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Medicaid › Healthcare Fraud › Nursing Homes

Medicaid is a partnership program between states and the federal government to provide healthcare coverage for lower income individuals, people with disabilities, older people, and certain families with... more +
Medicaid is a partnership program between states and the federal government to provide healthcare coverage for lower income individuals, people with disabilities, older people, and certain families with children.  less -
McDermott Will & Schulte

OIG Nursing Facility Compliance Program Guidance: Renewed Focus on Fraud and Abuse

McDermott Will & Schulte on

The US Department of Health and Human Services Office of Inspector General’s (OIG’s) release of Nursing Facility Industry Segment-Specific Compliance Program Guidance (ICPG) for the first time since 2008 reemphasizes the...more

Rivkin Radler LLP

NYS OMIG Publishes 2025 Work Plan

Rivkin Radler LLP on

On January 29, the New York State Office of the Medicaid Inspector General (OMIG) published its 2025 Work Plan, which provides a preview of the OMIG’s program integrity initiatives for the upcoming year. While this post...more

Baker Donelson

Enhancing Compliance in Nursing Facilities: OIG's New Guidance

Baker Donelson on

The Office of Inspector General (OIG) for the U.S. Department of Health and Human Services (HHS) issued new Nursing Facility Industry Segment-Specific Compliance Program Guidance (Nursing Facility ICPG) for nursing facilities...more

Cozen O'Connor

New York AG Secures $45 Million Settlement with Nursing Homes

Cozen O'Connor on

New York AG Letitia James entered into an Assurance of Discontinuance (“AOD”) with the owners, operators, management company, landlords, and associated entities of four nursing homes managed by Centers for Care LLC, d/b/a...more

Stark & Stark

New Jersey’s Nursing Homes: A Closer Look at CMS’s Special Focus Facilities

Stark & Stark on

In April of 2024, Centers for Medicare & Medicaid Services (CMS) updated their list of Special Focus Facilities. Special Focus Facilities (SFFs) are “nursing homes that have a history of serious quality issues and are...more

Polsinelli

Health Care Fraud and Abuse 2023 Year in Review

Polsinelli on

Introduction - Polsinelli proudly introduces the Health Care Fraud and Abuse 2023 Year in Review, a comprehensive examination of the evolving landscape surrounding the False Claims Act (“FCA”) and fraud & abuse enforcement...more

Stark & Stark

New Jersey Intends to Suspend Two South Jersey Nursing Homes from Medicaid

Stark & Stark on

The New Jersey Office of the State Comptroller’s (OSC) Medicaid Fraud Unit has moved to suspend two South Jersey nursing homes from New Jersey Medicaid, citing poor conditions at the facilities and evidence that their owners...more

Cozen O'Connor

Nursing Home Settles With AG James Over Allegations of Fraudulent Medicare Charges

Cozen O'Connor on

New York AG Letitia James, together with the DOJ, announced settlements with Saratoga Center for Rehabilitation and Skilled Nursing Care, a former 257-bed nursing home, and its owners, unlicensed operator, and landlord...more

Faegre Drinker Biddle & Reath LLP

State AG Updates: California, Pennsylvania, Illinois, Washington State, Connecticut and Coalitions of AGs

Faegre Drinker Biddle & Reath LLP on

In this edition of Faegre Drinker’s State Attorneys General Update, we discuss: • The California AG’s first enforcement action involving the California Consumer Privacy Act, which resulted in a $1.2 million...more

Oberheiden P.C.

OIG Compliance Program for Hospitals: 8 Keys to Success

Oberheiden P.C. on

The U.S. Department of Health and Human Services Office of Inspector General (HHS-OIG) is tasked with combating fraud under Medicare, Medicaid, and other federally funded healthcare programs. ...more

Farrell Fritz, P.C.

EDNY Certifies Interlocutory Appeal of False Claims Case To Second Circuit

Farrell Fritz, P.C. on

Last week, EDNY Chief Judge Margo Brodie certified a False Claims Act (FCA) appeal to the Second Circuit.  In United States ex rel. Quartararo v. Catholic Health System of Long Island Inc., the district court found that...more

Health Care Compliance Association (HCCA)

Report on Medicare Compliance Volume 29, Number 9. News Briefs: March 2020

Health Care Compliance Association (HCCA) on

Report on Medicare Compliance 29, no. 9 (March 9, 2020) - The U.S. Attorney’s Office for the District of Massachusetts said March 5 it has filed a False Claims Act complaint against SpineFrontier Inc., Impartial Medical...more

King & Spalding

In Significant Shift, DOJ Takes Position that Affordable Care Act Is Unconstitutional

King & Spalding on

On Monday, March 25, 2019, the Department of Justice (DOJ) endorsed the decision of a district court judge in the Northern District of Texas that invalidated the entire Affordable Care Act (ACA) as unconstitutional. Texas v....more

Bass, Berry & Sims PLC

Healthcare Fraud & Abuse Review 2017

Bass, Berry & Sims PLC on

A LOOK BACK... A LOOK AHEAD - While the uncertainty associated with legislative efforts to repeal the Patient Protection and Affordable Care Act (PPACA) dominated most of the headlines for the healthcare industry last year,...more

Akerman LLP - Health Law Rx

Florida Federal Court: Escobar Requires Reversal of $348 Million False Claims Act Jury Verdict

Akerman LLP - Health Law Rx on

The United States District Court for the Middle District of Florida vacated a large jury verdict in a False Claims Act case against the owners and operators of nursing homes because the evidence did not satisfy the...more

Polsinelli

DOJ Targets Nursing Fraud with New Task Forces

Polsinelli on

On March 30, 2016, the U.S. Department of Justice launched 10 regional task forces targeting “grossly substandard care” in nursing homes and other long-term care facilities across the country. The task forces combine federal,...more

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