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CMS Proposes Significant Change to Overpayment Refund Rules

Dec 30, 2022 | Health Care, Medicare and Medicaid

In 2014, the Centers for Medicare & Medicaid Services (CMS) published its then-long-awaited final rule implementing and interpreting the “60-day” overpayment rule, which was signed into law by President Obama four years prior as part of the Affordable Care Act. ...

Physician and Physician Practice Agree to Pay Over $2.6 Million to Resolve Alleged False Claims Act Violations

Nov 15, 2022 | False Claims Act, Fraud Investigations, Government Investigations, Health Care, Health Care Fraud

Late last week, the United States Attorney’s Office for the District of Connecticut announced that a Connecticut physician and physician practice agreed to pay more than $2.6 million to resolve allegations that they violated the False Claims Act (FCA) by submitting...

Real Estate Investment Trust Pays $3 Million to Resolve False Claims Act Allegations

Nov 14, 2022 | False Claims Act, Fraud Investigations, Health Care

Last week, the United States Attorney’s Office for the Western District of Texas (Austin) announced that Omega Healthcare Investors, Inc. had agreed to pay $3 million to resolve False Claims Act (FCA) allegations. According to its website, Omega Healthcare Investors...

Drug Charges Dropped Against Opioid Manufacturer and Pharmacists After Recent SCOTUS Ruling

Aug 17, 2022 | Health Care, Health Care Fraud

In June 2022, the U.S. Supreme Court issued an opinion in Ruan v. United States that clarified the mens rea requirement for those who manufacture, distribute, or dispense drugs and are subsequently prosecuted under the Controlled Substances Act, specifically 21 U.S.C....

North Carolina Woman Faces up to 120 Years in Prison for Role in $34 Million Health Care Fraud Scheme

Aug 9, 2022 | Health Care, Health Care Fraud

The DOJ just announced the conviction of, Jaroslava Ruiz, for her role in a scheme that defrauded private health insurers of approximately $34.6 million. Ruiz, of Chapel Hill, was convicted of one count of conspiracy to commit health care fraud and wire fraud and 10...

HHS Issues a Special Fraud Alert to the Telehealth Industry

Aug 3, 2022 | Health Care, Health Care Fraud

The U.S. Department of Health and Human Services issued a special fraud alert on July 20, 2022, relating to potential fraud concerns in the telehealth industry. Special fraud alerts are rare—this newest alert is only the fourth issued in the last decade. A special...
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