On October 2, the U.S. Department of Justice (DOJ) announced that Phamatech, Inc. and its CEO have agreed to pay $3,043,484 to settle alleged False Claims Act (FCA) allegations. San Diego-based Phamatech, a medical technology company that manufactures diagnostic devices and provides laboratory testing, allegedly submitted false claims to Medicare for drug-testing services.

In addition

A September 30 article in Managed Care Executive, “Are we there yet? A look at 4 value-based care programs,” offered a snapshot of four value-based care programs being undertaken by the Centers for Medicare & Medicaid Services (CMS) and Blue Cross Blue Shield of Massachusetts. Rivkin Radler’s Chris Kutner was quoted in the article.

Chris gave

On October 1, the U.S. Department of Health and Human Services announced $20 billion in additional funding as part of its Phase 3 Provider Relief Fund. This large push from the government is meant to (a) ensure that all eligible providers who received prior provider relief distributions have a balanced equitable payment equal to 2%

On September 23, the U.S. Department of Justice announced that pharmaceutical company Gilead Sciences, Inc. agreed to pay $97 million to resolve claims that it illegally used a foundation as a conduit to pay the copays of thousands of Medicare patients taking Gilead’s pulmonary arterial hypertension drug Letairis. In addition to the False Claims Act

The U.S. Department of Justice (DOJ) announced on August 27 that New Jersey-based Konica Minolta Healthcare Americas Inc. agreed to pay $500,000 to resolve allegations that its former subsidiary, Viztek LLC, misrepresented the capabilities of its electronic health records (EHR) software, which caused users of the software to file false claims with the federal government.

Teva Pharmaceuticals USA Inc. is in the crosshairs of the U.S. Department of Justice (DOJ) on two separate matters. On August 18, the DOJ announced that it filed a lawsuit against Teva and an affiliate, Teva Neuroscience Inc., under the False Claims Act for violations of the federal Anti-Kickback Statute. The suit alleges that the

In response to the COVID-19 pandemic since mid-March, the Centers for Medicare and Medicaid Services (CMS) worked quickly to issue emergency guidance that allowed temporary expansion of payment for telehealth services and provided certain flexibility in providing telehealth services. The COVID pandemic has significantly increased awareness of the benefits of telehealth, as many patients have

The U.S. Department of Health and Human Services (HHS) and Department of Justice (DOJ) have released the 2019 annual report for their Health Care Fraud and Abuse Control Program. The government recovered almost $3.6 billion, of which about $2.5 billion was returned to the Medicare trust fund. The recoveries included judgments and settlements from fraud

Community Medicaid Services will undergo a significant change on October 1, 2020, due to the passage of the New York State Budget Bill (“2020 Bill”). Although many of the changes in the 2020 Bill are subject to federal approval, this bulletin will offer an overview of what might be affected. You can take steps now

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,