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Philips Recalled CPAP, Bi-Level PAP, and Mechanical...
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December 4, 2014
Healthcare Fraud
CareAll Companies Agree to Pay $25 Million in False Claims Act Settlement
In yet another instance of costly and wasteful healthcare fraud, CareAll Management, LLC has agreed to pay $25 million to resolve allegations of illegal upcoding and falsification of information on official requests for reimbursement. In the context of healthcare fraud, the False Claims Act is triggered whenever an invoice is […]
December 3, 2014
Healthcare Fraud
Visiting Nurse Service Settles Alarming Long-Term Healthcare Fraud Allegations
For individuals in need of long-term care (i.e., a permanent stay in a nursing home), the options are to either self-fund the monthly charge or to apply for Medicaid benefits. As Medicare does not cover long-term care, patients in need of this vital service must be eligible by showing financial […]
October 29, 2014
Healthcare Fraud
Extendicare Health Services Inc. to Pay $38 Million to Settle FCA Allegations Involving Substandard Care
One of the most alarming forms of healthcare fraud involves the provision of substandard care and the subsequent billing for that care to government programs like Medicare and Medicaid. Under applicable laws, a medical facility or skilled nursing entity can expose itself to False Claims Act liability for failing to […]
October 23, 2014
False Claims Act Information
Examining the Distinction Between Conditions of Participation Versus Conditions of Payment
The statutory requirements of the False Claims Act are highly specific, requiring a precise intent to defraud the government out of taxpayer dollars. An emerging issue across several federal courts involves the pivotal distinction between conditions for participation in Medicare or Medicaid versus conditions for reimbursement for patients enrolled in […]
October 13, 2014
Healthcare Fraud
CVS Caremark Corporation Settles False Claims Act Allegations for $6 Million
In several prior posts, we have discussed the ongoing battle against “reverse false claims” involving Medicare and Medicaid patients. In general, a reverse false claim occurs when a healthcare provider or government contractor receives overpayment for an invoice and knowingly fails to issue a refund or reimbursement to the government. […]
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