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May 1, 2015
Healthcare Fraud
Texas Medical Center Settles Healthcare Fraud Allegations for $21.75 Million
Known as the “Heart Hospital,” the county-owned Citizens Medical Center has agreed to pay a staggering $21.75 million amid allegations it engaged in unlawful kickback schemes with several of its cardiology and emergency medicine practitioners. Under both the False Claims Act and the Stark Law, it is considered unlawful to […]
April 30, 2015
Healthcare Fraud
Pennsylvania Retirement Community Settles With Government Amid Medicare Fraud Allegations
According to a press release by the Department of Justice released on April 15, 2015, Pittsburgh’s Asbury Health Center has agreed to pay $1,331,837.96 to settle claims it did not follow proper protocol with regard to post-hospital skilled nursing services. Under applicable Medicare Part A rules, a patient may be […]
April 29, 2015
Healthcare Fraud
Health and Human Services & DOJ Report Record Healthcare Fraud Year
In yesterday’s post, we began examining the recent report offered jointly by the Department of Health and Human Services (HHS) and the Department of Justice (DOJ) with regard to their accomplishments in combatting wasteful healthcare fraud. In fiscal year 2014, a whopping $3.3 billion was recovered on behalf of taxpayers […]
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 27, 2015
False Claims Act Legal News
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 […]
April 24, 2015
False Claims Act Legal News
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 […]
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 20, 2015
SEC Fraud
SEC Settles Fraud Case Regarding Restrictive Language With KBR, Inc.
Whistleblowers with knowledge of possible securities fraud are able to report this fraud confidentially under the relatively new whistleblower provisions of the 2010 Dodd Frank Act. If an employee opts to report the information directly to the government, he or she is thereafter protected from retaliatory maneuvers by the employer […]
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 […]
April 15, 2015
Uncategorized>Student Loan Fraud
Department of Education Yanks Funding From Several ‘Risky’ Colleges and Universities
Over the past several years, a number of colleges and universities have faced significant fines, penalties, and liabilities for unlawfully inducing students into enrolling using falsified or exaggerated graduation and employment data or by paying recruiters by the enrollee. For instance, several U.S. law schools were named in a recent […]
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