May 5, 2015
SEC Fraud
SEC Chairwoman Marry Jo White in a speech on April 30, 2015 noted that “[t]he program, while clearly developing, has proven to be a game changer.” White noted the increasing volume and quality of tips as well as the powerful incentives to come to the SEC with evidence of wrongdoing. […]
May 5, 2015
Healthcare Fraud
The Jacksonville Center for Reproductive Medicine (JCRM) recently settled with the Department of Justice amid allegations it billed the government for fertility services at rates above and beyond those allowable under TRICARE guidelines.
May 4, 2015
Healthcare Fraud
In yet another case of healthcare fraud, Richmond, Virginia-based Health Diagnostics Laboratory and Alameda, California-based Singulex, Inc. have agreed to pay a combined $48.5 million to settle allegations of rampant False Claims Act violations. The case involves two issues under the False Claims Act. First, the labs are alleged to […]
May 1, 2015
Healthcare Fraud
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
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
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
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
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
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
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
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
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.