OIG Report: Medicare Paid out Millions in Improper Payments to Chiropractors

A report issued this month by the Office of Inspector General (OIG) finds that about half of Medicare payments made for chiropractic services between 2010 and 2015 were improper – that is they either were not medically necessary, not billed properly or not sufficiently documented. The report, titled “Medicare needs better controls to prevent fraud, […]

Second FCA Whistleblower Case Dismissed – What’s a Lawyer to Do?

For the second time in the last few weeks, a Florida district court judge has dismissed a whistleblower lawsuit filed against a healthcare company alleging fraud. The most recent dismissal, which took place on February 6, was of a lawsuit against electronic software company Epic that alleged it had overbilled for anesthesia procedures. In dismissing […]

Judge: Third Try Won’t be the Charm for Whistleblower

A U.S. District Court Judge earlier this month tossed a whistleblower lawsuit filed against a Florida compounding pharmacy finding that the former sales representative who filed the initial lawsuit in 2013 failed to make sufficient pleadings. However, defendant RS Compounding LLC in Tampa is not completely off the hook. The government intervened in, and the […]

GAO: CMS Fraud Prevention Working

The days of “pay and chase” in the world of healthcare fraud are waning thanks to fraud prevention methods that the Centers for Medicare and Medicaid Services have put into place. A newly released report from the Government Accountability Office (GAO) finds that Fraud Prevention System (FPS), which analyzes fee-for-service claims to identify healthcare providers […]

June a busy month for healthcare fraud enforcement

Individual physicians, medical billers, DME manufacturers, healthcare executives and even entire healthcare systems were on the receiving end of the U.S. Department of Health and Human Services Office of the Inspector General’s (OIG) enforcement efforts last month. In fact, there were 39 actions announced by the IG’s office in June, up from 35 in May […]

Genesis Healthcare Settlement Another Example of Government’s Anti-Fraud Campaign

Whatever else is taking place in the nation’s capital these days, one thing is for certain, there is no letup in the government’s crackdown on healthcare fraud. This is made clear by the continued announcements of multimillion-dollar settlements coming from various fraud-fighting agencies. One of the more recent settlements involves Genesis Healthcare, Inc., a Kennett […]

New Corporate Compliance Guidance Issued by DOJ

If you had any doubt that the U.S. Department of Justice had plans to back off its crackdown on healthcare fraud under then new Trump administration, all you need to do is look at its recently released guidance on corporate compliance to understand that it will continue to keep the pressure on. Titled Evaluation of […]

Case of 79-year-old Doctor Illustrates Need for Caution When Accepting Payments

The federal trial of a 79-year-old New Jersey physician charged in connection with a healthcare kickback scheme serves as yet another example of federal prosecutors’ aggressive stance against healthcare fraud and abuse. Dr. Bernard Greenspan is the latest physician to find himself facing jail time. He was among more than 40 people, many of them […]

New Exclusion Rules to Take Effect Next Month

Earlier this month, the Health and Human Services Office of the Inspector General (HHS-OIG) finalized its long-awaited rules on civil monetary penalties that could make it easier for providers to be excluded from participating in the Medicare and Medicaid programs. The final rule, which was published in the Federal Register on January 12, was first […]

The Health Law Offices of Anthony C. Vitale Scores Major Win Against Life Care Centers of America

$145M landmark settlement largest in DOJ history involving skilled nursing facility Oct. 26, 2016 (MIAMI, FLA.) It was a case that was eight years in the making, but on October 24, Anthony C. Vitale’s hard work and dedication paid off when Life Care Centers of America Inc., and its owner Forrest L. Preston, agreed to […]

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