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 […]

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

Of the various ways in which healthcare providers can violate the False Claims Act, ordering medically unnecessary procedures – particularly those involving the cardiac system – are considered particularly egregious. As opposed to illegal upcoding or kickback schemes, the performance of medically unnecessary procedures actually places patients directly in harm’s […]

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

When it comes to reimbursement for surgical procedures, Medicare and Medicaid maintain strict guidelines with regard to the location of the surgery and whether it took place in a hospital or independent facility. Recognizing that hospitals have a much higher overhead rate, and generally cost more to operate and maintain, […]

Connecticut Doctor Settles Allegations of Medicare Fraud

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 geriatric care. The physician, who has been practicing medicine for over 40 years, is alleged to have instructed his staff and billing […]

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 […]