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September 7, 2015 Healthcare Fraud

Quest Diagnostics to Pay $1.79 Million to Settle Fraud Claims

Under the guidelines of Medicare Part B, enrollees are entitled to coverage for medically necessary and essential diagnostic services, including bloodwork, x-rays, and similar imaging examinations. If a provider fails to adhere to the Medicare guidelines, it could quickly face liability under the False Claims Act for unlawfully billing the […]
September 4, 2015 Healthcare Fraud

New York Attorney General Announces $8 Million Settlement Over Unlicensed Detox Programs

Following a lengthy investigation by both the state of New York’s Medicaid Fraud Control Unit and the U.S. Attorney’s Office for the Eastern District of New York, several medical corporations operating in the state have agreed to pay $8 million to settle allegations of fraud against Medicaid and Medicare. The […]
September 3, 2015 False Claims Act Information

Nuances of Liability: Conditions of Payment vs. Conditions of Participation Under the False Claims Act

In yesterday’s post, we reviewed two concepts that often serve as the basis of a whistleblower’s complaint under the False Claims Act. The first is known as a condition of payment violation, which occurs when a provider knowingly submits a claim for reimbursement to Medicare or Medicaid in violation of […]
September 2, 2015 False Claims Act Information

Understanding Conditions of Payment vs. Conditions of Participation

The False Claims Act is a unique and nuanced law that has been in effect since the 1800s. Since then, it has undergone several amendments and become an integral part of the government’s fight against wasteful healthcare and defense fraud. One of the most highly-contested issues within False Claims Act […]
September 1, 2015 Reverse False Claims

District Court Offers Interpretation of “Identification” in Reverse False Claims Act Cases

As we have discussed in the past on this blog, the concept of “reverse false claims” has become more and more prevalent among False Claims Act cases. In general, a reverse false claim occurs when a government contractor, often a healthcare provider, receives overpayment for an otherwise legitimate invoice. Under […]
August 31, 2015 Healthcare Fraud

Missouri Healthcare Providers Agree to Settle False Claims Act Allegations

When the H.E.A.T. Task Force convened in 2009, part of their mission was to eliminate costly and wasteful kickback schemes from the government-backed healthcare system. Kickback schemes, like the one profiled in today’s case, often involve improper financial arrangements between doctors either pharmaceutical companies or major healthcare corporations. In essence, […]
August 28, 2015 Contractor Fraud

Technology Integration Group Agrees to Pay $5.9 Million to Settle False Claims Act Allegations

Government contract work can be exceptionally lucrative for a small or medium-sized business, often comprising a large majority of its income and workload. In return for the reliability of payments, not to mention the payments themselves, under a contract with the federal government, contractors are required to adhere to certain […]
August 27, 2015 Military Contractor Fraud

Lockheed Martin Sub-Division Sandia to Pay $4.7 Million to Settle False Claims Act Allegations

Earlier this month, government contractor Sandia National Laboratories agreed to pay $4.7 million amid allegations that it improperly and intentionally misallocated federal funding in order to pay for lobbying efforts to Congress regarding contracts for nuclear research and development. Much like healthcare fraud, government contracting fraud is becoming a growing […]
August 26, 2015 Healthcare Fraud

Medical Device Manufacturer NuVasive Agrees to Settle False Claims Act Allegations

The publicly-traded company known as NuVasive, Inc. has agreed to pay $13 million to settle claims it fraudulently induced doctors and healthcare professionals to overbill government programs like Medicare and Medicaid. The company, which is based in California, is known for its design, manufacture, and sale of products used in complex […]
August 25, 2015 Healthcare Fraud

Pediatric Services of America Settles False Claims Act Allegations for $6.88 Million

Under the False Claims Act, sins of omission are punished just as severely as sins of commission, and Pediatric Services of America can attest to this fact. Known as reverse false claims, failing to properly reimburse programs like Medicare and Medicaid for known overpayments is considered equivalent to overbilling and […]
August 24, 2015 Education Fraud

Maryland’s ‘Educational Affiliates’ Agrees to Pay $13 Million to Settle False Claims Act Allegations

Federal Student Financial Aid is the largest provider of funding for American college students in the United States. These funds have paid approximately $150 billion in grants, work-study funds, and financial aid to 13 million students. Like all federal money, these funds come with strings attached and universities are required […]
August 21, 2015 Grant Fraud

Wheeling Jesuit University to Pay $2.3 Million to Settle Allegations of Federal Grant Fund Misuse

Unfortunately, fraud within universities is not uncommon, and today’s case highlights a growing trend of grant fund misuse. Located in the mountains of West Virginia, Wheeling Jesuit University has agreed to pay $2.3 million it is alleged to have misused, all of which was provided by the National Aeronautics and […]
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