Mar 24, 2025 | Administrative Law, Health Care, Medicare and Medicaid, Overpayment Appeals
Because Medicare processes over one billion fee-for-service claims annually, it is impossible for CMS and its contractors to review every claim – or even a substantial percentage of claims – on a pre-payment basis. Accordingly, Medicare has set up various...
Feb 28, 2025 | False Claims Act, Government Investigations, Health Care, Health Care Fraud
Back in January, we wrote about a district judge in Massachusetts who granted summary judgment in favor of a False Claims Act (FCA) defendant, ruling that the “but for” causation standard should be applied when violations of the Anti-Kickback Statute (AKS)...
Feb 20, 2025 | DMEPOS, Government Investigations, Health Care, Health Care Fraud, Medicare and Medicaid
If you are a DMEPOS supplier and are purchasing opt-in Medicare leads, you should be aware of Medicare’s prohibition against telephone solicitation of beneficiaries. In order to enroll as a Medicare DMEPOS supplier, and as a condition of payment, DMEPOS providers must...
Feb 10, 2025 | False Claims Act, federal investigations, Fraud Investigations, Government Contract, Government Investigations
On January 31, 2025, President Trump issued Executive Order 14173, entitled “Ending Illegal Discrimination and Restoring Merit-Based Opportunity” (“EO”). The stated purpose of the EO “is to ensure that [the federal government enforces civil rights laws] by...
Feb 2, 2025 | False Claims Act, federal investigations, Fraud Investigations, Government Investigations
On February 1, 2025, President Trump announced the imposition of substantial tariffs on goods imported from Canada, Mexico, and China. These tariffs are likely to come with an increase in customs enforcement, with customs officials ensuring that incoming goods are...
