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Philips Recalled CPAP, Bi-Level PAP, and Mechanical...
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April 28, 2015
Healthcare Fraud
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 […]
April 23, 2015
Healthcare Fraud
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 […]
April 22, 2015
Healthcare Fraud
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 […]
April 21, 2015
Healthcare Fraud
DOJ’s Motion to Reopen PharMerica Whistleblower Case Highlights Critical FCA Issues
False Claims Act cases often conclude with a negotiated settlement between the Department of Justice (DOJ), defendant(s), and the relator(s). However, settlements are complex matters that contain a number of terms and provisions unique to each individual case.
April 16, 2015
Healthcare Fraud
Off-Label Marketing Becomes Global Issue as World Health Organization Encourages Cost-Effectiveness
Amid global shortages of life-saving medical resources, the United Nations’ World Health Organization has released a report focusing on various cost-saving tactics for member nations to consider while strategizing medical policy. At the heart of the matter, the WHO found that most nations do not have procedures in place to […]
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