Potential False Claims Act liability for nursing homes
By
Mysty Blagg
Jul 07, 2021
The FCA is the Department of Justice’s key tool in combating healthcare fraud and abuse The False Claims Act (FCA) provides a remedy of civil damages when a party 1) makes a false statement or engages...
Feds recover record $4 billion from fraudulent healthcare claims
Jan 25, 2011
The U.S. departments of Justice and Health and Human Services recovered a total of $4 billion in fiscal 2010 from healthcare fraud cases prosecuted under the False Claims Act, according to a new report...
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...
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.
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...
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...