Fraud and Abuse


Rivkin Health Attorneys Write the Book on Federal AKS and Safe Harbors
July 10, 2020 | Rivkin Rounds Staff | Electronic Health Records | Employer/Employee | False Claims Act | Fraud and Abuse | Hospitals | Legislation and Public Policy | Litigation | Medical Devices and Wearables | Pharmaceuticals | Private Insurers
Eric Fader, Jeff Kaiser, Chris Kutner, Ada Kozicz and Ben Malerba are authors of the newly released book, “The Federal Anti-Kickback Statute and Safe Harbors: A Practical Guide.” Published by the American Bar Association, the book covers all safe harbors currently in place, as well as the interplay between the Anti-Kickback Statute (AKS) and other …
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VNSNY Agrees to $57 Million Settlement
June 29, 2020 | Eric D. Fader | False Claims Act | Fraud and Abuse | Home Health | Litigation | Medicare and Medicaid
The Visiting Nurse Service of New York (VNSNY) has agreed to pay $57 million to settle a whistleblower lawsuit that alleged it billed the Medicare and Medicaid programs for hundreds of millions of dollars in home care visits that were not actually provided. The lawsuit, originally filed in 2014 by a former executive of VNSNY, …
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False Claims Act, Medical Necessity and Government Regulation of Medicine
May 14, 2020 | Rivkin Rounds Staff | False Claims Act | Fraud and Abuse | Hospitals | Litigation | Medicare and Medicaid
Rivkin Radler’s Geoffrey R. Kaiser authored an article for Law360 entitled “False Claims Act, Medical Necessity and Government Regulation of Medicine.” The full article can be found here. …
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OIG Posts FAQs on Enforcement During Pandemic
April 29, 2020 | Geoffrey R. Kaiser | Behavioral Health | False Claims Act | Fraud and Abuse | Hospitals | Legislation and Public Policy | Telehealth
On April 24, the Office of Inspector General (OIG) of the U.S. Department of Health and Human Services (HHS) published responses to certain frequently asked questions and further explained its application of administrative enforcement authorities to arrangements directly connected to the COVID-19 pandemic. OIG stated that it is accepting inquiries regarding application of its administrative …
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DOJ Charges California Physician with COVID-19 Fraud
April 21, 2020 | Marc S. Ullman | FDA | Fraud and Abuse | Litigation | Pharmaceuticals
On April 16, the United States Attorney’s Office for the Southern District of California charged Dr. Jennings Ryan Staley, a licensed physician and the operator of Skinny Beach Med Spa in San Diego, with mail fraud in connection with his offer to sell “COVID-19 treatment packs” to patients and the general public. Emails sent by Dr. Staley …
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Rivkin Radler Provides Business Briefing On Stark Law Waivers During COVID-19 Pandemic
April 14, 2020 | Rivkin Rounds Staff | Fraud and Abuse | Home Health | Hospitals | Legislation and Public Policy | Medicare and Medicaid
In the latest installment of Rivkin Radler’s COVID-19 Business Briefing Series, held on April 14, Geoffrey Kaiser and Ada Kozicz presented on the recent issuance by the U.S. Department of Health and Human Services (HHS) of blanket Stark Law waivers for certain types of business arrangements, intended to help address the current health emergency. On …
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Surgeon Sues Health System for ‘Forced Referrals’
April 8, 2020 | Rivkin Rounds Staff | Employer/Employee | False Claims Act | Fraud and Abuse | Hospitals | Litigation
An article in the April issue of Healthcare Risk Management, “Surgeon Sues Health System for ‘Forced Referrals’,” discussed a whistleblower lawsuit filed against a Florida health system. Rivkin Radler’s Geoffrey Kaiser was quoted in the article. Jeff pointed out that if a surgeon is an employee of a health system, requiring him to refer his …
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CMS Issues Guidance on Blanket Stark Law Waivers During COVID-19 Crisis
April 1, 2020 | Geoffrey R. Kaiser | Ada Kozicz | Fraud and Abuse | Home Health | Hospitals | Legislation and Public Policy | Medicare and Medicaid
On March 30, the Secretary of the U.S. Department of Health and Human Services issued blanket waivers of certain requirements of the federal physician self-referral law (Stark Law), retroactive to March 1, in response to the COVID-19 crisis. A detailed discussion of the waivers may be found here. …
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DOJ Takes First Action Against COVID-19 Fraud
March 25, 2020 | Marc S. Ullman | Fraud and Abuse | Litigation
On March 22, the U.S. Department of Justice (DOJ) announced its first action against COVID-19 fraudsters: a civil complaint seeking an injunction ordering the website coronavirusmedicalkit.com to shut down while an investigation into the site’s operators continues. A more detailed discussion of the DOJ’s action may be found here. …
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HHS Issues National Emergency Health Care Waivers
March 23, 2020 | Geoffrey R. Kaiser | Fraud and Abuse | HIPAA | Hospitals | Legislation and Public Policy | Medicare and Medicaid
Responding to the Coronavirus public health emergency, the Secretary of Health and Human Services (HHS) has waived certain requirements of the Medicare, Medicaid and Children’s Health Insurance Program (CHIP), including requirements relating to the Stark Self-Referral Law (“Stark”), the HIPAA privacy regulations and the Emergency Medical Treatment and Labor Act (EMTALA). This action was taken …
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