Health Care Investigations

The United States Department of Health and Human Services’ (HHS) hospital price transparency rule went into effect January 1, 2021. Lawmakers intend the rule to help better ensure Americans have clear information about the cost of hospital items and services before...

Those who run nursing home facilities must balance patient care, the needs of medical professionals serving these patients, the operations of the facility and the overall comfort of their residents within the confines of an array of federal, state and local...

With the United States Centers for Disease Control and Prevention (CDC) reporting over 450,000 opioid overdose deaths in the country from 1999 to 2018, it should come as no surprise that the government continues its crackdown on opioid violations. The government is...

The Department of Justice (DOJ) recently pursued a case against a medical device manufacturer. The federal agency claimed the healthcare business used illegal kickbacks to encourage medical professionals to use their products. The physicians would then bill Medicare,...

A new COVID-19 related testing scheme is the latest in a series of attempts to defraud nursing home residents. Nursing home administrators are wise to be aware of this latest scheme to help better ensure the safety of their residents.Details of this scheme Nursing...

Government officials have accused a Texas pharmacy owner of filing more than $5 million in fraudulent claims to several healthcare programs. The entrepreneur owned multiple pharmacies in Southern Texas, most notably in the Houston and Pharr areas. A government...

As the government continues its crackdown on the opioid crisis, whether or not a pharmacy could find itself the center of a lawsuit for failing to fill an opioid prescription may seem like a surprising question. And yet, that is exactly what three big companies are...

The Department of Justice (DOJ) is continuing its scrutiny of groups that provide Medicare Advantage plans. Just over a year ago, the Office of Inspector General reported that these plans led to billions in risk-adjusted payments that were not supported by specific...

The United States Centers for Medicare and Medicaid Services (CMS) has set a deadline for providers to begin repaying Accelerated and Advanced Payment Program (APP) loans provided through the Coronavirus Aid, Relief, and Economic Security (CARES) Act. In most cases,...

The United States Department of Justice (DOJ) recently accused a group of 10 individuals of partaking in a health care fraud scheme that cost the government over $1 billion. The accused include hospital executives and diagnostic lab owners as well as billers.According...