Search results

Order by most recent / most popular / relevance

Results: 1-10 of 11

Jury ruled in Tuomey Healthcare retrial that the hospital violated the Stark Law and False Claims Act

King & Spalding LLP
-
USA
-
May 13 2013

On May 8, 2013, a jury concluded that Tuomey Healthcare System, Inc. (Tuomey), a community hospital in Sumter, S.C., violated the Stark Law for

DOJ secures guilty pleas from owners of mental health corporation in $200 million Medicare fraud scheme

King & Spalding LLP
-
USA
-
April 18 2011

On April 14, 2011, Lawrence Duran and Marianella Valera, the owners of American Therapeutic Corporation (ATC), pleaded guilty to all counts in a superseding indictment charging Duran with 38 felony counts and Valera with 21 felony counts for a scheme that resulted in the submission of over $200 million in fraudulent claims to Medicare over eight years

Eleventh Circuit rejects insurers’ RICO class action against Astrazeneca seeking damages from off-label promotion

King & Spalding LLP
-
USA
-
March 21 2011

On March 11, 2011, the United States Court of Appeals for the Eleventh Circuit ruled that a class action lawsuit filed by welfare benefit plans failed to state federal Racketeer Influenced and Corrupt Organizations Act (RICO) claims against AstraZeneca stemming from the pharmaceutical company's off-label promotion of the antipsychotic drug Seroquel

Office of Inspector General publishes additional fraud & abuse training materials for new physicians

King & Spalding LLP
-
USA
-
February 21 2011

In November 2010, the Office of Inspector General (OIG) released a guide entitled "Roadmap for New Physicians: Avoiding Medicare and Medicaid Fraud and Abuse" (the Roadmap

Representatives Pete Stark and Wally Herger reintroduce a House bill

King & Spalding LLP
-
USA
-
February 21 2011

Representative Pete Stark (D-Calif.), author of what is colloquially referred to as the “Stark Law,” continues to focus on perceived fraud and abuse within the healthcare industry

Congressional Research Service issues report on Medicare program integrity

King & Spalding LLP
-
USA
-
August 8 2011

On July 29, 2011, the Congressional Research Service (CRS) issued a report entitled, “Medicare Program Integrity: Activities to Protect Medicare from Payment Errors, Fraud, and Abuse.”

CMS issues additional guidance on suspension of Medicaid payments pending an investigation of a credible allegation of fraud

King & Spalding LLP
-
USA
-
April 4 2011

On March 25, 2011, CMS released an informational bulletin providing guidance on Section 6402(h)(2) of the Patient Protection and Affordable Care Act (PPACA

Latest Medicare criminal fraud case alleges $375 million in unnecessary or unrendered home health services

King & Spalding LLP
-
USA
-
March 5 2012

On February 23, 2012, a Dallas-area physician and his office manager, as well as the owners of three home health agencies, were indicted on health care fraud and conspiracy charges stemming from $375 million in allegedly fraudulent Medicare and Medicaid claims relating to home health services

Denver Health Medical Center settles FCA short stay suit for $6.3 million

King & Spalding LLP
-
USA
-
January 17 2012

Denver Health and Hospital Authority, dba Denver Health Medical Center (DHMC), has agreed to pay $6.3 million to settle a False Claims Act suit alleging that, between 2006 and 2009, it “submitted false claims to Medicare and Medicaid by improperly submitting claims for short hospital stays as though they were ‘inpatient’ stays when they should have been billed as less expensive ‘outpatient’ or ‘observation’ stays.”

House subcommittee seeks report from CMS, HHS & DOJ on efforts to combat Medicare fraud

King & Spalding LLP
-
USA
-
March 12 2012

On March 7, 2012, Chair of the House Ways and Means Subcommittee on Oversight, Representative Charles W. Boustany, Jr. (R-La), issued letters to CMS, HHS and the DOJ requesting information about the entities’ efforts to combat Medicare fraud

next >