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Medicare 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 government in violation of [...]

By | 2018-09-12T16:46:44+00:00 September 7th, 2015|Healthcare Fraud|

Tennessee Hospital Agrees to Settle Allegations of False Billing and Unlawful Practices

The Regional Hospital of Jackson has agreed to pay $510,000 to settle allegations it engaged in medically unnecessary cardiac procedures and false billing. Of the various ways in which healthcare providers can violate the False Claims Act, ordering medically unnecessary procedures – particularly those involving the cardiac system [...]

By | 2018-03-25T15:42:09+00:00 August 20th, 2015|Healthcare Fraud|

Indianapolis Health Network Agrees to Settle False Claims Act Allegations for $20 Million

Indiana’s Community Health Network has agreed to settle claims it intentionally overbilled Medicare and Medicaid for procedures at ambulatory surgery centers.Image source: Wikimedia Commons When it comes to reimbursement for surgical procedures, Medicare and Medicaid maintain strict guidelines with regard to the location of the surgery and whether [...]

By | 2018-03-26T05:02:44+00:00 July 24th, 2015|Healthcare Fraud|

Vanguard Health Systems Agrees to Settle False Claims Act Allegations for $2.9 Million

Tennessee-based Vanguard Health Systems recently opted to settle extensive allegations of healthcare fraud for nearly $3 million. Vanguard Health Systems, which is based in Nashville, Tennessee, is accused of committing a number of violations under both the False Claims Act and the Stark Law, including illegal billing practices, [...]

By | 2018-03-26T09:28:22+00:00 July 16th, 2015|Healthcare Fraud|

Connecticut Doctor Settles Allegations of Medicare Fraud

The United States Attorney for the District of Connecticut recently announced a $218,000 settlement against a Ridgefield, Connecticut, geriatric physician. In a small but mighty settlement against an experienced Connecticut physician, the Department of Justice recently exposed significant fraud and upcoding schemes within a Ridgefield office specializing in [...]

By | 2018-03-25T14:35:36+00:00 June 29th, 2015|Healthcare Fraud|

Two Wheelchair Companies Settle Allegations of Medicare Fraud

Power mobility is one of the most costly medical devices currently allowable under Medicare and Medicaid guidelines. However, for patients who truly need this type of assistance, the help of a power wheelchair means the difference between a full and active lifestyle versus a purely homebound existence. As such, Medicare guidelines set forth precise [...]

By | 2018-10-04T15:55:08+00:00 June 11th, 2015|Healthcare Fraud|

Health Labs Agrees to Pay $48.5 Million to Settle Allegations of False Claims

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 have offered lucrative kickbacks [...]

By | 2018-09-12T11:55:03+00:00 May 4th, 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 eligible for post-hospital skilled [...]

By | 2018-09-21T14:30:40+00:00 April 30th, 2015|Healthcare Fraud|

Adventist Health Settles Allegations it Failed to Supervise Radiologists

In a recent healthcare fraud settlement, Adventist Health System – Sunbelt Healthcare Corporation has agreed to pay $5.4 million to settle allegations it improperly billed Medicare and Medicaid for radiology services. The settlement concludes an investigation conducted by the U.S. Attorney’s Office for the Middle District of Florida, the Civil Division’s Commercial Litigation Branch, [...]

By | 2018-08-21T14:27:47+00:00 April 9th, 2015|Healthcare Fraud|
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