Health Law Gurus

Health Law Gurus

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Category Archives: Fraud and Abuse

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Antidotes for America’s Addiction Crisis

Posted in Fraud and Abuse, OIG Fraud Alert, Prescription Drugs and Medical Devices, Trends
Opioid addiction and abuse has exploded into a national epidemic. Every three weeks, America faces a death toll equivalent to the September 11th attacks due to drug overdoses, 75 percent of which are from opioid use. With more Americans dying each year from drug overdoses than gun violence and car crashes combined, the issue has… Continue Reading

News from the Health Law Gurus™: Week of February 22, 2015

Posted in Affordable Care Act (ACA), EHR, Fraud and Abuse, HIPAA, News from the Health Law Gurus
News from the Health Law Gurus™ is a weekly summary of notable health law news from around the country with helpful links to related content. Check back every week for the latest health law news stories. Meaningful Use Attestation Deadline Extended to March 20, 2015 – According to a news alert from the Centers for… Continue Reading

Hospice Provider Pays $4 Million to Settle Allegations of Fraudulent Billing

Posted in False Claims Act, Fraud and Abuse
Good Shepherd Hospice, Inc., a for-profit hospice providing services in Oklahoma, Missouri, Kansas, and Texas (“Good Shepherd”), has agreed to pay $4 million to the U.S. government to settle allegations that it submitted false claims for hospice patients who were not terminally ill. Good Shepherd has also agreed to enter into a five-year corporate integrity… Continue Reading

CMS Announces Launch of Open Payments Database: $3.5 Billion Paid to Physicians and Teaching Hospitals

Posted in Affordable Care Act (ACA), Anti-Kickback Statute, Fraud and Abuse, Trends
The Open Payments database (the “Database”) is now live, and the first round of data is available to the public on the Centers for Medicare and Medicaid Services (“CMS”) website. This first round of data reflects “nearly 4.4 million payments valued at nearly $3.5 billion attributable to 546,000 individual physicians and almost 1,360 teaching hospitals,”… Continue Reading

News from the Health Law Gurus™: Week of August 31, 2014

Posted in Fraud and Abuse, News from the Health Law Gurus, Privacy, Technology, Trends
News from the Health Law Gurus™ is a weekly summary of notable health law news from around the country with helpful links to related content. Check back every week for the latest health law news stories. HealthCare.gov Has Been Hacked, but Your Personal Information Is Safe – HealthCare.gov was hacked in July of this year.… Continue Reading

News from the Health Law Gurus™: Week of August 17, 2014

Posted in Affordable Care Act (ACA), Compliance Issues, False Claims Act, Fraud and Abuse, Health Insurance, HIPAA, News from the Health Law Gurus, Stark Law
News from the Health Law Gurus™ is a weekly summary of notable health law news from around the country with helpful links to related content. Check back every week for the latest health law news stories. Chinese Hackers Infiltrate Health System Network Affecting 4.5 Million Individuals – Community Health Systems, Inc. (“CHS”) reported this week… Continue Reading

News from the Health Law Gurus™: Week of August 3, 2014

Posted in Affordable Care Act (ACA), Compliance Issues, Fraud and Abuse, News from the Health Law Gurus, Technology, Trends
News from the Health Law Gurus™ is a weekly summary of notable health law news from around the country with helpful links to related content. Check back every week for the latest health law news stories. ICD-10 Compliance Deadline Is Now October 1, 2015 – Health care providers, health plans, and health care clearinghouses (“Health… Continue Reading

News from the Health Law Gurus™: Week of July 20th, 2014

Posted in Affordable Care Act (ACA), False Claims Act, Fraud and Abuse, News from the Health Law Gurus, Privacy
News from the Health Law Gurus™ is a weekly summary of notable health law news from around the country with helpful links to related content. Check back every week for the latest health law news stories. Circuit Split on ACA Subsidies—On Tuesday, the Court of Appeals for the D.C. Circuit (“D.C. Circuit”) and the Court… Continue Reading

News from the Health Law Gurus™: Week of July 13th, 2014

Posted in Affordable Care Act (ACA), False Claims Act, Fraud and Abuse, Legislation, News from the Health Law Gurus
News from the Health Law Gurus™ is a weekly summary of notable health law news from around the country with helpful links to related content. Check back every week for the latest health law news stories. $1 Million Settlement Reached in $73 Million Overbilling FCA Suit—Florida-based Halifax Health (“Halifax”) has settled a False Claims Act… Continue Reading

Lab Arrangements under the Microscope: OIG Issues New Fraud Alert

Posted in Compliance Issues, Fraud and Abuse
Arrangements between laboratories and referring physicians/physician group practices (the “physicians”) have long been subject to scrutiny by the Department of Health and Human Services Office of Inspector General (“OIG”). On June 25, 2014, the OIG released additional guidance on certain types of these arrangements in a Special Fraud Alert titled “Laboratory Payments to Referring Physicians”… Continue Reading

News from the Health Law Gurus™: Week of May 18th, 2014

Posted in Fraud and Abuse, News from the Health Law Gurus, Regulations
News from the Health Law Gurus™ is a weekly summary of notable health law news from around the country with helpful links to related content. Check back every Friday for the latest health law news stories. Former Chief Exec of HMO Company Sentenced to Three Years—The Department of Justice (“DOJ”) announced on Monday that Todd… Continue Reading

News from the Health Law Gurus™: Week of May 11th, 2014

Posted in Fraud and Abuse, Medicaid, Medicare, News from the Health Law Gurus
News from the Health Law Gurus™ is a weekly summary of notable health law news from around the country with helpful links to related content. Check back every Friday for the latest health law news stories. OIG to Expand Its Exclusion Authority under Proposed Rule—In a proposed rule published in the Federal Register last week,… Continue Reading

News from the Health Law Gurus™: Week of April 27th, 2014

Posted in Affordable Care Act (ACA), False Claims Act, Fraud and Abuse, News from the Health Law Gurus, Technology, Trends
News from the Health Law Gurus™ is a weekly summary of notable health law news from around the country with helpful links to related content. Check back every Friday for the latest health law news stories. FSMB Provides Guidance for State Medical Boards on Use of Telemedicine Technology—The Federation of State Medical Boards (“FSMB”) released… Continue Reading

I’ll Be Watching You: Medicare Billing Info on over 880,000 Providers Released by CMS to Improve Transparency

Posted in Compliance Issues, Fraud and Abuse, Medicare
Every payment you take, every claim you make, someone will be watching you. No, we don’t mean Sting. We mean all the consumers and businesses that will have greater access to physician billing information now because today the Centers for Medicare and Medicaid Services (“CMS”) released billing and payment information for over 880,000 practitioners. This… Continue Reading

Seeing Dollar Signs: U.S. Settles with Ophthalmologist for $1.4 Million to Resolve FCA Claims

Posted in False Claims Act, Fraud and Abuse, Medicaid, Medicare
Last week, the United States settled with a Baltimore ophthalmologist for alleged violations of the False Claims Act (“FCA”). Pursuant to the settlement, the ophthalmologist, Dr. John Arthur Kiely, agreed to pay $1.4 million to the government and to be excluded from participation in Medicare and Medicaid for 20 years. Generally, the FCA imposes civil… Continue Reading