When does the 60-day clock start for an identified overpayment of federal funds to become a reverse false claim under amendments to the False Claims Act? A closely watched SDNY qui tam case may provide an answer.
In June, the United States and New York intervened in United States v. Continuum Health Partners, Inc.,
False Claims Act cases do not often go to trial, so they are noteworthy when they do. EDNY Judge John Gleeson has scheduled an FCA jury trial in October, United States ex rel. Ryan v. Lederman. Earlier this year, the Court granted summary judgment to the government in part and scheduled the remaining issues
At the end of June, the U.S. Attorney’s Office in Manhattan filed a False Claims Act complaint against Beth Israel Medical Center, St. Luke’s-Roosevelt Hospital Center, and Continuum Health Partners, United States v. Continuum Health Partners, Inc., alleging that defendants had knowingly failed to return overpayments owed to Medicaid arising out of a
A recent SDNY False Claims Act decision provides strong support for the argument that a false claim may not be based on conduct that follows federal or state rules and guidelines.
In United States ex rel. Doe v. Taconic Hills Central School District, relators alleged that the New York City Department of Education (“DOE”)
At the end of January, the Office of Inspector General for the Department of Health and Human Services (“HHS-OIG”) released its 2014 Work Plan. The Work Plan summarizes new and ongoing reviews and activities that HHS-OIG plans to pursue with respect to HHS programs and operations in the coming year. Senior HHS-OIG officials outlined
In Matter of Koch v. Sheehan, the New York Court of Appeals held that the Office of Medicaid Inspector General (“OMIG”) may remove a physician from the Medicaid program based solely on a consent order between the physician and the Bureau of Professional Medical Conduct (“BPMC”), even if BPMC does not suspend the physician’s
In U.S. ex rel. Fair Laboratory Practices Associates v. Quest Diagnostic, Inc., the Second Circuit upheld the dismissal of a health care fraud qui tam action because of ethical violations by one of the relators, who was formerly general counsel of defendant Unilab Corporation.
The former general counsel, along with two other former employees
In U.S. ex rel. Wolfson v. Park Avenue Medical Associates, the U.S. Attorney’s Office in the Southern District of New York entered into a $1 million False Claims Act settlement against three related companies for improperly billing Medicare for behavioral health services. The settlement agreement provided that the defendants “admit, acknowledge and accept responsibility
A bill proposed in the US House of Representatives may cause physicians to significantly restructure their practices as they relate to in-office ancillary services (IOAS).
Promoting Integrity in Medicare Act of 2013
The Stark Law is a federal statute which prohibits physicians from making referrals for Medicare-covered designated health services (DHS) to an entity with
Earlier this month, a bill to amend the False Claims Act (“FCA”), the “Fairness in Health Care Claims, Guidance and Investigations Act,” was introduced in the House of Representatives. According to one of the bill’s sponsors, Rep. Howard Coble (R-NC), the bill’s purpose is to ensure that unintentional billing disputes are not penalized as