[10/29/14]
Posted on October 29, 2014 in False Claims Act Defense
Published by: Hall Render
Several FCA opinions have been issued since the last FCA Update. The most interesting is a District of Nevada case, US ex rel Guardiola v Renown Health. Renown Health was the parent company for two other corporate defendants that provided acute health care services. The relator was Renown’s Director of Clinical Compliance. She alleged Renown improperly billed... READ MORE
Tags: 2010, AstraZeneca, Bristo-Myers Squibb, direct and independent, direct knowledge, False Claims, FCA, Guardiola, independent knowledge, jurisdiction, original source, public disclosure, RAC, Renown, Schumann
[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
[07/22/11]
Posted on July 22, 2011 in Long-Term Care, Home Health & Hospice
Written by: Kendra Conover
Recently, the Office of Inspector General (“OIG”) published a report of its findings pertaining to the nearly 70% growth of Medicare spending for hospice care provided to nursing facility (“NF”) residents from 2005 – 2009. During that time, Medicare spending on hospice care for residents in NFs increased sixty-nine percent (69%) from $2.55 billion to... READ MORE
Tags: cms, conover, Hospice, long term care, MAC, MedPAC, oig, RAC
