Tag archive: heat

Massive National Health Care Fraud Takedown

Last week, the OIG reported charges against 301 individuals for approximately $900 Million in false billing as part of the largest false claim takedown. The takedown focused on a broad range of providers including home health companies, physicians, physical and occupational therapy clinics, infusion clinics, mental health providers, DME suppliers, and compounding pharmacies. Of importance,…

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…

False Claims Act Update – 16 Hospitals to Pay $15.69M Related to Medically Unnecessary Psychotherapy Services

On May 7, 2015, the Department of Justice reported settlement with 16 separate hospitals for medically unnecessary or unreasonable psychotherapy services. The claims under scrutiny were Intensive Outpatient Psychotherapy (IOP) services, which represent a variety of treatment methods. The services, while billed to Medicare by the providers, were performed on the providers’ behalf by Allegiance…

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…

Hot Day for HEAT – Medicare Fraud Strike Force Announces 1 Conviction, 1 Guilty Plea & 1 Indictment Today

On April 17, 2015, the Health Care Fraud Prevention and Enforcement Action Team (HEAT) reported three new actions involving Medicare fraud and abuse. Since the Medicare Fraud Strike Force began in March 2007, HEAT has charged nearly 2,100 defendants who have collectively billed the Medicare program for more than $6.5B. The Medicare Fraud Strike Force,…

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…

Another False Claims Act Settlement for HEAT – Amedisys Inc. agrees to pay $150M

The Department of Justice announced a False Claims Act settlement where Amedisys agreed to pay $150 million and will be bound by a Corporate Integrity Agreement as a result of alleged improper financial relationships and false billing. The settlement resolves seven qui tam (whistleblower) lawsuits brought primarily from former Amedisys employees. The whistleblowers will collectively…

RehabCare settles FCA allegations for $30 Million

Next time you wonder how serious the government is about anti-kickback law, think about the latest False Claims Act settlement of $30 Million.  This settlement was part of the government’s emphasis on combating health care fraud and marks another achievement for the Health Care Fraud Prevention and Enforcement Action Team (HEAT) initiative, partnering Department of…

MISSOURI

St. Louis  |  Clayton  |   Kansas City

ILLINOIS

Alton  |  Carbondale  |  Edwardsville  |  O'Fallon

The information on this website is for general information purposes only. Nothing on this site should be taken as legal advice for any individual case or situation.
This information is not intended to create, and receipt or viewing does not constitute, an attorney-client relationship. © 2014 Sandberg Phoenix & von Gontard P.C. All Rights Reserved.

Menu