The United States Department of Justice recently announced that a hospital out of Virginia has agreed to pay $50 to settle claims that it violated the False Claims Act (FCA). This most recent settlement highlights the government's continued focus on aggressively pursuing potential health care fraud cases. The settlement was the result of a Qui Tam case originally brought by a former hospital executive. After the hospital executive initiated this lawsuit, the government chose to step in and move the case forward.
The presumptive Democratic presidential nominee, Joe Biden, recently chose his running mate, Sen. Kamala Harris of California. The announcement provides an opportunity to discuss the impact of a vice-president on the field of health care.
Federal prosecutors have accused a pharmaceutical company, Regeneron Pharmaceuticals, Inc, of using charitable organizations to funnel illegal kickback payments to doctors. The allegations are connected to the use of an injectable drug used to treat macular degeneration. The company funded a charitable organization, the Chronic Disease Fund, to help cover Medicare patients’ co-pays for this expensive medication.
The U.S. Attorney's Office in New Jersey recently completed an investigation that resulted in health care fraud charges for a medical device company. The investigation was the result of a qui tam lawsuit. This whistleblower claim began when a non-practicing physician filed a complaint about the company, Merit Medical Systems, Inc., stating he formerly worked with the medical device company and that his attempts at encouraging compliance while employed were "to no avail."
Lawmakers designed the federal Anti-Kickback Statute (AKS) to help better ensure medical professionals focus on the well-being of their patients. Lawmakers intended this piece of regulation to reduce the risk of medical decisions based on financial gain. But what happens when the government accuses a medical company or individual of an AKS violation? The following discussion provides a basic timeline.
The current coronavirus pandemic has forced us to rethink our daily lives. We have had to change how we work, how we communicate, and how we get medical care.
A court recently found former Jacksonville Jaguars defensive back Monty Ray Grow guilty of health care fraud and sentenced him to 22 years imprisonment as well as over $19 million in mandatory restitution. The conviction was part of criminal allegations connected to prescription of unnecessary medications to Tricare recipients, a federal insurance program that aids military members.
The United States Department of Justice (DOJ) recently announced it was pursuing allegations of health care fraud against a spine device manufacturer along with its executives.
The government uses the Anti-Kickback Statute (AKS) to help better ensure doctors are not letting financial gain impact decisions about patient care. As a result, the government may make an AKS claim if a doctor is getting payment or has some financial benefit from an arrangement with other health care providers.
Patients are not the only ones who pay the bill when it comes to medical care. In some cases, the government is also spending money. The government may pay the entire or a portion of the bill, for example, for Medicare patients. As a result, lawmakers have put various regulations in place to better ensure the money is used as it is intended.