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The Anti-Kickback Statute (AKS) makes it illegal to encourage referrals for Medicare services in exchange for renumeration or other types of payment. There are some exceptions, referred to as safe harbors. One example is the personal services and contracts safe...
Allegations of a Medicare overpayment are not uncommon. The government estimates that it overpays millions in Medicare claims to physicians and healthcare providers every single year. The government states these overpayments are of the result of a place-of-service...
The Department of Health and Human Services (HHS) recently announced that it is digging into risk adjustment tactics it claims may have led to overpayments. The review will focus specifically on certain Medicare Advantage (MA) plans. Secretary Xavier Becerra noted the...
Officers recently called on families who had patients at certain hospice centers to reach out if had suspicions about a loved one’s death, especially if that loved one was a resident at Peaceful Touch Hospice and Palliative Care in Plano. The request comes after...
The United States Department of Justice (DOJ) recently reported that it recovered $5.6 billion in settlements and judgments from civil false claims cases in 2021. This is significant as it marks the second-largest total of recovered funds under the False Claims Act...
The federal government will come after physicians and other medical professionals if it believes these professionals are putting financial gain over patient needs. They will aggressively pursue charges against those it feels fail to honor these goals and they will...
The pandemic shifted many things in our life. We became more comfortable using technology to have video calls and meetings with friends and loved ones, we shifted many of our offices to a remote style of work for at least a portion of the pandemic and even learned how...
The government continues to doggedly pursue investigations of allegations of healthcare fraud. Healthcare groups and other organizations that take payments directly from patients as opposed to billing insurance may think they can avoid federal scrutiny, but this is...
The federal government is not shy when it comes to allegations of healthcare fraud. These investigations can include pretty much anyone that operates in the healthcare marketplace, from physicians and nurses to large hospitals and independently operated ambulance...
The False Claims Act (FCA) is one of the federal government's largest tools when it comes to allegations of healthcare fraud. The Department of Justice (DOJ) reports that it received over $2 billion as a result of FCA cases during the fiscal year ending in September...