To say the feds are keeping a closer eye on you is probably a bit of an understatement.
False Claims notch a record year, increasing threat to skilled nursing
By
Kimberly Marselas
Feb 26, 2024
Healthcare providers were forced to pay a historic $2.7 billion to resolve federal False Claims Act allegations last year, an escalation that will likely allow the government to support even more investigations...
Whistleblowers get another chance to fine-tune 8-year-old allegations against Genesis
By
Kimberly Marselas
Apr 19, 2024
More than eight years after first alleging False Claims Act violations against Genesis Healthcare and Sun Healthcare, a group of whistleblowers was given more time to refine its case.
The risks of ‘swapping’ for durable medical equipment
By
Lori Rubin
Japa Volchok, D.O.
Apr 14, 2021
Skilled nursing facilities are to assume the cost of durable medical equipment, prosthetics, orthotics and supplies (DMEPOS) under a bundled payment methodology for residents in Medicare Part A covered...
$10 million therapy-provider kickback case may proceed, judge says
By
McKnight's Staff
Mar 20, 2013
A False Claims Act lawsuit involving a nursing home chain and therapy providers in Missouri can move forward, a federal judge has ruled. The case originated when a whistleblower alleged that a therapy...
Judge lets kickback case vs. therapy provider go forward
By
McKnight's Staff
May 01, 2013
A whistleblower lawsuit involving a nursing home chain and therapy providers in Missouri can move forward, a federal judge has ruled. The False Claims Act case originated with allegations that a therapy...
‘Extrapolation’ demonstrates False Claims Act liability in rehab
By
Jason Edgecombe and Ted Lotchin
Aug 11, 2015
Recent FCA complaints have relied on a number of arguments to substantiate the submission of false claims for Medicare reimbursement: systematic upcoding to higher RUG levels due to corporate “pressure”...
Judge dismisses claims of ‘nationwide’ Medicare fraud in Omnicare antipsychotics case
By
McKnight's Staff
May 23, 2013
Long-term care pharmacy Omnicare will not face charges that it engaged in “nationwide” Medicare fraud for off-label antipsychotics prescriptions, a federal judge recently ruled. However, the...
PharMerica faces False Claims lawsuit
Aug 14, 2013
PharMerica has been charged in a False Claims Act lawsuit by the federal government.
False Claims Act liability for poor quality of care
By
Jason R. Edgecombe and Ted Lotchin
Sep 14, 2015
Not surprisingly, different federal courts have staked out different positions on the standard for liability under a worthless services complaint.