Jul 10, 2024 | False Claims Act
The DOJ announced that Guardian Health Care Inc., Gem City Home Care LLC, Care Connection of Cincinnati LLC, and Evolution Health LLC (“Companies”) will pay $4,496,330 to resolve allegations of violating the False Claims Act (“FCA”). The Companies, which were...
Jul 3, 2024 | Data Breach, HIPAA
We recently wrote about a Pennsylvania federal court’s dismissal of a proposed “online tracking technology” class action brought against a local hospital, one of a rising number of lawsuits brought against hospitals and other HIPAA-covered entities which deploy third...
Jul 3, 2024 | Health Care
The Justice Department has continued to intensify its investigative efforts to combat fraud draining billions of dollars from the United States health care system annually. On Thursday, Attorney General Merrick Garland announced charges against 193 people for their...
Jul 1, 2024 | Medicare and Medicaid
Medicare has recently intensified its focus on durable medical equipment (DME) due to concerns about fraud and overpayments. Common schemes of DME fraud include billing for equipment that was never provided, upcoding to more expensive items, or prescribing medically...
Jun 28, 2024 | Commercial Payor Audits, Medicare and Medicaid, Overpayment Appeals
As most healthcare providers know, Medicare, like most payors, operates on a “pay and chase” system; meaning, they pay the vast majority of claims promptly, and then audit and attempt to recoup overpayments later should they discover information that calls the...
Jun 27, 2024 | Criminal Matters, federal investigations, SEC Investigations, White Collar Crime
This week, the Supreme Court issued a flurry of important decisions, including two major decisions related to white collar criminal enforcement, both which deal significant blows to the government. Snyder v. United States – Supreme Court Significantly Limits Scope of...
Jun 27, 2024 | Code Enforcement
Navigating the intricacies of code enforcement in Georgia can be daunting for property owners and business operators. Whether you’re a homeowner, a landlord, or a commercial property owner, it’s crucial to be aware of the local regulations and the...
Jun 27, 2024 | Health Care
Earlier this month, we represented a podiatry practice in a Medicare Part B overpayment appeal before an Administrative Law Judge. The appeal involved the use of amniotic fluid injections used on patients in 2021. Medicare demanded an overpayment over $95K plus...
Jun 25, 2024 | False Claims Act, Government Investigations, Health Care, Health Care Fraud, Medicare and Medicaid
The False Claims Act, with its threat of treble damages and astronomical per-claim penalties, may not have been designed to punish substandard medical care, but as a recent $15 million FCA settlement demonstrates, the line between substandard medical care and...
