Archive

Catch of the Week: New York-Presbyterian Hospital

Posted 01/26/24

This week's Department of Justice (DOJ) Catch of the Week goes to New York-Presbyterian Hospital. Yesterday (January 25), the hospital agreed to pay $801,000 to settle charges it violated the False Claims Act by billing Medicare, Medicaid and TRICARE for medically unnecessary images for radiation therapy treatments provided to cancer patients. The settlement is notable not for the relatively small amount of money...

Tagged in: Catch of the Week, FCA Federal, Healthcare Fraud, Lack of Medical Necessity, Medicaid, Medicare, Other Government Health Programs, Whistleblower Case,

Silver Lake Hospital and Investors Pay $30 Million to Settle Health Care Case

Posted 01/22/24

Silver Lake Hospital, operating as Columbus LTACH in Newark, New Jersey, and certain investors recently agreed to pay a combined $30.6 million to settle False Claims Act allegations relating to Medicare payments and violations under the Federal Debt Collection Procedures Act (FDCPA). Silver Lake is a long-term care hospital a whistleblower alleged was claiming excessive "cost outlier" payments from Medicare, a...

Tagged in: FCA Federal, Healthcare Fraud, Medicare,

Testing Lab and Owner/CEO Settle False Claims Act Case for $13.25 Million

Posted 01/12/24

Laboratory Analysis. Scientist Measuring Sample

RDx Bioscience Inc. (“RDx”), a clinical laboratory that operated in New Jersey, and its owner and CEO agreed to pay $13.25 million to settle a False Claims Act case alleging kickbacks and unnecessary testing schemes, according to a recent DOJ press release. The press release also notes that RDx and its owner/CEO agreed to cooperate with the DOJ’s “investigations of, and litigation against, other participants...

Tagged in: Anti-Kickback and Stark, FCA Federal, Healthcare Fraud, Laboratory and IDTF, Lack of Medical Necessity,

Top Ten False Claims Act Recoveries in 2023

Posted 01/11/24

It was another big year for DOJ enforcement under the False Claims Act, the government's primary fraud-fighting tool. As usual, most of the recoveries were in the healthcare space with seven of the Top-10 involving various schemes to defraud Medicare and Medicaid. Several of these Top-10 recoveries involved enforcement actions targeting violations of the Anti-Kickback Statute and Stark Law, which prohibit medical...

Tagged in: Anti-Kickback and Stark, Electronic Health Records, FCA Federal, Government Programs Fraud, Healthcare Fraud, Medicaid, Medical Billing Fraud, Medicare, Top 10, Whistleblower Case,

Private Equity Firms Buying Healthcare Companies May Increase Risks to Patients and Lead to More Whistleblower Actions

Posted 01/8/24

Businessman Under Dark Shadow Pointing Finger

Private equity (PE) firms are in the hot seat, particularly when it comes to acquiring and investing in healthcare companies. According to a recent CNN article, a research study published in JAMA found that “[h]ealth care became more hazardous for patients at hospitals purchased by private equity firms.” This not only should concern patients and Government enforcers. It also could be a harbinger of more...

Tagged in: Healthcare Antitrust, Healthcare Fraud, Whistleblower Eligibility,

Catch of the Week: Moffitt Cancer Center

Posted 01/5/24

This week's Department of Justice (DOJ) Catch of the Week goes to Tampa-based H. Lee Moffitt Cancer Center & Research Institute Hospital. Yesterday (January 4), the non-profit cancer treatment and research center agreed to pay roughly $19.6 million to settle DOJ charges of violating the False Claims Act by billing Medicare for patient care services provided during research studies not eligible for...

Tagged in: Catch of the Week, FCA Federal, Healthcare Fraud, Improper Medical Facility, Medical Billing Fraud, Medicare,

Community Health Network Pays $345 Million to Settle Stark Law Case

Posted 12/21/23

Handshake in room with dark window blinds

Community Health Network Inc., based in Indianapolis, recently settled with the U.S. government for $345 million, addressing allegations under the False Claims Act related to the Stark Law. This landmark case emphasizes the importance of whistleblowers to combat Medicare fraud. The Stark Law prevents hospitals from billing Medicare for services referred by physicians who have a financial relationship with the...

Tagged in: Anti-Kickback and Stark, FCA Federal, Healthcare Fraud, Medicare, Whistleblower Case,

Caught in the Crosshairs - Loyal Source Government Services

Posted 12/1/23

US Customs and Border Protection Flyer Behind US Flag

As reported in the Washington Post yesterday (November 30), a long-serving Customs and Border Protection (CBP) official filed a whistleblower complaint with Congress claiming significant failures by medical service contractor Loyal Source Government Services and CBP's refusal to address them. Even worse, when the whistleblower -- 14-year CBP veteran Troy Hendrickson -- tried to raise his concerns with his CBP...

Tagged in: Healthcare Fraud, Retaliation, Whistleblower Case,

OIG Identifies Fraud as Top Challenge in 2023 HHS Annual Report - Bring on the Whistleblowers

Posted 11/21/23

Person with Magnifying Glass and Pen Examining Stack of Papers

The Department of Health and Human Services (HHS) Office of the Inspector General (OIG) just released its 2023 Annual Report on its Top Management and Performance Challenges for the past year. Among the key challenges OIG identified is better protecting HHS programs -- Medicare and Medicaid being chief among them -- from fraud, waste, and abuse. No big surprise as this is a perennial challenge for the federal...

Tagged in: Healthcare Fraud, Medicaid, Medicare,

Caught in the Crosshairs - Department of Veteran Affairs

Posted 11/17/23

As reported this week in Military Times, a group of whistleblowers have complained of significant failings in the Department of Veteran Affairs (VA) suicide prevention hotline. According to the article, the Veterans Crisis Line has rapidly expanded in recent years, growing from roughly 900 employees in 2021 to more than 1,800 employees today. At the same time, however, there has been an equally dramatic rise in...

Tagged in: Other Government Health Programs,

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Catch of the Week: New York-Presbyterian Hospital

Silver Lake Hospital and Investors Pay $30 Million to Settle Health Care Case

Testing Lab and Owner/CEO Settle False Claims Act Case for $13.25 Million

Top Ten False Claims Act Recoveries in 2023

Private Equity Firms Buying Healthcare Companies May Increase Risks to Patients and Lead to More Whistleblower Actions

Catch of the Week: Moffitt Cancer Center

Community Health Network Pays $345 Million to Settle Stark Law Case

Caught in the Crosshairs - Loyal Source Government Services

OIG Identifies Fraud as Top Challenge in 2023 HHS Annual Report - Bring on the Whistleblowers

Caught in the Crosshairs - Department of Veteran Affairs

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