False Claims

Any physician or practice manager who gets notification of a Medicare audit likely feels a bit of panic — and for good reason. What begins as a routine billing review can rapidly escalate into a Department of Justice investigation that can threaten everything you have...

Laboratory owners, like any business owner, want to reach out to fellow professionals and market the benefits of using their services versus their competitors. Although this is often a successful business strategy that works well in most markets, the rules are much...

Lawmakers recently introduced a new law that directly impacts the ability to bill Medicare for certain healthcare services that make use of artificial intelligence (AI). If passed, the Health Tech Investment Act would change Medicare’s coverage of algorithm-based...

The federal government continues its crackdown on health care fraud throughout the country, recently announcing criminal charges against hundreds, including four Texans. The Texans were business owners who failed to follow proper protocol when billing the government....

Medical device companies play an important role in patient care. They are responsible for developing and providing innovative technologies that enhance the diagnosis, treatment, and management of various health conditions. These companies invest in research and...

False claims investigations can cause stress and uncertainty for healthcare professionals. These investigations often arise from allegations of fraudulent billing or misrepresentation to government programs like Medicare or Medicaid. Healthcare administrators,...

The False Claims Act (FCA), enacted in 1863, is a federal law that allows the government to combat fraud by imposing liability on individuals and companies who knowingly submit false claims for government funds. Under the FCA, violators must pay up to three times the...

A group of lawmakers claim “flawed court interpretations” have led to a loophole within the False Claims Act (FCA). In an effort to put an end to this loophole, these lawmakers have proposed the False Claims Amendments Act of 2023. What is the loophole? The lawmakers...

Allegations of a violation of the False Claims Act (FCA) are serious. Physicians must make sure their billing practices are in line with this and other federal regulations or they can face steep financial penalties and potential imprisonment. Any physician who learns...

Physicians and other healthcare professionals enter the medical field to help provide care to patients. Each individual professional will vary slightly in how they provide care. This is normal. What can be frustrating is the question of who gets to decide if a...