Sep 9, 2025 | Health Care, Health Care Fraud, Medicare and Medicaid
On September 8, 2025, the U.S. Department of Health & Human Services’ Office of Inspector General (HHS-OIG) issued a report expressing “major” fraud, waste, and abuse concerns related to skin substitutes billed to Medicare Part B. According to...
Jul 2, 2025 | Commercial Payor Audits, federal investigations, Health Care, Health Care Fraud, Medicare and Medicaid
The attorneys at Chilivis Grubman represent a wide variety of healthcare providers and suppliers in connection with Medicare audits and overpayment appeals. Clients often ask us how long a CMS contractor has to reopen a claim for purposes of conducting a post-payment...
Jun 15, 2025 | False Claims Act, Fraud Investigations, Government Investigations, Health Care, Health Care Fraud, Medicare and Medicaid, White Collar Crime
Last month, North Carolina Attorney General Jeff Jackson announced that his office had reached a consent judgment of over $4.7 million with Kernersville-based healthcare provider Steven Osbey to resolve an alleged Medicaid fraud scheme. 💰 What Happened According to...
Jun 7, 2025 | False Claims Act, Government Investigations, Health Care, Health Care Fraud, Medicare and Medicaid
On June 3, the United States Attorney’s Office for the Southern District of Florida in Miami announced that it had filed a complaint under the False Claims Act (FCA) against Florida-based medical billing company AIMA. According to the DOJ’s complaint,...
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...
