Fraud and Abuse


EHR Exposé Shakes Up Industry
March 19, 2019 | Eric D. Fader | Electronic Health Records | False Claims Act | Fraud and Abuse | Hospitals | Legislation and Public Policy | Litigation | Medicare and Medicaid
A three-month joint investigation of electronic health records (EHR) systems has culminated in a release of a March 18 article in Kaiser Health News (KHN) and Fortune Magazine, “Death By 1,000 Clicks: Where Electronic Health Records Went Wrong.” The lengthy, meticulously sourced article calls EHR systems “an unholy mess.” KHN and Fortune have made the …
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CMS to Propose Significant Changes to Stark Law
March 7, 2019 | Cassandra Rivais | Fraud and Abuse | Legislation and Public Policy | Medicare and Medicaid
At the Federation of American Hospitals’ 2019 Public Policy Conference on March 4, Centers for Medicare & Medicaid Services (CMS) Administrator Seema Verma announced the agency’s plan to make dramatic changes to the federal physician self-referral prohibition, commonly known as the Stark Law. The changes are designed to support a value-based model of care in …
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EHR Vendor to Pay $57 Million to Settle FCA Case
February 11, 2019 | Geoffrey R. Kaiser | Electronic Health Records | False Claims Act | Fraud and Abuse | Litigation | Medicare and Medicaid
On February 6, the U.S. Department of Justice announced that Greenway Health LLC, a Florida-based developer of electronic health records (EHR) software, will pay $57.25 million as part of a False Claims Act settlement. The United States had alleged that Greenway misrepresented the capabilities of its software product, called “Prime Suite,” causing healthcare providers to submit …
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Pathology Lab Company to Pay $63.5 Million to Settle FCA Case
February 5, 2019 | Christopher J. Kutner | Electronic Health Records | False Claims Act | Fraud and Abuse | Litigation | Medicare and Medicaid
Inform Diagnostics, a Texas-based pathology laboratory company, will pay the federal government $63.5 million to resolve allegations that the company violated the False Claims Act (FCA). The U.S. Department of Justice announced the settlement on January 30. Inform Diagnostics was alleged to have engaged in improper financial relationships with physicians, including providing them with subsidies …
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FTC to Focus on Unsubstantiated Health Claims
January 30, 2019 | Steven Shapiro | Fraud and Abuse | Litigation | Pharmaceuticals
On January 28, the Federal Trade Commission (FTC) published on its Business Blog a post titled “Hey Nineteen: Nine FTC developments that could impact your business in 2019.” Of most importance to the healthcare industry is the FTC’s promise to focus on unsubstantiated health claims in advertising. The relevant paragraph of the post reads as …
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Walgreens Pays $269.2 Million to Settle Fraud Allegations
January 24, 2019 | Geoffrey R. Kaiser | False Claims Act | Fraud and Abuse | Litigation | Medicare and Medicaid | Pharmaceuticals
Walgreens Boots Alliance, Inc., the operator of the Walgreens pharmacy chain, has agreed to pay $269.2 million in two settlements with the U.S. Department of Justice to resolve fraud allegations. The two cases arose from lawsuits filed by whistleblowers under the False Claims Act and were prosecuted federally by the U.S. Attorney’s Office for the Southern …
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Orthodontic Practice Pays $9 Million Settlement
January 23, 2019 | Eric D. Fader | Fraud and Abuse | Litigation | Medicare and Medicaid
On January 15, New York Attorney General Letitia James announced that Diamond Braces, an orthodontic practice with 10 offices in the State of New York, has settled charges that it allowed uncertified employees to perform orthodontic procedures and then improperly billed the Medicaid program for the procedures. The settlement included $4.5 million in restitution for …
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Rivkin Attorneys to Speak at “The Business of Medicine” Seminar
January 14, 2019 | Rivkin Rounds Staff | Employer/Employee | Fraud and Abuse | HIPAA | Hospitals | Medicare and Medicaid
Rivkin Radler’s Jeffrey Rust and Eric Fader will be among the presenters at “The Business of Medicine,” a seminar to be held on Saturday, January 26, 2019, at the Convene conference center, 101 Park Avenue (at 41st Street), New York, New York. Neuro Alert Services LLC, a multistate provider of intraoperative neurophysiologic monitoring services, designed …
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The False Claims Act: A Powerful Tool Against Federal Health Care Program Fraud
January 7, 2019 | Rivkin Rounds Staff | False Claims Act | Fraud and Abuse | Litigation | Medical Devices and Wearables | Medicare and Medicaid | Pharmaceuticals
Evan Krinick authored an article, “The False Claims Act: A Powerful Tool Against Federal Health Care Program Fraud,” that was published in the New York Law Journal.  The article discusses recent actions taken by U.S. Attorneys in New York against health care providers under the FCA. …
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Diabetes Pill Marketers Settle FTC Complaint
December 14, 2018 | Steven Shapiro | Fraud and Abuse | Litigation | Pharmaceuticals
On December 4, the Federal Trade Commission (FTC) announced the settlement of a complaint against Nobetes Corporation, which marketed and sold a pill that supposedly treats diabetes. The FTC complaint had alleged that the company made false or unsubstantiated health claims, engaged in illegal billing practices, and used deceptive endorsements in the marketing and sale …
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