The Health Law Firm

JUNE 20, 2012

Appeals Court Ruling Revives Securities Fraud Class Action Lawsuit. In making this decision, the appeals court has renewed a securities fraud class action that was dismissed by a trial court in 2010. To view the appeals court ruling in Public Pension Fund Group v. KV Pharmaceutical Company, click here.

Fraud 40

Fraud FDA 40

Healthcare IT Today

NOVEMBER 4, 2022

The US Department of Justice complaint alleges that from January 2010 to July 2017, the vendor engaged in multiple kickback schemes, including creating a partnership with a clinical laboratory, Miraca Life Science, through which ModMed received payments whenever its users sent lab orders to Miraca.

Governance 72

Governance Fraud 72

HIPAA Journal

JUNE 5, 2023

The leaked data included the personal information of individuals employed by the city between July 2010 and January 2022. Initially, 10 gigabytes of stolen data was released on the group’s dark web data leak site, followed by a massive data dump of 600 gigabytes when the city continued to refuse to pay the ransom.

Ransomware 58

Ransomware Fraud HIPAA 58

Compliancy Group

DECEMBER 13, 2024

Maintaining healthcare compliance includes being vigilant for warning signs of potential waste, abuse, and fraud due to identity theft. The term red flag refers to warning signs of fraud, waste, and abuse due to identity theft and other unlawful acts. Specific indications or red flags can tip you off to nefarious activities.

Compliance Officers 52

Compliance Officers Compliance Electronic Medical Records Fraud 52

Provider Trust

APRIL 18, 2024

ProviderTrust was founded in 2010 with a mission to create a safe healthcare experience for everyone. About ProviderTrust ProviderTrust was founded in 2010 with a mission to create safer healthcare for everyone through OIG and state Medicaid exclusion monitoring. To learn more, visit providertrust.com.

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Compliance Licensing Fraud Medicaid 52

The Health Law Firm

SEPTEMBER 19, 2012

The woman was arrested for allegedly stealing money from 11 clients in 2010 and 2011. Investigation by the Medicaid Fraud Control Unit (MFCU) Led to Arrest. To see the press release from the AG, click here.

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Fraud Medicaid Medicaid 40

The Health Law Firm

AUGUST 31, 2016

After the 2008 financial crisis, the US Congress passed the Dodd-Frank Wall Street Reform and Protection (Dodd-Frank) Act to combat financial fraud in our capital markets. 1376 (2010). 111-203, 124 Stat.

Fraud 40

Fraud Health Insurance 40

HIPAA Journal

OCTOBER 21, 2022

For example, the Administrative Requirements (Part 162) helped reduce insurance fraud and accelerated eligibility inquiries, authorization requests, and claims processing. Only one penalty was issued in each of 2008 and 2009, 2 in 2010, 3 in 2011, and 6 in 2012.

HIPAA 107

HIPAA Compliance Medicare Medicare 107

Healthcare Law Blog

JULY 29, 2022

According to the appellate court, the trial court’s jury instruction “brushed aside causation” and “misinterpreted” a 2010 amendment to the AKS. The Eighth Circuit Court of Appeals recently tossed a $5.5

Fraud 52

Fraud 52

Provider Trust

MAY 16, 2024

This landmark milestone represents a continued commitment by ProviderTrust and its nearly 1,000 healthcare client organizations to ensure Medicare and Medicaid dollars are protected from fraud, waste, and abuse. Healthcare compliance plays an instrumental role in the success of the entire healthcare ecosystem.

Fraud 52

Fraud Medicaid Medicaid Licensing 52

Provider Trust

MAY 16, 2024

This landmark milestone represents a continued commitment by ProviderTrust and its nearly 1,000 healthcare client organizations to ensure Medicare and Medicaid dollars are protected from fraud, waste, and abuse. Healthcare compliance plays an instrumental role in the success of the entire healthcare ecosystem.

Fraud 52

Fraud Medicaid Medicaid Licensing 52

CMS.gov

NOVEMBER 16, 2018

2018 Medicare Fee-For-Service improper payment rate is lowest since 2010. Fraud, waste, & abuse. 2018 Medicare Fee-For-Service improper payment rate is lowest since 2010 Significant progress in saving $4.59B in estimated improper payments for the Medicare Fee-For-Service program. Jeremy.Booth@c…. Fri, 11/16/2018 - 18:46.

Medicare 20

Medicare Medicare Overpayments Overpayment 20

Healthcare IT Today

NOVEMBER 22, 2023

Web developers have created systems for thwarting such fraud, so let’s look at how they would work in health care. is a greatly expanded version of the classic Blue Button created by the Department of Veteran Affairs in 2010. Each digital card includes a URL where the payer can retrieve the keys needed validate the card.

Department of Veterans Affairs 134

Department of Veterans Affairs Medicare Medicare COVID-19 134

HIPAA Journal

NOVEMBER 17, 2022

Salud Family Health said affected employees and patients have been offered free credit monitoring and identity fraud protection services, and security policies and procedures are being reviewed and will be updated to protect against future cyberattacks. New York-Presbyterian Hospital Discovers Breach Affecting up to 12,000 Patients.

Ransomware 84

Ransomware Health Insurance Fraud HIPAA 84

Health Populi

APRIL 24, 2018

” The brief answer is that the country experienced a huge fraud incident discovered in 2017 , involving 18 networks of corruption leading to at least 42 criminal cases. The resulting monetary loss was calculated to be at least $160 mm of fraud in 2017 alone. But you may be asking, “What happened in Colombia?”

Health Insurance 74

Health Insurance Fraud Hospitals Doctors 74

MedTrainer

JANUARY 12, 2024

Compliance in healthcare began to encompass billing, fraud, and abuse prevention. Affordable Care Act (2010): The ACA introduced the concept of value-based care, emphasizing quality and patient outcomes over quantity of services. Compliance efforts shifted toward protecting patient information.

Compliance 52

Compliance HIPAA Telemedicine ACA 52

Healthcare IT Today

JUNE 3, 2024

Yes, I know that the Affordable Care Act of 2010 mandated that health insurance companies can only keep to 20% of your premium and have to return the other 80% as benefits. The FBI is also tasked with combating fraud so they can do the investigation The real answer to ‘What are we waiting for?’ is ‘the will of this society.’

Health Insurance 80

Health Insurance ACA Doctors Fraud 80

MedTrainer

JULY 29, 2024

Training is required topics including fraud ( Stark Law ), HIPAA , and employee safety. Federal Regulation Impact on Corporate Compliance Training From the late 1990s to 2010, the OIG strongly encouraged healthcare providers across all sectors to implement compliance programs.

Compliance 52

Compliance US Department of Health and Human Services Regulatory Compliance Compliance Officers 52

HIPAA Journal

JANUARY 24, 2023

The theft of protected health information places patients and health plan members at risk of identity theft and fraud, but by far the biggest concern is the threat to patient safety. That task has become increasingly difficult due to the increase in data breaches, which have tripled since 2010. million records in 2021 to 51.9

HIPAA 122

HIPAA Ransomware Hospitals Fraud 122

MedTrainer

AUGUST 8, 2024

Fraud, Waste, and Abuse (FWA) Training Fraud, Waste, and Abuse (FWA) training is designed to help healthcare professionals detect, prevent, correct, and report fraudulent, wasteful, and abusive practices within the Medicare system. Attestation: Providers must complete training within 90 days of their hire date and annually thereafter.

Medicare 52

Medicare Medicare Compliance Medicaid 52

Healthcare Law Blog

FEBRUARY 9, 2024

Global billing or collaborative care arrangements are not per se violations of the Anti-Kickback Statute, however, there is greater fraud and abuse risk in these types of arrangements unless there is active, ongoing monitoring for compliance. Million To Resolve Health Care Fraud Allegations | United States Department of Justice [3] See Defs.

Hospitals 52

Hospitals Compliance Officers Compliance Overpayment 52

Health Care Law Brief

APRIL 12, 2023

405.986) or “reliable evidence” of fraud or “similar fault” (as defined in 42 C.F.R. 2010) (quoting S. Azar , the United States District Court for the District of Columbia held that the “knowledge” standard under the FCA is a more demanding standard of care than the “reasonable diligence” standard under the 60 Day Rule.

Medicare 52

Medicare Medicare Overpayments Overpayment 52

AIHC

JUNE 3, 2024

The estimated homicide rate for men increased by 7% from 2010 to 2016. The article states that Americans over 60 years of age fell victim to so-called elder fraud crimes more frequently last year than during any other year and accounted for an estimated $3.4 seniors account for $3.4 billion in reported losses, FBI says.

Elder Abuse 52

Elder Abuse Compliance Nursing Homes Compliance Officers 52

HIT Consultant

NOVEMBER 2, 2021

In 2010, the Affordable Care Act ushered in a new era for Medicaid Modularity, an approach anchored by breaking down large, monolith systems into smaller, more nimble and self-contained modules that can de-risk healthcare delivery and unlock innovation. Victor Sterling, Principal Industry Consultant at SAS.

Medicare 52

Medicare Medicare Medicaid Medicaid 52

Innovaare Compliance

FEBRUARY 9, 2021

The Affordable Care Act of 2010 mandates the CMS to make quality bonus payments (QBPs) to Medicare Advantage (MA) organizations that achieve at least four stars in a 5-star quality rating system and, starting in 2012, the CMS incentivizes health plans to improve member experiences by increasing the QBP amount, based on their star rating.

Medicare 40

Medicare Medicare Medicaid Medicaid 40

Hall Render

NOVEMBER 28, 2023

Due to CMS’s increasing concern “about program integrity issues within the hospice community, particularly (though not exclusively) potential and actual criminal behavior, fraud schemes, and improper billing,” it proposed to increase the risk screening category into which hospices were placed. CMS is finalizing this proposal.

Medicare 40

Medicare Medicare Payment Systems Medicaid 40

Health Law Advisor

MARCH 1, 2023

1] Originally enacted in 2010, the Online Prescribing Act has allowed health care providers to register with the State to prescribe and dispense certain FDA-approved drugs via online pharmacies and utilization of telehealth visits.

Telemedicine 52

Telemedicine COVID-19 Fraud Licensing 52

C&M Health Law

JANUARY 25, 2023

hospitalizations and emergency department visits) and to audit Medicare claims to assess potential fraud. Section 1001 of the Act delays the 4% Statutory Pay-As-You-Go Act of 2010 (PAYGO) sequester for two years, through the end of calendar year 2024.

Medicaid 104

Medicaid Medicaid Medicare Medicare 104

Drug & Device Law

FEBRUARY 15, 2024

2022) (recognizing the following product defect liability theories: “(1) negligent design of the product; (2) negligent manufacture of the product; (3) negligent failure to warn about some aspect of the product; (4) breach of express or implied warranty; or (5) misrepresentation or fraud”). 09-cv-10248, 2010 WL 4982899, at *5-6 (E.D.

FDA 52

FDA Fraud Compliance Hospitals 52

Drug & Device Law

DECEMBER 21, 2023

23, 2010) ( here ), can supersede our list, so far they’ve been thankfully uncommon. The logic of the consumer fraud claim made no sense. Letting plaintiffs use RICO (or the False Claims Act) to bring fraud on the FDA claims (preemption only applies to state law) is a distinct minority position, but the Ninth Circuit has.

FDA 52

FDA Fraud Informed Consent 52

Drug & Device Law

DECEMBER 4, 2023

2010) (citations and quotation marks omitted). “[W]e have exercised restraint” and “opt for the interpretation that restricts liability, rather than expands it, until the Supreme Court of [the affected state] decides differently.” 2010). “[E]ven if we were torn between two competing yet sensible interpretations of [state] law. . .,

Fraud 52

Fraud FDA Hospitals Doctors 52

Drug & Device Law

NOVEMBER 10, 2023

Not a single state, including Pennsylvania, allows recover of medical monitoring for “breach of warranty or fraud or violation of consumer protection statutes,” and Valsartan doesn’t cite any precedent for its contrary conclusion. ALI, Principles of the Law of Aggregate Litigation §2.04, comment b (2010). 2023 WL 1818922, at *36.

FDA 59

FDA Governance Fraud 59

Drug & Device Law

JULY 24, 2023

What’s worse, the fraud on the FDA claim, if brought under state law, would be preempted by Buckman Co. The class period is between 1999 and 2010. Fourth, similar factual problems were shoved under the rug with respect to the purported “pattern of racketeering activity” – allegations of “mail fraud and wire fraud.”

Fraud 52

Fraud FDA Doctors 52

Drug & Device Law

JANUARY 24, 2023

It was not enough for plaintiff to cite to post-2010 studies; she has to plead what information was provided to the FDA and when. Plaintiff’s fraud claims (including consumer fraud) were dismissed for failing to plead that her physician relied on any alleged omission—another claim dismissed under the learned intermediary doctrine.

Fraud 59

Fraud FDA Governance 59

Drug & Device Law

DECEMBER 30, 2022

2010), required the Gravitt court to let one claim survive the motion to dismiss, based on the idea that the purported claim for failure to report to FDA “implicates the state law duty of a manufacturer to inform regulators and the public when it has a reason to know that a product is riskier than initially believed.” Stryker Corp. ,

FDA 59

FDA Fraud 59

Drug & Device Law

NOVEMBER 28, 2022

2010) (Matsen); Nelson v. 3d 213, 222-23, 229-32 (S.D.N.Y. 2018) (Etminan); Gerke v. Travelers Casualty Insurance Co. , 316, 328-29 (D. 2013) (Painter); McClellan v. I-Flow Corp. , 2d 1092, 1119-25 (D. Tennessee Gas Pipeline Co. 1998 WL 1297690, at *4, 7-8 (W.D. 31, 1998), aff’d , 243 F.3d 3d 244 (6th Cir. 2001) (Kilburn); and Wade-Greaux v.

Informed Consent 59

Informed Consent Fraud FDA HIPAA 59

Drug & Device Law

AUGUST 8, 2022

The unfortunate truth is that ECFMG was also a victim of this fake doctor’s fraud. Smith, LLC , 2010 WL 11566367, at *7 (N.D. May 14, 2010) (“Defendant [standards institute’s] standards are voluntary, consensus standards, and Defendant. . . 2010); In re Welding Fume Products Liability Litigation , 526 F. 471 (11th Cir.

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Doctors Fraud Licensing Compliance 52