Hall Render

JANUARY 29, 2025

The United States Department of Justice (DOJ) recently settled part of a qui tam lawsuit under the False Claims Act for alleged violations of the Medicare 14-Day Rule for $388,667. The DOJ, therefore, claimed the laboratory and health system knowingly caused the submission of false claims for reimbursement to Medicare.

Medicare 52

Medicare Medicare Hospitals Compliance 52

The Health Law Firm

JULY 9, 2012

A Pennsylvania man has been charged in a 23-count indictment in relation to an alleged scheme to defraud Medicare by billing for fraudulent ambulance services. The charges were announced by the Department of Justice (DOJ) on June 29, 2012. By Miles Indest. Straw" Owner Allegedly Used to Start Ambulance Company.

Medicare 40

Medicare Medicare Fraud 40

The Health Law Firm

NOVEMBER 2, 2012

A Los Angeles medical equipment supplier will spend 30 months in prison for submitting nearly $1 million in false claims to Medicare. The man was sentenced on October 5, 2012. Man Used Kickbacks and Illegally Solicited Medicare Beneficiaries in Scheme. The claims were almost all for expensive, high-end power wheelchairs.

Medicare 40

Medicare Medicare Fraud 40

The Health Law Firm

MARCH 4, 2013

A report released by the Government Accountability Office (GAO) on February 27, 2013, announced that Medicare will remain a "high-risk" program with respect to its fraud and waste vulnerability. In 2012, according to the report, CMS let more than $44 billion in improper payments go out. Leider, J.D., The Health Law Firm.

Medicare 40

Medicare Medicare Fraud Medicaid 40

The Health Law Firm

OCTOBER 3, 2012

On September 19, 2012, power wheelchair suppliers voiced their concerns over a new government program called the Power Mobility Devices (PMDs) Demonstration at a Senate Special Committee on Aging. To see the Power Mobility Devices (PMDs) Demonstration operational guide from the Centers for Medicare and Medicaid Services (CMS), click here.

Medicare 40

Medicare Medicare Fraud Medicaid 40

The Health Law Firm

DECEMBER 10, 2012

A Detroit-area registered nurse was sentenced on November 19, 2012, to 30 months in federal prison for his alleged part in a nearly $13.8 million Medicare fraud scheme. Nurse Caught Reportedly Signing False Medicare Claims. Indest III, J.D., Board Certified by The Florida Bar in Health Law.

Nurses 40

Nurses Medicare Medicare Fraud 40

The Health Law Firm

AUGUST 31, 2012

The Department of Justice (DOJ) announced that a Daytona Beach chiropractor pleaded guilty to health care fraud, conspiracy to illegally distribute prescription drugs and money laundering on August 28, 2012. Chiropractor Submitted Inflated Bills to Medicare. Click here to read the entire press release from the DOJ.

Fraud 40

Fraud Medicare Medicare 40

The Health Law Firm

NOVEMBER 9, 2012

The Los Angeles Times article, released October 12, 2012, names an official with knowledge of this matter as the source. According to an article in the Los Angeles Times, authorities are looking into reports that CVS has been refilling prescriptions and submitting insurance claims without patients’ permission.

US Department of Health and Human Services 40

US Department of Health and Human Services Fraud Medicare Medicare 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

The Health Law Firm

OCTOBER 4, 2012

alleging Medicare fraud against Parrish Medical Center, was dismissed by a US District Judge in Tampa, Florida, on August 15, 2012. Indest III, J.D., Board Certified by The Florida Bar in Health Law. A whistleblower lawsuit against Blackstone Medical, Inc.,

Fraud 40

Fraud Medicare Medicare 40

HIPAA Journal

MARCH 20, 2025

150,000 Settlement 2012 Alaska DHSS $1,700,000 Settlement 2012 Massachusetts Eye and Ear Infirmary and Massachusetts Eye and Ear Associates, Inc. Dominion National Insurance Company, and Dominion Dental Services USA, Inc. CA Healthcare Provider 2,364,359 Hacking/IT Incident 57 2024 Medical Management Resource Group, L.L.C.

HIPAA 111

HIPAA Ransomware Compliance Hospitals 111

Healthcare Law Today

JANUARY 2, 2023

” The currently proposed provision has similar effect to the language CMS proposed in 2012 and, after consideration of comments, ultimately rejected in the 2014 Final Rule (Medicare Advantage and Part D) and 2016 Final Rule (Medicare Part A and Part B). The FCA is a fraud statute, requiring intent. 3729(b)(1)(A).

Overpayments 52

Overpayments Overpayment ACA Medicare 52

Innovaare Compliance

FEBRUARY 9, 2021

Annually, the Centers for Medicare & Medicaid Services (CMS) releases star ratings, which measure the quality of care health plans deliver for its members. Medicare Advantage and Part D) for a comprehensive assessment of a health plan’s performance. Read More – Medicare Star Ratings Changes 2021 . Industry trends.

Medicare 40

Medicare Medicare Medicaid Medicaid 40

Provider Trust

MARCH 16, 2022

Exclusions are administrative actions that are placed upon an individual or entity by HHS OIG, a state agency or Medicaid Fraud Control Unit (MFCU), or by one of the many agencies associated with SAM.gov. What is an exclusion and how does it affect your organization? Read our post to learn how often you should check the OIG exclusion list.

Medicaid 52

Medicaid Medicaid Medicare Medicare 52

Health Care Law Brief

NOVEMBER 30, 2021

In an advisory opinion posted November 10, 2021 ( AO 21-15 ), the Office of the Inspector General of the United States Department of Health and Human Services (OIG) appeared to soften a disturbing position that it had taken in 2012 regarding the employment safe harbor.

Medicare 40

Medicare Medicare Regulatory Compliance Fraud 40

Health Populi

OCTOBER 8, 2019

The study reviewed reports and articles published between January 1, 2012 and May 15, 2019, dressing the topic of waste across six domains previously identified by the Institute of Medicine: Failure of care delivery, with waste ranging between $102 bn and $166 bn. Failure of care coordination, with a waste-range of $27 bn – $78 bn.

Prescription Drug Pricing 108

Prescription Drug Pricing Medicare Medicare ACA 108

New Jersey Healthcare Blog

JULY 22, 2022

1117(a), the Department of Human Services, Office of Program Integrity and Accountability proposed amendments, repeals, and new rules to comply with the Department’s Fee-for-Service initiative, the Centers for Medicare and Medicaid Services’ guidelines for funding, Danielle’s Law, P.L. In 2012, N.J.S.A. 191 (N.J.S.A.

COVID-19 Vaccine 40

COVID-19 Vaccine Licensing COVID-19 Public Health 40

Drug & Device Law

JANUARY 30, 2023

470 (1996), was decided – removing express preemption as a defense for manufacturers of §510(k) products So defendants moved on fraud on the FDA under an implied preemption theory and won. Mensing , 564 U.S. Mensing , 564 U.S. Lohr , 518 U.S. Davidowitz , 312 U.S. Davidowitz , 312 U.S.

FDA 72

FDA Fraud Governance Medicare 72