False Claims Act liability for poor quality of care
By
Jason R. Edgecombe and Ted Lotchin
Sep 14, 2015
Not surprisingly, different federal courts have staked out different positions on the standard for liability under a worthless services complaint.
‘Extrapolation’ demonstrates False Claims Act liability in rehab
By
Jason Edgecombe and Ted Lotchin
Aug 11, 2015
Recent FCA complaints have relied on a number of arguments to substantiate the submission of false claims for Medicare reimbursement: systematic upcoding to higher RUG levels due to corporate “pressure”...
Long-term care providers would do well to know the lesson from one Pennsylvania continuing care facility, which averted costly litigation when it discovered and later reported irregularities of more than...
Brookdale ‘whistleblower’ suit dismissed
By
John Hall
Apr 06, 2015
A federal judge has dismissed a former Brookdale Senior Living employee’s False Claims Act suit against the company while leaving the door open for an amended complaint, according to published reports
False Claims Act suit could affect CMS overpayment rule
By
John Hall
Mar 30, 2015
A complex argument over how to identify Medicaid overpayments could be why the Centers for Medicare & Medicaid Services postponed its pending rule on waiting periods for overpayment resolution, a Washington,...
Former NQF safety advocate settles false claims complaint for $1 million
By
John Hall
Mar 06, 2015
The former chair of a National Quality Forum safety committee has agreed to pay a $1 million civil fine to settle allegations he violated the False Claims Act by soliciting and accepting kickbacks, according...
Court: Provider must face federal upcoding charges
By
John Hall
Feb 24, 2015
A federal judge has ruled that a hospitalist company with thousands of post-acute care customers must face federal charges that it overbilled the Medicare and Medicaid programs millions of dollars.
Hospice pays $6.5 million fine to settle fraud case
By
John Hall
Feb 20, 2015
A New York hospice provider Wednesday agreed to pay approximately $6.5 million in fines to settle alleged false Medicare and Medicaid claims over a 16-month period.
Also in the news for Tuesday, February 10
Feb 10, 2015
Hospice company settles False Claims Act allegations for $4 million … Colorado says no to right-to-die legislation … NYT examines Obamacare’s issue for GOP … PA recovers $1.8 million...
NJ physicians to face charges that they kept people as inpatients to qualify them for SNF coverage, judge...
By
Tim Mullaney
Sep 03, 2014
A whistleblower can continue to pursue charges that a number of New Jersey physicians improperly designated Medicare beneficiaries as inpatients and sometimes prolonged their hospital stay to qualify them...