New Yorker Article on Whistleblowers Features Constantine Cannon
Posted 01/28/19
Managed Care
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January 28, 2019
Partner Mary Inman and Constantine Cannon clients David Sewell & Benjamin Poehling featured in the New Yorker article, The Personal Toll of Whistle-Blowing. Click here to read the article.Top Ten Healthcare Recoveries of 2018
Posted 01/15/19
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- Amerisource Bergen Corporation - In...
Listen: Expected Dismissal of Providence Health Upcoding Suit
Posted 12/7/18
Constantine Cannon partner Mary Inman joins the RAC Monitor “Monitor Monday” podcast to comment on the government’s decision to decline to intervene in a $188.1 million whistleblower lawsuit Med Analytics, LLC filed against Providence Health (now known as Providence St. Joseph) alleging Providence upcoded diagnoses it submitted to government health programs for reimbursement. Several reports have indicated the...
Watch: “Taking Advantage” Highlights Medicare Risk Adjustment Fraud
Posted 11/2/18
“Widespread and Persistent” Problems in Medicare Managed Care Burden Patients and Are Potential Violations of the False Claims Act
Posted 10/30/18
Overpayment Rule Decision Doesn't Imperil Risk Adjustment Cases: Mary Inman and Max Voldman in RAC Monitor
Posted 10/19/18
Despite MAOs’ Claims, Recent Decision Doesn’t Imperil DOJ and Whistleblower Risk Adjustment Fraud Cases
Posted 10/17/18
Whistleblower attorneys Mary Inman and Max Voldman published in RAC Monitor (Oct. 17, 2018). Click here to read the article.
October 1, 2018
HealthCare Partners Holdings LLC, a DaVita entity, will pay $270 million to settle allegations arising from DaVita's collection and submission of diagnosis data for Medicare Advantage beneficiaries to whom DaVita provided healthcare services. HealthCare Partners, an independent physician association, allegedly instituted practices that caused the submission of incorrect diagnosis codes - diagnosis codes that increased payments from CMS to the MAOs, and then from the MAOs to DaVita/HealthCare Partners. DaVita had voluntarily disclosed some practices, including improper medical coding guidance provided to physicians. In addition, a whistleblower, James Swoben, alleged in a False Claims Act qui tam case that HealthCare Partners had engaged in improper "one-way chart reviews," which added diagnosis codes identified from the review of patient charts, but did not delete previously-submitted diagnosis codes that were not supported by the patient charts. Swoben will receive a whistleblower reward of $10,199,100. DOJConstantine Cannon Partner Jessica Moore on Court’s Decision in Medicare Advantage Case
Posted 07/23/18
Becker’s Hospital Review published Four Key Takeaways From 9th Circuit’s Resurrection of the Silingo Medicare Advantage Case, written by Constantine Cannon partner Jessica T. Moore. In the article, Ms. Moore analyzes the Ninth Circuit’s July, 2018, ruling in U.S. ex rel. Silingo v. WellPoint, Inc., a case brought by a whistleblower under the False Claims Act alleging risk adjustment fraud in Medicare’s Part C...