tennessee has significant implications on provider arrangements structured in reliance on the knowledge and approval of the Centers for Medicare and Medicaid Services (CMS). In U.S. ex … Continue reading
RSS Feed for Health Law Sidebar