Health and Human Services Issues Its FY 2014 Healthcare Fraud Report

Over the course of the next two posts, we will examine the recent report released by the Department of Health and Human Services detailing its successes in combating healthcare fraud during fiscal year 2014. With regard to False Claims Act settlements, healthcare fraud remains one of the top issues impacting […]

Air Ideal, Inc. Settles False Claims Act Allegations With DOJ in Unique Agreement

The Small Business Administration maintains several programs and opportunities to help historically underserved communities and demographics. One such program is known as the Historically Underutilized Business Zone program, also known as the HUBZone program. Under HUBZone rules, preferential treatment may be available for potential business owners seeking to start or […]

DOJ Blocks Lance Armstrong Settlement; Cites Public Interest Concerns

In 2010, Lance Armstrong’s former cycling teammate, Floyd Landis, filed a lawsuit against Armstrong under the False Claims Act. In essence, Landis’s claims centered on the nearly 30 million in taxpayer dollars given to the team during its sponsorship by the U.S. Postal Service – and the subsequent revelation that […]

How Courts are Holding on ‘Worthless Services’ Allegations Under the False Claims Act

In yesterday’s post, we examined the emerging concept known as ‘worthless services’ within the context of the False Claims Act. Under the FCA, a defendant may face liability for intentionally submitting claims for reimbursement to Medicare or Medicaid that are known to be false or based on false information. On […]

Recognizing ‘Worthless Services’ Under the False Claims Act

When it comes to committing fraud against Medicare and Medicaid, there are a number of ways for doctors, hospitals, and medical companies to get around the rules. Some encourage billing specialists to “upcode” for higher reimbursement rates, essentially billing Medicare or Medicaid for services never rendered. Others, quite alarmingly, perform […]