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Department of Justice Files False Claims Act Lawsuit Against Wound Care Provider

Apr 14, 2025 | False Claims Act, Fraud Investigations, Government Investigations, Health Care, Health Care Fraud, Medicare and Medicaid

On April 4, 2025, the Department of Justice announced that it had filed a lawsuit under the federal False Claims Act against Vohra Wound Physicians Management and its founder, Dr. Ameet Vohra.  According to the DOJ, Dr. Vohra and his company allegedly submitted false...

MEDICARE’S “WITHOUT FAULT” PROVISION: A PROVIDER’S SECRET WEAPON?

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...

Dr. Oz Faces Scrutiny During Senate Confirmation Hearing for CMS Administrator

Mar 18, 2025 | Healthcare Transactions, Medicare and Medicaid

On March 14, Dr. Mehmet Oz, President Donald Trump’s nominee for the Centers for Medicare and Medicaid Services (CMS) Administrator, appeared before the Senate Finance Committee for his confirmation hearing. During the two-and-a-half-hour session, Dr. Oz navigated a...

Spectra Clinical Labs Operator Convicted for Role in Defrauding Medicare of Over $4 Million

Mar 4, 2025 | Medicare and Medicaid

A federal jury in Detroit convicted Sherif Khalil, a 50-year-old man from Redondo Beach, California, for his involvement in a fraud scheme that put Medicare out of over $4 million. The fraud stemmed from the submission of false claims for medically unnecessary urine...

Opt-in DME Leads and Medicare’s Anti-Solicitation Rule

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...

Medical Center’s Failure to Report & Return Overpayment Results in $29 Million FCA Settlement

Feb 17, 2025 | False Claims Act, Fraud Investigations, Government Investigations, Health Care Fraud, Medicare and Medicaid

The DOJ announced that SVCMC Inc., formerly known as Saint Vincent’s Catholic Medical Centers of New York (SVCMC), will pay $29 million to resolve allegations of violating the False Claims Act. According to the DOJ, the medical center knowingly retained...
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