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On the Ballot 2020: Health Care Policy Outlook - Diagnosing Health Care Podcast
Ex Rel. Radio - Prevention Is Priceless: FCA Protection in the Healthcare Industry
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On July 1, the US Department of Health and Human Services’ Office of Inspector General (OIG) released Advisory Opinion No. 25-08, issuing an unfavorable determination regarding a proposed arrangement in which a medical device...more
Prevailing at summary judgment is rare. Prevailing when there are competing motions on the same issue (fraud) is even rarer. In this opinion, Judge Davis granted the Defendants’ motion and denied the Plaintiff’s, ending the...more
A class action suit is brewing in Minnesota which has the potential for major implications in the way major case investigations are litigated and negotiated. In Taqueria El Primo LLC et al. v. Illinois Farmers Ins. Co. et...more
Question: I am under audit by a dental plan I participate with. The audit has identified a few issues in connection with how my billing employees have been submitting claims for payment. For example, the name of the treating...more
On Friday, January 13, the Supreme Court agreed to consider whether the False Claims Act (“FCA”) covers compliance lapses tied to regulatory interpretations that are incorrect but “objectively reasonable.” The Supreme Court...more
On September 2, 2022, the US Department of Health and Human Services (HHS) Office of the Inspector General (OIG) released a data brief analyzing telehealth services covered by Medicare and related program integrity risks. OIG...more
A pair of reports recently issued by the US Department of Health and Human Services (HHS) Office of the Inspector General (OIG) highlight the important role telehealth services have played in ensuring access to medical...more
Plaintiffs alleged in their putative nationwide class action complaint that Quest Diagnostics was liable for consumer fraud, unjust enrichment, and violations of the Fair Debt Collections Practices Act for overbilling...more
In the final Medicare Physician Fee Schedule for 2014 (“2014 PFS”), CMS implemented a new condition of payment for “incident to” services that has significant fraud and abuse implications for any Medicare provider who relies...more