News & Analysis as of

Nursing Homes Healthcare Fraud

ArentFox Schiff

Investigations Newsletter: CEO of Health Care Software Company Convicted of $1 Billion in Medicare Fraud

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CEO of Health Care Software Company Convicted of $1 Billion in Medicare Fraud - A federal jury in Miami convicted Gary Cox, the CEO of Power Mobility Doctor Rx, LLC, of six health care-fraud-related counts for his role in...more

Rivkin Radler LLP

PA Nursing Home Companies to Pay $15 Million for Healthcare Fraud

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Two Pennsylvania nursing home operators were recently sentenced in federal court to pay more than $15 million in restitution in a healthcare fraud case. Comprehensive Healthcare Management Services, the operator of Brighton...more

ArentFox Schiff

Investigations Newsletter: FCA Complaint Filed Against One of Nation’s Largest Specialty Wound Care Providers

ArentFox Schiff on

FCA Complaint Filed Against One of Nation’s Largest Specialty Wound Care Providers - On April 4, the government filed a complaint against Vohra Wound Physicians Management LLC, its founder, Dr. Ameet Vohra, and VHS...more

McDermott Will & Schulte

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

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

Morrison & Foerster LLP

The Inaugural Meeting of the White House’s Pricing Strike Force Focuses on Healthcare, Groceries, and Junk Fees

The Biden Administration recently convened the first meeting of its Strike Force on Unfair and Illegal Pricing (Strike Force), an interagency initiative announced in March 2024 to “root out and stop illegal corporate behavior...more

Stark & Stark

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

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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

Morrison & Foerster LLP

True Facts About False Claims: MoFo's FCA Newsletter - April 2024

Designed for busy in-house counsel and compliance professionals, this newsletter seeks to bring you up to speed on key federal and state False Claims Act (FCA) developments, with links to primary resources. Each quarter, we...more

Troutman Pepper Locke

Lessons for Skilled Nursing and Assisted Living Facilities From the ‘Largest Health Care Fraud Case’

Troutman Pepper Locke on

Phillip Esformes, the alleged mastermind of one of “the largest single criminal health care fraud cases ever brought against individuals by the Department of Justice,”has finally reached a plea deal with the Department of...more

Stark & Stark

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

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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

Harris Beach Murtha PLLC

OIG December Enforcement Summary

The following is a summary of selected federal Department of Health and Human Services’ Office of Inspector General (OIG) reports of fraud and abuse enforcement activity across the country. The enforcement actions reported...more

ArentFox Schiff

Investigations Newsletter: Texas Clinical Laboratory and Owner to Pay $5.7 Million to Resolve Outstanding FCA Judgment

ArentFox Schiff on

Texas Clinical Laboratory and Owner to Pay $5.7 Million to Resolve Outstanding FCA Judgment - Defunct BestCare Laboratory Services LLC and its founder will pay $5.7 million to settle an outstanding 2018 False Claims Act...more

McDermott Will & Schulte

Healthcare Regulatory Check-Up Newsletter | May 2023 Recap

This issue of McDermott’s Healthcare Regulatory Check-Up highlights significant regulatory activity for May 2023. We discuss several criminal and civil enforcement actions that involve violations of the False Claims Act (FCA)...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

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

McDermott Will & Schulte

Healthcare Regulatory Check-up Newsletter | July 2022 Recap

This issue of McDermott’s Healthcare Regulatory Check-Up highlights significant activity between June 21 and July 20, 2022. During this period, the Supreme Court of the United States overturned Roe v. Wade, which historically...more

Dentons

Department of Justice Files False Claims Act Charges Against Nursing Home Chain

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The United States Department of Justice (DOJ) has filed another False Claims Act case against a long-term care provider premised on the quality of care provided to its residents. The DOJ is increasingly utilizing substandard...more

McDermott Will & Schulte

Healthcare Regulatory Check-up Newsletter | May 2022 Recap

This issue of McDermott’s Healthcare Regulatory Check-Up highlights notable enforcement activity between April 21 and May 20, 2022, including a telemedicine case involving $64 million in false and fraudulent claims. We also...more

Mintz - Health Care Viewpoints

Health Care Enforcement Year In Review & 2022 Outlook

STATISTICAL TRENDS IN FALSE CLAIMS ACT LITIGATION - FCA case activity for 2021 reveals seemingly contrary trends. For the federal fiscal year (FY) that ended September 30, 2021, the DOJ annual report on FCA enforcement...more

Bradley Arant Boult Cummings LLP

Skyline Fraud Charges Serve as a Warning to Inexperienced Operators

In the past month, state and federal prosecutors have separately charged the former CEO of Skyline Healthcare, Joseph Schwartz, with Medicaid and tax fraud. The criminal actions, which represent the latest legal action...more

Health Care Compliance Association (HCCA)

Rob DeConti on the Latest Guidance and Insights from the OIG at HHS

In this podcast Rob DeConti, Assistant Inspector General for Legal Affairs within the office of counsel to the Inspector General at HHS, was good enough to share a tremendous amount of insight into what the OIG is seeing,...more

Brooks Pierce

Increased DOJ Enforcement in the Health Care Space

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Health care providers and entities take note: The Department of Justice (DOJ) is increasingly focused on enforcement in the health care space. DOJ has long prioritized health care fraud, but under the prior administration...more

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