Case: The Louisiana physician received $336,000 in kickbacks from a drug testing lab representing a percentage of the reimbursement proceeds generated via the referrals of Medicare patients' urine … [Read more...]
DOJ
Enforcement Trends: New DOJ Policy Targeting Whistleblowers with Weak Cases May Make Life Easier for Labs
March 4, 2019
It's not just new laws, regulations or even court cases. Trends in health care fraud enforcement are sometimes driven by changes in prosecution policies, including those that aren't made public. Such … [Read more...]
WHISTLEBLOWERS
Case of the Month: Facing 3 against 1, Texas Lab Settles EHR Consulting Kickback Charges
February 22, 2019
Question: What happens when multiple whistleblowers bring separate qui tam lawsuits against a lab for the same offense? Answer: Under the False Claims Act (FCA), only the first whistleblower to … [Read more...]
FLSA
Case of the Month: Hospital Employees’ Wage Class Action Lawsuit Goes Terribly Wrong
February 11, 2019
It wasn't the outcome the four hospital employees envisioned when they filed their lawsuit charging the University of Pittsburgh Medical Center of violating the federal Fair Labor Standards Act (FLSA) … [Read more...]
LEGISLATION
Compliance Alert: New Private-Pay Opioid Law Puts All Drug Addiction & Rehab Labs at Risk of Federal Prosecution
January 7, 2019
Recent federal legislation addressing the opioid crisis may have unintended consequences on the lab industry. The idea was to allow the feds to prosecute a certain kind of abuse banned by the … [Read more...]
ENFORCEMENT
By the Numbers: DOJ Recovers Billions in FY 2018
December 31, 2018
Year after year, the False Claims Act (FCA) remains the federal government's most valuable fraud enforcement tool. Although recovery amounts have declined slightly in the past two years, FCA … [Read more...]
ANTI-KICKBACK
Enforcement Trends: Feds Administer a Double Dose of Civil Monetary Penalty Increases
October 23, 2018
Potential penalties for Medicare violations will be higher if they're assessed on or after Oct. 11, 2018. That's when the newly announced Dept. of Health and Human Services' (HHS) inflation-adjusted … [Read more...]
CYBERSECURITY
Case of the Month: Anthem Settles Massive HIPAA Breach Case for Record $16 Million
October 19, 2018
Pop Quiz: What's the highest amount a health care entity ever paid to the HHS Office for Civil Rights (OCR) to settle a HIPAA violation? The answer used to be $5.5 million paid by Advocate Health … [Read more...]
ENFORCEMENT
Alabama Hospital and Lab Subsidiary Agree to $4.25 Million Kickback Settlement
October 19, 2018
Case: Aperian Laboratory Solutions and its parent East Alabama Medical Center will fork over $4.25 million + legal costs to settle charges of paying kickbacks for referrals and then falsely billing … [Read more...]
ENFORCEMENT
Ohio Hospital System Settles Kickback Claims for $14.25 Million
August 31, 2018
Case: Mercy Health has agreed to pay $14.25 million to settle charges of having improper financial relationships with six referring staff physicians. The feds accused the Cincinnati-based nonprofit … [Read more...]
