Healthcare Law Blog

JULY 29, 2022

According to the appellate court, the trial court’s jury instruction “brushed aside causation” and “misinterpreted” a 2010 amendment to the AKS. The Eighth Circuit Court of Appeals recently tossed a $5.5

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Fraud 52

The Health Law Firm

SEPTEMBER 12, 2012

The report focuses on the nation’s mental health clinics that overbilled Medicare in 2010, some by tens of millions of dollars. Big Busts in Two South Florida Mental Health Clinics for Medicare Fraud. The majority of these clinics were located in South Florida, Texas and Louisiana. To see the full report from the OIG, click here.

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MedTrainer

JANUARY 12, 2024

Compliance in healthcare began to encompass billing, fraud, and abuse prevention. Affordable Care Act (2010): The ACA introduced the concept of value-based care, emphasizing quality and patient outcomes over quantity of services. Compliance efforts shifted toward protecting patient information.

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Healthcare IT Today

NOVEMBER 4, 2022

The US Department of Justice complaint alleges that from January 2010 to July 2017, the vendor engaged in multiple kickback schemes, including creating a partnership with a clinical laboratory, Miraca Life Science, through which ModMed received payments whenever its users sent lab orders to Miraca.

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Governance Fraud 62

The Health Law Firm

AUGUST 31, 2016

After the 2008 financial crisis, the US Congress passed the Dodd-Frank Wall Street Reform and Protection (Dodd-Frank) Act to combat financial fraud in our capital markets. 1376 (2010). 111-203, 124 Stat.

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Healthcare Law Blog

FEBRUARY 9, 2024

Global billing or collaborative care arrangements are not per se violations of the Anti-Kickback Statute, however, there is greater fraud and abuse risk in these types of arrangements unless there is active, ongoing monitoring for compliance. Million To Resolve Health Care Fraud Allegations | United States Department of Justice [3] See Defs.

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The Health Law Firm

JUNE 20, 2012

Appeals Court Ruling Revives Securities Fraud Class Action Lawsuit. In making this decision, the appeals court has renewed a securities fraud class action that was dismissed by a trial court in 2010. To view the appeals court ruling in Public Pension Fund Group v. KV Pharmaceutical Company, click here.

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HIPAA Journal

OCTOBER 21, 2022

For example, the Administrative Requirements (Part 162) helped reduce insurance fraud and accelerated eligibility inquiries, authorization requests, and claims processing. Only one penalty was issued in each of 2008 and 2009, 2 in 2010, 3 in 2011, and 6 in 2012.

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Health Care Law Brief

APRIL 12, 2023

405.986) or “reliable evidence” of fraud or “similar fault” (as defined in 42 C.F.R. 2010) (quoting S. Azar , the United States District Court for the District of Columbia held that the “knowledge” standard under the FCA is a more demanding standard of care than the “reasonable diligence” standard under the 60 Day Rule.

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Medicare Medicare Overpayments Overpayment 52

The Health Law Firm

SEPTEMBER 19, 2012

The woman was arrested for allegedly stealing money from 11 clients in 2010 and 2011. Investigation by the Medicaid Fraud Control Unit (MFCU) Led to Arrest. To see the press release from the AG, click here.

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HIPAA Journal

NOVEMBER 17, 2022

Salud Family Health said affected employees and patients have been offered free credit monitoring and identity fraud protection services, and security policies and procedures are being reviewed and will be updated to protect against future cyberattacks. New York-Presbyterian Hospital Discovers Breach Affecting up to 12,000 Patients.

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Ransomware Health Insurance Hospitals Fraud 76

Healthcare IT Today

NOVEMBER 22, 2023

Web developers have created systems for thwarting such fraud, so let’s look at how they would work in health care. is a greatly expanded version of the classic Blue Button created by the Department of Veteran Affairs in 2010. Each digital card includes a URL where the payer can retrieve the keys needed validate the card.

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Health Populi

APRIL 24, 2018

” The brief answer is that the country experienced a huge fraud incident discovered in 2017 , involving 18 networks of corruption leading to at least 42 criminal cases. The resulting monetary loss was calculated to be at least $160 mm of fraud in 2017 alone. But you may be asking, “What happened in Colombia?”

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Health Insurance Fraud Hospitals Nurses 74

Health Law Advisor

MARCH 1, 2023

1] Originally enacted in 2010, the Online Prescribing Act has allowed health care providers to register with the State to prescribe and dispense certain FDA-approved drugs via online pharmacies and utilization of telehealth visits.

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Telemedicine COVID-19 Fraud Licensing 52

HIPAA Journal

JANUARY 24, 2023

The theft of protected health information places patients and health plan members at risk of identity theft and fraud, but by far the biggest concern is the threat to patient safety. That task has become increasingly difficult due to the increase in data breaches, which have tripled since 2010. million records in 2021 to 51.9

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Ransomware HIPAA Hospitals Fraud 113

HIPAA Journal

MAY 18, 2023

The Connecticut Attorney General was the first to exercise this right in 2010 against Health Net Inc. State attorneys general HIPAA cases were relatively rare occurrences, with only 11 settlements reached with HIPAA-covered entities and business associates to resolve HIPAA violations between 2010 and 2015. million 78.8 million 78.8

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HIPAA Compliance Ransomware Hospitals 95

Healthcare IT News - Telehealth

JULY 19, 2021

The practice was an early adopter of telehealth back in 2010, implementing it as a way to care for people unable to attend in-person sessions. Unsecure telehealth connections can open the door for fraud, phishing and ransomware attacks, with serious reputational and financial consequences. THE PROBLEM.

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COVID-19 HIPAA Ransomware Governance 156

Innovaare Compliance

FEBRUARY 9, 2021

The Affordable Care Act of 2010 mandates the CMS to make quality bonus payments (QBPs) to Medicare Advantage (MA) organizations that achieve at least four stars in a 5-star quality rating system and, starting in 2012, the CMS incentivizes health plans to improve member experiences by increasing the QBP amount, based on their star rating.

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HIT Consultant

NOVEMBER 2, 2021

In 2010, the Affordable Care Act ushered in a new era for Medicaid Modularity, an approach anchored by breaking down large, monolith systems into smaller, more nimble and self-contained modules that can de-risk healthcare delivery and unlock innovation. Victor Sterling, Principal Industry Consultant at SAS.

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Medicare Medicare Medicaid Medicaid 52

Hall Render

NOVEMBER 28, 2023

Due to CMS’s increasing concern “about program integrity issues within the hospice community, particularly (though not exclusively) potential and actual criminal behavior, fraud schemes, and improper billing,” it proposed to increase the risk screening category into which hospices were placed. CMS is finalizing this proposal.

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C&M Health Law

JANUARY 25, 2023

hospitalizations and emergency department visits) and to audit Medicare claims to assess potential fraud. Section 1001 of the Act delays the 4% Statutory Pay-As-You-Go Act of 2010 (PAYGO) sequester for two years, through the end of calendar year 2024.

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Medicaid Medicaid Medicare Medicare 104

Drug & Device Law

DECEMBER 21, 2023

23, 2010) ( here ), can supersede our list, so far they’ve been thankfully uncommon. The logic of the consumer fraud claim made no sense. Letting plaintiffs use RICO (or the False Claims Act) to bring fraud on the FDA claims (preemption only applies to state law) is a distinct minority position, but the Ninth Circuit has.

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Drug & Device Law

DECEMBER 4, 2023

2010) (citations and quotation marks omitted). “[W]e have exercised restraint” and “opt for the interpretation that restricts liability, rather than expands it, until the Supreme Court of [the affected state] decides differently.” 2010). “[E]ven if we were torn between two competing yet sensible interpretations of [state] law. . .,

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Drug & Device Law

JULY 24, 2023

What’s worse, the fraud on the FDA claim, if brought under state law, would be preempted by Buckman Co. The class period is between 1999 and 2010. Fourth, similar factual problems were shoved under the rug with respect to the purported “pattern of racketeering activity” – allegations of “mail fraud and wire fraud.”

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Drug & Device Law

NOVEMBER 10, 2023

Not a single state, including Pennsylvania, allows recover of medical monitoring for “breach of warranty or fraud or violation of consumer protection statutes,” and Valsartan doesn’t cite any precedent for its contrary conclusion. ALI, Principles of the Law of Aggregate Litigation §2.04, comment b (2010). 2023 WL 1818922, at *36.

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Drug & Device Law

NOVEMBER 28, 2022

2010) (Matsen); Nelson v. 3d 213, 222-23, 229-32 (S.D.N.Y. 2018) (Etminan); Gerke v. Travelers Casualty Insurance Co. , 316, 328-29 (D. 2013) (Painter); McClellan v. I-Flow Corp. , 2d 1092, 1119-25 (D. Tennessee Gas Pipeline Co. 1998 WL 1297690, at *4, 7-8 (W.D. 31, 1998), aff’d , 243 F.3d 3d 244 (6th Cir. 2001) (Kilburn); and Wade-Greaux v.

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Informed Consent Fraud FDA HIPAA 59

Drug & Device Law

DECEMBER 30, 2022

2010), required the Gravitt court to let one claim survive the motion to dismiss, based on the idea that the purported claim for failure to report to FDA “implicates the state law duty of a manufacturer to inform regulators and the public when it has a reason to know that a product is riskier than initially believed.” Stryker Corp. ,

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Drug & Device Law

AUGUST 8, 2022

The unfortunate truth is that ECFMG was also a victim of this fake doctor’s fraud. Smith, LLC , 2010 WL 11566367, at *7 (N.D. May 14, 2010) (“Defendant [standards institute’s] standards are voluntary, consensus standards, and Defendant. . . 2010); In re Welding Fume Products Liability Litigation , 526 F. 471 (11th Cir.

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Doctors Fraud Licensing Compliance 52

Drug & Device Law

FEBRUARY 15, 2024

2022) (recognizing the following product defect liability theories: “(1) negligent design of the product; (2) negligent manufacture of the product; (3) negligent failure to warn about some aspect of the product; (4) breach of express or implied warranty; or (5) misrepresentation or fraud”). 09-cv-10248, 2010 WL 4982899, at *5-6 (E.D.

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FDA Compliance Fraud Hospitals 52

Drug & Device Law

JANUARY 24, 2023

It was not enough for plaintiff to cite to post-2010 studies; she has to plead what information was provided to the FDA and when. Plaintiff’s fraud claims (including consumer fraud) were dismissed for failing to plead that her physician relied on any alleged omission—another claim dismissed under the learned intermediary doctrine.

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Drug & Device Law

MARCH 7, 2022

Here, Plaintiffs fail to supply factual support showing Defendant acted with “oppression, fraud, or malice,” relying instead upon conclusory allegations. 2010) (applying TwIqbal because “[p]unitive damages are never awarded as a matter of right, are disfavored by the law”). at *8 (agreeing with Bouncing Angels, Inc. Medtronic, Inc. ,

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