Mar 30, 2025 | False Claims Act, Health Care, Health Care Fraud
The Eighth Amendment to the United States Constitution guarantees the “freedom from excessive fines.” In 2018, the late Justice Ruth Bader Ginsberg held that this safeguard is “fundamental to our scheme of ordered liberty.” Timbs v. Indiana. And yet, it is not...
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...
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....
