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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...

Virginia Hospital Indicted for Fraud

Jan 31, 2025 | Fraud Investigations, Government Investigations, Health Care, Health Care Fraud, White Collar Crime

Earlier this month, the Department of Justice announced that it had indicted the Chesapeake Regional Medical Center (CRMC) with healthcare fraud and conspiracy in relation to unnecessary gynecological and other procedures performed by one of its employed physicians....

False Claims Act Settlements and Judgments Exceed $2.9B in Fiscal Year 2024

Jan 16, 2025 | False Claims Act

On January 15, 2025, the DOJ announced that its False Claims Act (FCA) recovery for fiscal year 2024 (which ended on September 30, 2024) exceeded $2.9 billion. This figure is slightly higher than the total recovery from the prior fiscal year ($2.7B) and the year...

Annual Defense Appropriations Legislation Brings Major Changes to Administrative False Claim Act

Jan 14, 2025 | Administrative Law, False Claims Act, Fraud Investigations, Health Care, Health Care Fraud

Late last year, President Biden signed the annual National Defense Authorization Act (NDAA) for fiscal year 2025.  This alone is not newsworthy, as this has happened every year since the NDAA was introduced in 1961.  Generally speaking, the NDAA governs Department of...

CMS Issues Final Regulations Regarding Medicare 60-Day Rule

Nov 11, 2024 | Health Care, Medicare and Medicaid

When the Affordable Care Act was passed and signed into law by President Obama in 2010, one of its provisions required Medicare providers and suppliers to report and refund Medicare overpayments within 60 days of “identifying” such an overpayment.  Violating this...
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