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Seventh Circuit Clarifies “Authoritative Guidance” for the False Claims Act

Hall Render

However, some of the defendant’s customers typically paid less than the retail price for their medications through several discount programs that the defendant offered between 2006 and 2015. This footnote originated as a footnote in a memorandum issued by CMS in October of 2006. Practical Takeaways. Practical Takeaways.

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Excluded Psychiatrist Results in Allegations of Violating the False Claims Act

Healthcare Compliance Blog

In 2006, the excluded psychiatrist was convicted in Florida of conspiracy to commit healthcare fraud. While he served as the clinical director, the psychiatry company and its owner billed and sought reimbursement from federal healthcare programs, including Medicare, Tricare, and the Railroad Retirement Medicare Program.

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Whistleblowers Accuse Nursing Care Company of Medicare Fraud

The Health Law Firm

The nursing care company is accused of defrauding Medicare of millions of dollars for unnecessary and expensive therapy treatments from 2006 to 2011, according to the Wall Street Journal. Click here to read the entire article from the Wall Street Journal.

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Pennsylvania Man Charged with Medicare Fraud in Ambulance Scheme

The Health Law Firm

A Pennsylvania man has been charged in a 23-count indictment in relation to an alleged scheme to defraud Medicare by billing for fraudulent ambulance services. Between 2006 and 2011, the man allegedly billed Medicare for transporting kidney dialysis patients who did not medically need ambulance service. By Miles Indest.

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What is HIPAA?

HIPAA Journal

Title II: Preventing health care fraud and abuse; administration simplification; medical liability reform. The provisions related to administrative simplification are discussed below, while the provisions for medical liability reform (of which there are few) only relate to whistle blower protection for reporting fraud and abuse.

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An Overview of the New York OMIG Exclusion List

Provider Trust

In 2006, New York’s Office of the Medicaid Inspector General (OMIG) was established as an independent office within New York State’s Department of Health to combat fraud and abuse in New York State’s Medicaid program. What is New York's OMIG List of Restricted and Excluded Providers? Who needs to monitor the OMIG List?

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How HHS-OIG, Regulators Enforce Vendor Compliance

Provider Trust

Additionally, check out this HHS-OIG 2016 report, Medicare: Vulnerabilities Related to Provider Enrollment and Ownership Disclosure , which revealed “vulnerabilities that could allow potentially fraudulent providers to enroll in the Medicare program.”. Moon , for submitting claims while excluded from March 2006 through July 2013.