Archive
Fraud & Abuse
What Cigna’s FCA Settlement Means for Other Medicare Advantage Plans
From HealthPayerIntelligence, Victoria Bailey: Cigna’s recent brush with False Claims Act violations serves as a reminder that Medicare Advantage organizations should be routinely assessing their risk…
Two Dallas Physicians Charged in $12 Million Fraud Scheme
From D Magazine, by Will Maddox: Drs. Desi and Deno Barroga were indicted for allegedly receiving $12 million from fraudulent claims and illegally distributing hydrocodone to…
New Stark Law Exception and Anti-Kickback Statute Safe Harbor Aim to Combat Physician Burnout
From Stevens & Lee: The Stark Law exception requires that health care entities make their physician wellness program available to all physicians who practice in the…
Complex AKS/Stark Complaint Survives Rule 9(b) Particularity Challenge – A Guide for FCA Complaints
Francis C. Oroszlan, Brett Barnett and Timothy Fry, for McQuireWoods: Generally, a complaint will survive a motion to dismiss if it states a plausible claim and…
Top Ten Health Law Myths
I have been practicing health law for more than 25 years and have had the benefit of working with a lot of healthcare providers. My clients…
Improper Billing of “P-Stim” Devices is Focus of Recent FCA Settlements
Improper billing for electro-acupuncture using a “P-Stim” device (or peri-auricular stimulation device) has been the subject of two False Claims Act (FCA) settlements already in 2021,…
Texas Company Agrees to Reimburse Medicare for Improper Billing Related to Neurostimulators
Spinal Decompression Clinic of Texas (“SDCT”) has agreed to pay $330,898.00 to resolve liability under the False Claims Act for the alleged improper billing of electro-acupuncture…
The United States and Tennessee Resolve False Claims Act Claims Relating to “P-Stim” Devices
A physician and two chiropractors agreed to pay the United States and Tennessee a total of $1.72 million to resolve liability under the False Claims Act…
OIG Issues New Guidance Regarding Big-Box Store Gift Cards as Patient Incentives
OIG has taken the position that gift cards to “big-box” retailers are identified as impermissible “cash or cash equivalent” incentives under the Civil Monetary Penalties Law.
Patient Recruiter Convicted in $2.8 Million Telemedicine Scheme Against Medicare
The owner of an Orlando-area telemarketing call center was convicted for his role in a kickback scheme involving expensive genetic tests and fraudulent telemedicine services that…