DOJ’s Adventist Settlement Puts the Power of Whistleblowers in "Stark" Relief
Posted 09/23/15
The Compliance & Ethics Blog (September 23, 2015). Click here to read the article.
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DOJ’s Adventist Settlement Puts the Power of Whistleblowers in “Stark” Relief
Posted 09/23/15
By Tim McCormack and Molly Knobler (published on SCCE’s Compliance and Ethics Blog)
There is no denying that certain aspects of the Physician Self-Referral Law, more commonly known as the “Stark Law,” are complicated. The Stark Law and its corresponding regulatory scheme include a web of technical terms, safe harbors, and interpretive guidance. Is this complexity a necessary byproduct of the...
September 23, 2015
The Florida Attorney General announced a $3.5 million settlement with Adventist Health System Sunbelt Healthcare Corporation and Adventist Health System/Sunbelt, Inc. to resolve two suits brought by whistleblowers alleging that Adventist maintained improper financial relationships with physicians and submitted claims to Florida Medicaid for services and items the physicians referred. The settlement resolves claims that Adventist submitted false Medicaid claims and awarded referring doctors based on the number of tests and procedures the doctors ordered. Adventist also entered into separate civil settlements with the federal government, North Carolina and Texas, agreeing to pay more than $115 million. FL.In Their Own Words — Buckley
Posted 09/23/15
-- “At night we can hear them screaming, but we’re not allowed to do anything about it.”
Gregory Buckley Sr., father of murdered Marine Gregory Buckley Jr., recalling his son’s description of hearing Afghanistan police officers raping young boys, something he reported but was told to ignore by his superiors. You can read more here.Whistleblower News From The Inside — September 23, 2015
Posted 09/23/15
By the C|C Whistleblower Lawyer Team
Veterans Affairs IG ignores thousands of complaints every year – The inspector general for the agency investigates less than 10% of the 40,000 complaints it receives annually, and whistleblowers say even those investigations are flawed and cursory. USA Today
Whistleblower says Vanguard owes $34 billion to IRS – Former Vanguard Group tax lawyer David Danon alleges that...
Sleep-Disorder Fraud
Posted 09/22/15
Can one commit fraud while sleeping? Sort of.
Increasing numbers of troubled sleepers are seeking diagnosis and treatment of chronic sleep disorders that affect more than fifty million Americans. The significant growth in sleep medicine over recent years brings increasing opportunities for the unscrupulous to engage in fraudulent services and billing
The most common method of diagnosing sleep disorders is a...
In Their Own Words — Delery
Posted 09/22/15
-- "Americans should be able to trust that the food we buy for ourselves and our families is safe.”
Acting Associate Attorney General Stuart F. Delery on the sentencing of Stewart Parnell, former owner of Peanut Corporation of America, to 28 years in prison for his role in knowingly shipping salmonella-tainted peanut butter that led to serious injuries. Click here for more.Whistleblower News From The Inside — September 22, 2015
Posted 09/22/15
By the C|C Whistleblower Lawyer Team
Former owner of Peanut Corporation of America sentenced to prison for peanut fraud -- Stewart Parnell was sentenced to 28 years for his role in shipping salmonella-positive peanut products before the results of microbiological testing were received and falsifying test results, the largest criminal sentence in a food safety case. DOJ
Adventist Health System to Pay $115M to...
Medicare Advantage Plan Loses Members, Responds with Plans to Raise Risk Adjustment Scores
Posted 09/22/15
By Tim McCormack and Molly Knobler (published on The Compliance & Ethics Blog)
Modern Healthcare recently reported that although enrollment in the Medicare Managed Care Program (also known as Medicare Advantage or Medicare Part C) has grown by 8% on average since 2010, several top Medicare Advantage Plans are losing membership. Highmark, Blue Cross and Blue Shield of North Carolina, HealthNow New York, Wellcare...
Medicare Advantage Plan Loses Members, Responds with Plans to Raise Risk Adjustment Scores
Posted 09/21/15
The Compliance & Ethics Blog (September 21, 2015)
Click here to read the article.