Category: Medicare Fraud
OIG Has Tried to Encourage CMS to Close a Drug Payment Loophole Twice, But CMS Won’t Budge
Government oversight can sometimes be a frustrating business. That maxim is particularly true when it comes to persuading the Centers for Medicare & Medicaid Services...
Inpatient Psychiatric Facilities are Overpaid for Unnecessary Outlier Payments
At the end of the day, virtually all of the Medicare program – and any health insurance plan for that matter – relies on the...
Providing Travel and Lodging to Patients Prescribed Certain Drugs is Not Necessarily Pharmaceutical Fraud
The most common answer you will get when you ask a lawyer a question is, “It depends.” While that answer is not always the most...
New OIG Report Raises Concerns That Health Risk Assessments May Be Source of Improper Medicare Advantage Payments
As part of its watchdog function, the OIG confirmed in its 2020 report that payments made through the Medicare Advantage program were improperly inflated to...
Study Shows Whistleblowers Help Curb Fraud
According to a study by Jaron H. Wilde at the University of Iowa (an assistant professor of accounting in the Tippie College of Business), whistleblowers...
Hospitals in Trouble for Improperly Billing Medicare and Medicaid Health Care Programs
St. Michael’s Medical Center in Newark, New Jersey recently resolved allegations with the Department of Justice that it falsely billed Medicare and Medicaid for medically...
Whistleblower Motivations
Nolan Auerbach & White 3 named partners themselves have collectively has represented the interests of whistleblowers for over 50 years! Thousands of potential healthcare whistleblowers...
California Hospital Agrees to Settle With Department of Justice for Millions
The Department of Justice recently announced that Tri-City Medical Center, a hospital located in Southern California, has agreed to pay over $3.2 million to resolve...
DME Suppliers Cheat Medicare When They Bill for Skilled Nursing Facility Patients
Medicare pays a bundled payment to skilled nursing facilities that cover all of a patient’s needs, including the provision of durable medical equipment (DME). In...