Failure to Repay Can Result in FCA Case

There’s nothing wrong with holding on to money for as long as you can before giving it back, is there? Well, if you’re a medical practice and you delay repaying overpayments owed to the government, then it can get you in some hot water. That’s what happened to First Coast Cardiovascular Institute, P.A., a Jacksonville, […]

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 […]

SCOTUS Hears Arguments on Implied Certification Theory

Last month, the United States Supreme Court took up the issue of whether False Claims Act (FCA) cases may be brought by whistleblowers and the government under the theory known as “implied certification.” And, if so, under what circumstances. On April 19, the high court heard oral arguments in Universal Health Services v. United States […]

SCOTUS to take on implied certification liability under FCA

The U.S. Supreme Court will decide whether False Claims Act (FCA) cases may be brought by whistleblowers and the government under the theory known as “implied certification” and if so, under what circumstances. Under this theory, when a provider submits a claim for government payment, it does so with the implication that it is being […]

How whistleblowers are helping to fight healthcare fraud

Earlier this month, the Department of Justice announced it had resolved a $237 million judgment against Toumey Healthcare System in South Carolina for violations of the Stark Law. In this particular case, the hospital was alleged to have entered into contracts with 19 specialists that required them to refer their outpatient procedures to the hospital […]

Federal prosecutors increasingly target individual healthcare execs in anti-fraud efforts

Last month’s sentencing of the former president and CEO of OtisMed Corporation to two years in prison should serve as yet another example that federal prosecutors are not holding back when it comes to holding corporate executives accountable. Charlie Chi was sentenced for intentionally distributing a medical device used in knee replacement surgery despite the […]

What happens if you become the target of a healthcare fraud investigation?

No healthcare provider wants to become the target of a healthcare fraud investigation. But, as we have seen, it happens more often than we would like to think. Not only does a healthcare fraud investigation come with the potential for criminal penalties, but the state also can impose harsh consequences resulting in the loss of […]

Whistleblower lawsuits: How to avoid becoming a target

Earlier this month, three former managers of AIDS Healthcare Foundation Inc. (AHF) filed federal and state Whistleblower Act claims against their former employer. They allege that the nation’s largest supplier of HIV/AIDS medical care participated in patient referral kickbacks to the tune of at least $20 million since 2010. All three plaintiffs held management positions […]