Medicare Advantage plan settles upcoding allegations for $22.5M
By
Kimberly Marselas
Aug 02, 2023
A Medicare Advantage plan will pay $22.5 million to settle allegations that it systematically reviewed patient charts to tack on additional charges before submitting claims to Medicare, federal law enforcement...
Lab owner bilked Medicare of $7 million in nursing home COVID scheme, feds say
By
Kimberly Marselas
Jul 21, 2023
A laboratory owner preyed on nursing home clients to bilk Medicare out of at least $7 million in claims for early COVID-era tests that were unnecessary and, in some cases, never performed, the government...
To control private equity, legal experts suggest government sharpen existing tools
By
Kimberly Marselas
Mar 25, 2022
While the Biden administration is targeting private equity firms that invest in nursing homes for reforms, two attorneys well-versed in fraud argue that existing mechanisms could deter private equity from...
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.
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.”
Rehab firm will pay $2M to resolve False Claims Act allegations involving 11 nursing homes
By
Kimberly Marselas
Jul 26, 2021
A California-based therapy company has agreed to pay $2 million to quash allegations that it overbilled for rehab services provided at 11 skilled nursing facilities.
Nursing facilities victorious over ‘woefully’ weak whistleblower claim
By
Kimberly Marselas
Sep 22, 2023
A federal judge has dismissed False Claims allegations against eight skilled nursing facilities and their therapy partner, saying a would-be whistleblower didn’t offer enough detail to explain how a...
‘Grossly substandard’ care leads to False Claims charges for Ohio-based nursing home operator
By
Kimberly Marselas
Jun 16, 2022
The Justice Department late Wednesday announced it has sued three connected nursing homes in Ohio and Pennsylvania, citing their “grossly substandard skilled nursing services.”
Baseless False Claims cases could decline with Supreme Court intervention
By
Kimberly Marselas
Dec 05, 2022
The Supreme Court will hear arguments Tuesday from federal lawyers seeking to dismiss more False Claims allegations in which the government chooses not to intervene, a move that would likely reduce the...