[02/27/15]
Posted on February 27, 2015 in Litigation Analysis
Written by: Drew B. Howk
The Fourth District of the Appellate Court of Illinois reaffirmed that claims by a physician that a hospital’s failure to renew his privileges caused actual and intentional harm to his professional reputation are barred by the Illinois’s Hospital Licensing Act. Only claims alleging an actual or deliberate intention to physically harm the physician or others trump a hospital’s... READ MORE
Tags: Appeal, Hospital Licensing Act, Illinois, immunity, Peer review, reputation, whistleblower
[02/24/15]
Posted on February 24, 2015 in False Claims Act Defense
Written by: David B. Honig and Andrew B. Howk
A recent case out of the Northern District of Illinois Federal Court, US ex rel. Oughatiyan v. IPC the Hospitalist Company, Inc., demonstrates the high risk inherent in evaluation and management (E&M) coding for health care providers. READ MORE
Tags: 9(b), E&M, evaluation and management, False Claims Act, FCA, hospitalist, Illinois, IPC, Northern District of Illinois, Oughatiyan, Seventh Circuit
[12/04/14]
Posted on December 4, 2014 in False Claims Act Defense
Written by: Drew B. Howk
In U.S. ex rel. Grenadyor v. Ukranian Village Pharmacy, Inc. et al., the Seventh Circuit affirmed a trial court’s dismissal of a whistleblower’s complaint for its failure to provide sufficient specificity regarding the alleged fraud. In the opinion, Judge Posner drives a stake through the heart of a common boilerplate phrase with clarity and precision that makes a... READ MORE
Tags: 7th Circuit, 9(b), dismissal, Illinois, motion to dismiss, particularity, pleading, Posner, Seventh Circuit
[02/06/12]
Posted on February 6, 2012 in Long-Term Care, Home Health & Hospice
Written by: Bufford, David W.
The Centers for Medicare & Medicaid Services (CMS) has pushed back the start of two anti-fraud programs to June due to provider concerns. Two pilot programs, one that would require prior authorization for scooters and power wheelchairs and one allowing recovery audit contractors (RAC) to review claims prior to payment, were initially slated to begin January 1, 2012. READ MORE
Tags: abuse, authorization, bufford, California, claim, Claims, cms, demonstration project, Florida, fraud, Home Health, Illinois, january, jent, june, Litigation and Risk Management, long term care, Louisiana, Medicaid/Medicare Enrollment and Regulatory Compliance, Michigan, New York, North Carolina, Ohio, payment, Pennsylvania, power, prior, RAC, review, scooter, selby, Texas, wheelchair
