False Claims Act

Is the Government Overreaching with its use of the False Claims Act? The AHA Sure Seems to Think So.

(September 11, 2010): Earlier this week, the American Hospital Association (AHA),... 

“Finders Keepers” Doesn’t Apply to Medicare Overpayments for Partial Hospitalization Services

(July 15, 2010):  Since the May 2009 passage of the Fraud Enforcement and Recovery... 

PPACA Creates a Minefield for CMHCs Who Fail to Promptly Return an Overpayment

(July 9, 2010):  Does the failure of a CMHC to promptly return a Medicare overpayment warrant... 

The “Fraud and Abuse” Enforcement Impact of the Health Care Reform Bill on Community Mental Health Clinics and the Partial Hospitalization Program Services They Provide

(April 1, 2010): On March 21, 2010, the House voted to approve legislation previously... 

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HEAT Enforcement

Additional Cities will have HEAT Teams in 2011

(August 27, 2010): Yesterday, Attorney General Eric Holder and U. S. Department of Health and Human Services (HHS) Secretary Kathleen Sebelius conducted the second of a planned series of “Regional Health Care Fraud Prevention Summits.”  The first summit was recently conducted in Miami, Florida.  This summit was held in Los Angeles, California.  In... [Read more of this review]

Medicare Fraud Strike Force Operation Leads to Charges against 94 Defendants, including 4 in South Texas

 (July 17, 2010): Yesterday, the Department of Justice (DOJ) announced charges against 94 physicians, medical assistants, and health care company owners and executives in connection with alleged false Medicare claims amounting to more than $251 million.  24 defendants from Miami account for approximately $103 million of that amount.  Four defendants... [Read more of this review]

Texas Psychiatrist Indicted and Arrested

(July 9, 2010):  On June 14, 2010 the U.S. Attorney’s Office for the Western District of Texas announced that a Federal Grand Jury had returned a 99-count indictment against a pain management physician who operated clinics in San Antonio and El Paso.  The physician was charged with 21 counts of health care fraud, 20 counts of false statements relating... [Read more of this review]

Owner of Texas Behavioral Health Counseling Clinic Pleads Guilty to Medicare Fraud

(June 5, 2010):  Early last week, the U.S. Attorney’s Office in Houston, Texas announced that a plea agreement had been reached with the owner of a behavioral counseling center in Houston.  The owner pled guilty to (1) conspiracy to commit health care fraud, (2) health care fraud and (3) aggravated identity theft, all arising out of the defendant’s... [Read more of this review]

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