Search Results (167)
Documents on White Collar Crime, Health Care
Show: results per page
|Jury Finds Tuomey Healthcare System Guilty Of Stark and False Claims Act Violations Pursuant To Physician Employment Agreements|
Waller Lansden Dortch Davis LLP;
May 17, 2013, previously published on May 13, 2013Following a month-long retrial, a South Carolina jury has concluded that Tuomey Healthcare System, Inc. (Tuomey) violated the Stark Law and the False Claims Act by illegally paying referring physicians. The jury found that Tuomey’s compensation arrangements with referring physicians were...
|An In-Depth Look at the Fraud Charges Against Vitas Hospice Services|
Waller Lansden Dortch Davis LLP;
May 17, 2013, previously published on May 15, 2013Earlier this month, the United States Department of Justice (“DOJ”) filed a suit against Vitas Hospice Services, L.L.C. and its subsidiary entities (“Vitas”) alleging that Vitas submitted false claims for hospice services which were excessive, unnecessary, or not provided,...
|$39 Million Jury Verdict in False Claims Act Suit against Tuomey Healthcare|
Scott Ewing, Jeremy D. Kernodle; Haynes and Boone, LLP;
May 17, 2013, previously published on May 15, 2013Last week, a federal jury in South Carolina found that Tuomey Healthcare System, Inc. violated the Stark Law and the False Claims Act by submitting false claims for reimbursement to the United States, resulting in $39 million in damages to the government. United States ex rel. Drakeford v. Tuomey...
|E/M Update: DOJ Targets Improper Use of Modifier 25|
Stephanie M. Barr; Marshall Dennehey Warner Coleman & Goggin, P.C.;
May 8, 2013, previously published on May 7, 2013Evaluation and management (E/M) services are visits to patients by physicians and non-physician practitioners to assess and manage a patient's health. E/M services are grouped into visit types, including office visits (new patient and established patient) and hospital visits (inpatient and...
|Fourth Circuit Upholds Lengthy “Stent” for Interventional Cardiologist|
John Staige Davis; Williams Mullen;
April 29, 2013, previously published on April 25, 2013Can a cardiologist be sent to prison for performing medically unnecessary stent procedures, even though he stented a considerably lower percentage of his patients than his peers?
|OIG Fraud Alert on Physician-Owned Distributorships (PODs)|
Michael A. Dowell; Hinshaw & Culbertson LLP;
April 15, 2013, previously published on April 2, 2013On March 26, 2013, the Office of Inspector General (OIG) of the U.S. Department of Health and Human Services issued its “Special Fraud Alert: Physician-Owned Entities” (Alert). The Alert addresses physician-owned distributorships (PODs) that derive revenue from selling, or arranging for...
|Increased Government Scrutiny of Physician-Owned Device Distributorships|
Duane Morris LLP;
April 6, 2013, previously published on April 3, 2013On March 26, 2013, the Office of Inspector General of the U.S. Department of Health and Human Services (OIG) increased its scrutiny of and pressure on physician-owned entities (particularly medical device distributorships) by issuance of a Special Fraud Alert. Although there is nothing specifically...
|Sixth Circuit Rules No FCA Liability Based on Violation of Medicare Requirements|
Ellyn L. Sternfield; Mintz, Levin, Cohn, Ferris, Glovsky and Popeo, P.C.;
April 6, 2013, previously published on April 3, 2013On April 1st, the Sixth Circuit reversed an $11.1 million dollar summary judgment finding entered against MedQuest Associates, a diagnostic testing company. In its opinion, the Sixth Circuit found that violation of two Medicare enrollment requirements did not warrant liability under the federal...
|OIG Issues Warning to Hospitals and Other Providers In Special Fraud Alert on Physician-Owned Distributorships for Implantable Medical Devices|
Clay J. Countryman; Breazeale, Sachse & Wilson, L.L.P.;
April 4, 2013, previously published on April 1, 2013On March 26, 2013, the Office of Inspector General (OIG) of the U.S. Department of Health and Human Services issued a Special Fraud Alert on Physician-Owned Entities. In the introduction, the OIG provided that this Special Fraud Alert addresses physician-owned entities (i.e., referred to as...
|Preparing for the Unexpected: The Affordable Care Act’s Whistleblower Provision|
Igor M. Babichenko, Mary E. Pivec; Williams Mullen;
March 14, 2013, previously published on March 14, 2013On February 27, 2013, the Occupational Safety and Health Administration published its interim final rule setting forth the procedures for handling complaints brought under the whistleblower provision of the Affordable Care Act (“ACA”). This whistleblower provision presents yet another...