HHS-OIG Continues to Uncover Unfounded Malnutrition Claims in Medicare Data
Posted 01/25/17
By the C|C Whistleblower Lawyer Team
Inaccurate medical coding of malnutrition in seniors is a multi-billion dollar problem for Medicare, the federal health insurance program that primarily provides coverage to people aged 65 and older. As obscure as it sounds, it’s also an issue for the average American taxpayer, whose tax dollars are wrongly paid out to hospitals clever—or careless—enough to falsely claim...
By the C|C Whistleblower Lawyer Team
Texas-based MB2 Dental Solutions and 21 of the company's affiliated pediatric dental practices agreed to pay $8.45 million to resolve allegations they violated the 
By 
By the C|C Whistleblower Lawyer Team
Long Island Natives Reported Systemic and Abusive Billing Practices, Including:
· performing unnecessary and excessive testing;
· purposely scheduling tests based on financial gain, not patient need;
· falsifying the identity of rendering radiologists while using the services of uncredentialed physicians; and
· charging for services not performed.
Constantine Cannon...
By the C|C Whistleblower Lawyer Team
This week's Department of Justice "Catch of the Week" goes to Pennsylvania-based hospital chain Vibra Healthcare LLC. On Wednesday, the company agreed to pay $32.7 million to settle charges it violated the 
By the C|C Whistleblower Lawyer Team
This week's Department of Justice "Catch of the Week" goes to Pennsylvania-based hospital chain Vibra Healthcare LLC. On Wednesday, the company agreed to pay $32.7 million to settle charges it violated the False Claims Act by billing Medicare for medically unnecessary services. Vibra operates roughly three-dozen long term care hospitals and inpatient rehabilitation...
By the C|C Whistleblower Lawyer Team
This week's Department of Justice "Catch of the Week" goes to North American Health Care Inc. On Monday, the California-based operator of dozens of skilled nursing facilities -- along with its Chairman John Sorenson and Senior Vice President of Reimbursement Analysis Margaret Gelvezon -- agreed to pay $30 million to resolve charges they violated the 
By 
By the C|C Whistleblower Lawyer Team
This week's Department of Justice "Catch of the Week" goes to Jacksonville-based Physicians Group Services, P.A., doing business as Coastal Spine and Pain. On Wednesday, the surgery and pain-management clinic agreed to pay $7.4 million to settle charges it violated the 
By Rosie Dawn Griffin
Medicare fraud takes many forms, but a persistent scheme in the inpatient context—where the amount of government reimbursement can be based, in addition to procedure costs, on patients’ overall health—involves “upcoding” inpatient diagnosis-related-group (DRG) codes to make individual patients appear sicker, and therefore more costly to treat, than they actually are. Fraudsters...