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...
Six nursing home entities file for bankruptcy following $258M FCA ruling
By
Danielle Brown
Mar 04, 2021
Six affiliated nursing home businesses of Consulate Health Care have filed for Chapter 11 bankruptcy in response to a $258 million judgment in a False Claims Act case against the operator.
Legal expert warns providers at increased risk for COVID lawsuits
By
Danielle Brown
Sep 04, 2020
Providers could see a wave of coronavirus-related lawsuits in the near future as cases rise, which is why a legal expert is stressing the importance of documentation and training to prevent operators from...
Saber to pay $10M False Claims settlement, denies therapy upcoding
By
Danielle Brown
Apr 15, 2020
A skilled nursing operator accused of pressuring some therapists and managers to place all patients in the highest rehab payment classification, regardless of clinical needs, is settling federal fraud...
New attorney general, Justice policies could take steam out of False Claims Act cases
By
Marty Stempniak
Feb 20, 2019
A new attorney general at the helm, plus possible policy changes on the horizon, could spell a slowdown in fraud accusations against providers.
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.
‘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”...
$9 million verdict against nursing home thrown out by appeals court
By
Elizabeth Newman
Aug 26, 2014
An Illinois nursing home won a victory last week when the U.S. Court of Appeals for the Seventh Circuit voided a $9 million verdict.
PharMerica faces False Claims lawsuit
Aug 14, 2013
PharMerica has been charged in a False Claims Act lawsuit by the federal government.
Government whistleblower lawsuit: PharMerica improperly dispensed, billed for narcotics
By
Tim Mullaney
Aug 13, 2013
Long-term care pharmacy company PharMerica dispensed controlled narcotics without valid prescriptions and billed Medicare for the drugs, the federal government has charged in a False Claims Act lawsuit.