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 […]

Florida-Based Coastal Dermatology Settles False Claims Act Allegations for $787,000

Following an investigation by the Department of Health and Human Services, along with the Office of Inspector General and the Department of Defense’s investigative unit, a Florida dermatology clinic known as Coastal Dermatology has opted to settle allegations of fraud and illegal billing procedures. The allegations – which are not […]

Michigan’s Agility Health to Settle False Claims Act Charges Claims for $1 Million

In a press release issued by the Department of Justice on February 25, 2015, authorities revealed the details of alleged misconduct occurring within the national health management chain known as Agility Health, LLC and one of its local Michigan facilities known as Oceana County Medical Care Facility. The case was […]

Michigan Hospital Settles Self-Disclosed False Claims Act Case for Over $4 Million

In a rare turn of events, the Department of Justice has actually commended Michigan-based Portage Hospital, LLC after it opted to self-report various perceived violations of the False Claims Act by a member of its physical therapy staff. The U.S. Attorney’s Office said in a statement: “Portage Hospital is to […]