Category archive: HEAT

False Claims Update: OIG Continues to Focus on Ambulance Services

Reduction of fraud and abuse remains a focus of the government’s efforts to ensure providers accountability.  Recently, the Department of Justice (DOJ) announced a $3.199 Million settlement of alleged False Claims Act violations resulting from an ambulance “swapping” arrangement between a skilled nursing home and ambulance service (Regent settlement). Once again, the Department of Justice…

Beware of Low Hanging Fruit – OIG Targets for Fraud and Abuse

On June 18, 2015, the US Attorney announced two investigations resulting in a number of accusations of Medicare and Medicaid fraud and abuse. The “Home Alone IV” take-down and the largest national health care fraud take-down to date involving more than 200 subjects accused of defrauding Medicare and Medicaid of more than $700 Million in…

Hot Day for HEAT – DOJ Settles FCA Lawsuit with PharMerica for $31.5M

Summer’s almost here and the weather is heating up for HEAT, the Department of Justice’s (DOJ) task force to combat healthcare fraud. This whistleblower initiated action was brought to the attention of the government by a former pharmacist employed by PharMerica. The settlement announced today relates to allegations of dispensing Schedule II controlled drugs without…

Learning the Hard Way – Omnicare to Pay $124M False Claims Settlement

False Claims Act (FCA) allegations are serious business. Anti-Kickback Statute prohibits offering, paying, soliciting or receiving remuneration to induce referrals of items or services covered by Medicare, Medicaid and other federally funded programs. Omnicare learned the hard way just how serious FCA actions can be when a whistleblower made allegations against it. The Department of…

DOJ sues HCR Manorcare for alleged Medically Unnecessary Therapy

Fraud and Abuse in healthcare remains a hot issue, as evidenced by recent HEAT announcements. Following three qui tam (whistleblower) actions being filed, the Department of Justice announced it would intervene in the consolidated lawsuits. At issue was whether HCR Manorcare exerted pressure on SNF administrators and rehabilitation therapists to provide medically unnecessary and unreasonable…

HEAT Settlement Resolves Alleged Inducement of Medicare and Medicaid Business

Next time you wonder how seriously the Department of Justice (DOJ) and its Health Care Fraud Prevention and Enforcement Action Team (HEAT) takes fraud and abuse, be assured they are very serious. This recently announced settlement arose from allegations the DOJ received from a whistleblower that Rite Aid provided gift cards to Medicaid and/or Medicare…

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