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upcoding

Hamilton Healthcare Accused of Allowing Excluded Practitioner to Treat Medicare and Medicaid Patients

Harrisburg, Pennsylvania-based Hamilton Healthcare has agreed to settle allegations of Medicare and Medicaid fraud. As a healthcare practitioner, permission to work with Medicaid and Medicare participants can be an extremely lucrative area of practice. For many physicians working in areas with an aging or low-income demographic, government healthcare [...]

By | 2018-03-27T02:28:06+00:00 July 17th, 2015|Healthcare Fraud|

Medical Center of Central Georgia to Settle Allegations of Illegal Upcoding for $20 Million

Illegal billing practices are one of the most common components of a False Claims Act lawsuit. Oftentimes, healthcare facilities engage in years’ worth of fraudulent billing practices before a courageous whistleblower comes forward with allegations of misconduct. At that time, the federal government may opt to intervene in the matter and the perpetrators may [...]

By | 2018-09-13T11:41:32+00:00 May 11th, 2015|Healthcare Fraud|

Florida Fertility Clinic Settles Upcoding Allegations With Department of Justice

The Jacksonville Center for Reproductive Medicine is alleged to have “upcoded” several fertility services performed by nurses and medical assistants.Image source: Flickr CC user COD Newsroom The Jacksonville Center for Reproductive Medicine (JCRM) recently settled with the Department of Justice amid allegations it billed the government for fertility [...]

By | 2018-03-26T01:53:34+00:00 May 5th, 2015|Healthcare Fraud|

Baptist Health Medical Center to Settle False Claims Act Allegations for $2.7 Million

Medical practitioners seeking to treat Medicare patients are required to abide by the policy manuals and guidelines put out by the federal government. If a practitioner knowingly violates these mandates and intentionally bills Medicare for reimbursement despite the deviation, this could trigger False Claims Act liability. One of the more common violations of Medicare [...]

By | 2018-08-21T14:47:56+00:00 March 19th, 2015|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 submitted for repayment on [...]

By | 2018-08-21T14:58:58+00:00 December 4th, 2014|Healthcare Fraud|

Arizona Hospital Network Carondelet, Corp. Pays $35 Million to Settle Healthcare Fraud Claims

In yet another healthcare fraud case, a prominent Arizona-based hospital management company has agreed to remit $35 million to settle allegations of improper billing procedures. Earlier this month, Carondelet Health Network – which manages Carondelet St. Mary’s Hospital and Carondelet St. Joseph’s Hospital, both in the Tuscon area – agreed [...]

By | 2018-03-27T09:45:56+00:00 August 29th, 2014|Healthcare Fraud|

Unique Whistleblower Lawsuit Points Finger at Insurance Company Aveta, Inc.

A whistleblower is alleging fraud by health insurance provider Aveta, Inc. in a lawsuit claiming $1 billion in overpayments by Medicare. The lawsuit is still under investigation by the DOJ. In today’s whistleblower case, we examine a story involving health insurance company Aveta, Inc. and its ongoing defense of a whistleblower lawsuit brought [...]

By | 2014-07-04T22:16:43+00:00 July 4th, 2014|Healthcare Fraud|
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