Nursing home cannot use Medicaid payment structure to evade ‘worthless services’ charges,...
By
Tim Mullaney
Jul 17, 2014
A nursing home cannot cite Medicare and Medicaid payment methods to escape charges that it provided “worthless services,” a federal judge recently ruled in a False Claims Act case.
Meds not dispensed without valid scrips, PharMerica says
By
Ashley Carman
Oct 01, 2013
Long-term care pharmacy giant PharMerica dispensed controlled narcotics without valid prescriptions and charged Medicare, the federal government alleges in a False Claims Act lawsuit. The company “vigorously”...
CMS overpayment rule may bring more whistleblower, false claims cases
By
Aug 30, 2016
A rule released earlier this year by the Centers for Medicare & Medicaid Services targeting overpayments may lead to an increase in cases involving the regulation, according to law experts.
In good news for providers, Supreme Court lowers bar on False Claims dismissals
By
Kimberly Marselas
Jun 16, 2023
The federal government can move to dismiss any False Claim suit, even over the objection of whistleblowers who stand to gain financially from ongoing litigation, the Supreme Court ruled Friday morning.
‘False and misleading’ marketing of drug to LTC providers to cost pharma company nearly $96M
By
Danielle Brown
Sep 29, 2019
A California-based pharmaceutical company has agreed to pay nearly $96 million to resolve False Claims Act violations for its alleged “false and misleading marketing” of a drug to long-term care providers...
Comments on a public conference call led to whistleblower lawsuit against nursing home therapy provider
By
McKnight's Staff
May 28, 2013
Comments made during a therapy provider’s public conference call in 2006 aroused the suspicion of a listener, who went on to file a whistleblower lawsuit. This was disclosed in a recent court filing...
Federal government joins upcoding case against hospitalist company operating in LTC facilities
By
Tim Mullaney
Dec 10, 2013
The federal government has intervened in a whistleblower lawsuit alleging that a large hospitalist company systematically overbilled government health programs, the U.S. Department of Justice announced...
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...
DOJ files false claims case against nursing home chain, director of operations
By
Sep 08, 2016
A Tennessee-based skilled nursing provider is facing a False Claims Act complaint after it allegedly submitted claims for services that were “grossly substandard” or not provided at all over...
Feds’ value-based changes present ‘long overdue’ opening for SNFs
By
Kimberly Marselas
Apr 06, 2023
Payment and quality experts on Wednesday described extensive changes proposed for skilled nursing’s value-based purchasing program as “long overdue” and a way to “reset the playing field.”