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New York Optician Convicted of Medicaid Fraud for Nursing Home Residents

Healthcare Compliance Blog

A New York optician has pled guilty to grand larceny for submitting false claims for optician services that he alleged were for specific nursing home residents, but which were never provided. On January 27, 2022, he was sentenced to 90 days in state prison, followed by 5 years’ probation, and was ordered to pay $74,00 in restitution.

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CMS Proposes Minimum Staffing Requirements and Enhanced Facility Assessments for Nursing Homes

C&M Health Law

Department of Health and Human Services, through the Centers for Medicare & Medicaid Services (“CMS”) issued a much anticipated and contested proposed rule that seeks to establish minimum staffing level requirements for nursing homes. hours of nursing staff per resident per day, or 3.0 HPRD from nurse aids (NAs). [2]

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Massachusetts Medicaid Fraud Division Recovers Over $55 Million in 2021

Healthcare Compliance Blog

On January 19, 2022, the Massachusetts Medicaid Fraud Division announced that in calendar year 2021, more than $55 million was recovered from individuals and entities who defrauded the state. The Attorney General’s Medicaid Fraud Division investigates and prosecutes providers who defraud the state Medicaid program, MassHealth.

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HHS & DOJ FY 2022 Enforcement Targeted Fraud in COVID-19, Telemedicine, Opioid and Prescription Drugs, and Substance Use Treatment Centers, Among Other Initiatives

Healthcare Law Blog

The Department of Health and Human Services (HHS) and the Department of Justice (DOJ) recently released its “Health Care Fraud and Abuse Control Program Annual Report for Fiscal Year 2022 ” (the “Report”), highlighting continued enforcement and recovery actions under the Health Care Fraud and Abuse Control Program (HCFAC).

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North Dakota CNA Found Guilty after Injuring Nursing Home Resident by Improper Lifting

Med-Net Compliance

The evidence at the trial showed that the CNA performed an improper, one-person lift of a nursing home resident which resulted in severe and painful injuries to the resident. The CNA is being held in custody until the date of her sentencing hearing on November 29, 2022. “[The

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Woman Arrested for Practicing Medicine without a License at 7 Nursing Homes

Med-Net Compliance

South Carolina Attorney General Alan Wilson announced that his office’s Medicaid Fraud Control Unit (SCMFCU) arrested a 37-year-old woman for allegedly practicing medicine as a registered nurse without a license at seven nursing and assisted living facilities in Anderson, Greenville, and Pickens counties.

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DOJ Recouped $2.2 Billion Under FCA in 2022

Hall Render

billion in False Claims Act (“FCA”) related settlements and judgments in the federal fiscal year 2022. Whistleblowers continue to be one of the federal government’s greatest assets in FCA cases, as whistleblowers filed 652 qui tam suits in 2022 with recovery totaling $1.9 Health Care Fraud Actions Medicaid.