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Pharmaceutical | Pharma 101

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Medicare Fraud 101 Blog. Qui Tam 101 Blog. Pharma 101 Pharmaceutical Fraud. Pharmaceutical Fraud News and Insight form the Qui Tam and False Claims Act Perspective. August 29, 2016. Kickbacks Crackdown Worldwide: Will Pharma Finally Get the Message? The Wall Street Journal recently reported that six employees of Novartis have been indicted in South Korea amidst allegations that the company paid $2.3 million…. Read More ». June 29, 2016. Read More ». June 17, 2016. Read More ». February 5, 2016. The Gover...

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HHS-OIG Warns Against Sham Medical Directorships - Medicare Fraud 101

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Pharmaceutical Fraud 101 Blog. Qui Tam 101 Blog. HHS-OIG Warns Against Sham Medical Directorships. July 14, 2015. In October 2011, Nolan Auerbach and White announced the $7.5 million settlement of its client’s False Claims Act. Action, alleging that Select Medical. Paid suspect “Medical Director” payments to a number of Ohio physicians. Recently, HHS-OIG put the medical community on notice when it released a Fraud Alert. Children’s Hospital Pays Government $12.9 Million for Allegedly Submitting...Contact...

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Court Decides Exemption for Healthcare Whistleblowers with HIPAA Records - Medicare Fraud 101

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Pharmaceutical Fraud 101 Blog. Qui Tam 101 Blog. Court Decides Exemption for Healthcare Whistleblowers with HIPAA Records. July 29, 2015. Consistent with the specific exemption under HIPAA, the United States District Court in the Eastern District of Arkansas has ruled. 1) Disclsoures by whistleblowers. A covered entity is not considered to have violated the requirements of this subpart if a member of its workforce or a business associate discloses protected health information, provided that:. B) An attor...

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Are Some Health Systems Violating the Law When Acquiring Medical Practices? - Medicare Fraud 101

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Pharmaceutical Fraud 101 Blog. Qui Tam 101 Blog. Are Some Health Systems Violating the Law When Acquiring Medical Practices? May 22, 2015. In April 2014, All Children’s Hospital, et al. agreed to pay $7 million to resolve a False Claims Act. Relator received a reward. Of nearly $2 million. A year later, in April 2015, the nationwide dermatology practice Family Dermatology agreed to pay over $3 million, resolving three separate. In both of these settlements, almost all of the. Like a line out of. Serious ...

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Justice Department Alleges Nursing Home Chain's "Ultra High Bill Targets" Caused Its Facilities to Submit False Medicare Claims - Medicare Fraud 101

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Pharmaceutical Fraud 101 Blog. Qui Tam 101 Blog. Justice Department Alleges Nursing Home Chain’s “Ultra High Bill Targets” Caused Its Facilities to Submit False Medicare Claims. May 12, 2015. DOJ filed a False Claims Act complaint-in-intervention. SNFs) in 30 states. According to the government’s FCA Medicare fraud. The government maintains that these billing goals were specifically designed to increase revenues without regard to the patients’ actual clinical needs. The underlying. Whistleblowers Often P...

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Hospital Fraud Archives - Medicare Fraud 101

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Pharmaceutical Fraud 101 Blog. Qui Tam 101 Blog. Medicare Fraud News, Breaking Headlines and Insight from the Qui Tam Perspective. Category Archives: Hospital Fraud. June 24, 2016. Are Hospitals Pressuring ER Physicians to Inappropriately Admit Patients? Over the last few years, the government has devoted substantial resources to pursue hospitals that inappropriately admit patients to inpatient stays. This month, the government…. Read More ». February 19, 2016. Read More ». August 21, 2015. July 29, 2015.

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Whistleblowers Often Play Key Roles in FCA Cases Alleging Inappropriate Inpatient Admission Cases - Medicare Fraud 101

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Pharmaceutical Fraud 101 Blog. Qui Tam 101 Blog. Whistleblowers Often Play Key Roles in FCA Cases Alleging Inappropriate Inpatient Admission Cases. May 1, 2015. However, upon closer inspection, the MCCG recovery appears to be an outlier, for the government may have successfully pursued this case forward without the assistance of a. With Dignity Health, the relator was the health system’s Health Director of Medical Management. 8220;Billing Medicare for higher cost inpatients services that patients do not ...

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Simple Reality for Healthcare Providers: Retaining Medicare Overpayments Is Theft - Medicare Fraud 101

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Pharmaceutical Fraud 101 Blog. Qui Tam 101 Blog. Simple Reality for Healthcare Providers: Retaining Medicare Overpayments Is Theft. June 19, 2015. For years, however, dishonest healthcare providers oftentimes engaged in a finders’ keepers approach to the receipt of Medicare overpayments. Periodically, hospital administrators are facing this fact pattern and weighing their options. However, there is only. Action that seeks to recover these stolen funds. More information for whistleblowers. Is located at t...

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Government Continues Efforts to Curb Improper One-Day Inpatient Admissions - Medicare Fraud 101

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Pharmaceutical Fraud 101 Blog. Qui Tam 101 Blog. Government Continues Efforts to Curb Improper One-Day Inpatient Admissions. March 30, 2015. For years, the Government has intervened in False Claims Act. Cases and/or otherwise recouped monies from health systems based upon inpatient services that lacked medical necessity. Many of these recoveries have involved hospitals submitting claims to Medicare for medically unnecessary one-day stays, which should have been treated as less expensive outpatients.