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Medicare Fraud

Quest Diagnostics to Pay $1.79 Million to Settle Fraud Claims

A New Jersey-based diagnostic clinical laboratory has agreed to pay $1.79 million to settle claims it defrauded Medicare.Image source: Wikimedia Commons 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 [...]

By | 2018-03-26T02:28:28+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|

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

Health Diagnostics Laboratory and Singulex, Inc. have both agreed to settle claims of wrongfully engaging in kickbacks with physicians, as well as ordering medically unnecessary tests on behalf of Medicare and Medicaid patients.Image source: Wikimedia Commons In yet another case of healthcare fraud, Richmond, Virginia-based Health Diagnostics Laboratory [...]

By | 2018-03-27T02:36:22+00:00 May 4th, 2015|Healthcare Fraud|

DOJ’s Motion to Reopen PharMerica Whistleblower Case Highlights Critical FCA Issues

Despite having reached a settlement in September, the DOJ has motioned to reopen the whistleblower case against PharMerica, citing several ongoing disputes.Image source: Wikimedia Commons 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 [...]

By | 2018-03-25T16:10:50+00:00 April 21st, 2015|Healthcare Fraud|

Adventist Health Settles Allegations it Failed to Supervise Radiologists

Adventist Health System has agreed to settle claims it did not properly supervise oncology radiology procedures.Image source: Wikimedia Commons 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 [...]

By | 2018-03-25T10:35:53+00:00 April 9th, 2015|Healthcare Fraud|
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