The Health Law Firm

MARCH 13, 2013

Individuals working in the health care industry, whether for hospitals, nursing homes, medical groups, home health agencies or others, often become aware of questionable activities. In many cases the activity may amount to fraud on the government. This is the first blog of a two-part series.

Fraud 40

Fraud Governance Nursing Homes Nurses 40

Pharmacy Law Blog

FEBRUARY 13, 2018

On November 22, 2017, a Florida woman who was accused of a $45 million Medicare fraud, received a six-and-a-half-year prison sentence, following a 2016 U.S. Supreme Court decision in her case holding that the government could not freeze untainted assets. Indest III, J.D., Board Certified by The Florida Bar in Health Law.

Fraud 40

Fraud Medicare Medicare Governance 40

Hall Render

FEBRUARY 27, 2023

The government initiated 296 FCA cases on its own last year without input of a relator, which is the highest volume of DOJ initiated cases since the 1986 FCA amendments. This has been a growing trend in health care enforcement, and health care fraud remained the leading source of all FCA cases in 2022. COVID-10 Related Fraud.

Nursing Homes 40

Nursing Homes Fraud Medicaid Medicaid 40

Provider Trust

JANUARY 25, 2024

This report helps HHS fulfill its mission to improve the health and well-being of Americans while also providing suggestions for how healthcare organizations can stay ahead of the curve to avoid and combat fraud, waste, and abuse. Unfortunately, Medicare Advantage programs are not exempt from instances of fraud, waste, and abuse.

Fraud 52

Fraud Medicaid Medicaid Medicare 52

MedTrainer

NOVEMBER 6, 2023

While specific compliance requirements vary depending on the type of facility — from large hospitals and surgery centers to clinics and nursing homes — having a well-structured compliance plan is essential for all medical settings. But what exactly is a compliance plan in healthcare, and why is it so crucial?

Compliance 52

Compliance Fraud Nursing Homes Governance 52

Hall Render

NOVEMBER 10, 2023

Since the release of its first compliance program guidance (“CPG”) for hospitals in 1998, OIG has developed a series of voluntary CPGs directed at various subsets of the health care industry, such as hospitals, nursing homes, third-party billing companies, clinical laboratories, among many others.

Compliance 40

Compliance Compliance Officers Fraud Governance 40

Healthcare Law Blog

NOVEMBER 16, 2023

More broadly, the Final Rule is an important step towards achieving the Biden-Harris Administration’s stated goal of increasing nursing home transparency and accountability. In particular, CMS is interested in evaluating how certain ownership structures impact care and treatment outcomes.

Nurses 52

Nurses Medicaid Medicaid Medicare 52

Med Law Blog

MAY 1, 2023

Howell, Constantine Yannelis and Abhinav Gupta positing that their research shows that “PE ownership increases short term mortality of Medicare patients by 10%, in nursing homes”.

Nursing Homes 52

Nursing Homes Malpractice Hospitals Nurses 52

Hall Render

APRIL 14, 2023

NATIONAL 94% of Organizations Experienced a Cyberattack in 2022 AHA blog: Strengthening crisis management in rural health care Biden signs bill ending Covid-19 national emergency Cancer drug shortages are creating dire circumstances for some patients CMS Releases FY24 IPPS Proposed Rule, Seeks to Boost Rates by 2.8%

Nursing Homes 40

Nursing Homes US Department of Health and Human Services Nurses COVID-19 40

AIHC

FEBRUARY 16, 2024

The GCPG standardized the seven Elements of a Successful Compliance Program, which differs slightly from the individual compliance guidance documents (CPGs) directed at various segments of the health care industry, such as hospitals, nursing homes, third-party billers, and durable medical equipment suppliers. The result?

Compliance 52

Compliance US Department of Health and Human Services COVID-19 Hospitals 52

AIHC

FEBRUARY 16, 2024

The GCPG standardized the seven Elements of a Successful Compliance Program, which differs slightly from the individual compliance guidance documents (CPGs) directed at various segments of the health care industry, such as hospitals, nursing homes, third-party billers, and durable medical equipment suppliers. The result?

Compliance 52

Compliance US Department of Health and Human Services COVID-19 Hospitals 52

Drug & Device Law

DECEMBER 29, 2023

2023) (federal government may unilaterally obtain dismissal of FCA claims, and calling the constitutionality of the FCA’s private enforcement mechanism into question) ( here ); Quishenberry v. 2023) ( Buckman preemption barred MDL asserting fraud on EPA), cert. In 2023, these include United States ex rel. Polansky v. 3d 239 (Cal.

FDA 105

FDA US Department of Health and Human Services COVID-19 Informed Consent 105

Drug & Device Law

JANUARY 17, 2024

O’Lear is a criminal case, in which the defendant was convicted by a jury of healthcare fraud (billing Medicare and Medicaid for fictitious mobile X-rays at nursing homes) and aggravated identity theft. (The Ninth Circuit okayed such exclusions in a couple of unpublished memoranda dispositions.)

COVID-19 98

COVID-19 Nursing Homes Fraud FDA 98