An announcement came back in back in October 2016 from the Centers for Medicare & Medicaid Services (CMS). It announced that it had awarded to various entities the next round of contracts to serve as Recovery Audit Contractors (RACs) for their Medicare program. In totality, five separate RAC contractors were awarded. Each one was connected […]
Along with 14 of its member shareholders, Fredericksburg Hospitalist Group has agreed to pay nearly $4.2 million to settle a federal False Claims Act case brought under the qui tam whistleblower provisions of the FCA.
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St. Agnes Healthcare in Baltimore, Maryland has agreed to pay the United States a sum of $122,928 to resolve issues under the False Claims Act. These allegations allege that they submitted false claims to Medicare by billing for E&M Services at a higher reimbursement rate than the Federal health care programs allowed.
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Massachusetts Attorney General Maura Healey announced today a settlement with a pediatric dentist in Springfield. Healey’s office returned $500,000 to MassHealth, the state’s Medicaid program, resolving claims that improper billing for services occurred.
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The Navicent Health Medical Center has agreed to pay $2.5 million to settle federal allegations that it submitted bills for ambulance trips that were either medically unnecessary or inflated. The settlement follows a 27-month investigation, which was prompted by a whistleblower.
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The Charlotte-Mecklenburg Hospital Authority, dba Carolinas Healthcare System (CHS), has agreed pay the Government $6.5 million according to U.S. Attorney Jill Westmoreland Rose. This was to resolve allegations that the company violated the False Claims Act, by “up-coding” claims for urine drug tests in order to receive higher payment than allowed for the tests. The settlement […]
Orthopedic and Sports Medicine Center-Norman (collectively “OSC”) have paid $1,537,796 to settle civil claims stemming from allegations that they submitted false claims to Medicare, Medicaid, the Department of Veterans Affairs, and TRICARE. In reaching this settlement, OSC did not admit liability, and the government did not make any concessions regarding the legitimacy of the claims. The agreement […]
Fredericksburg Hospitalist Group, located in Richmond, VA, and fourteen of its member shareholders have agreed to pay nearly $4.2 million to settle a federal FCA case brought under the “qui tam whistleblower” provisions. Dana J. Boente, U.S. Attorney for the Eastern District of Virgini, said, “Rooting out fraudulent billing by healthcare providers is a priority. This […]
Medicare Advantage Organization and Former COO to Pay $32.5 Million to Settle False Claims Act Allegations
Freedom Health Inc., a Tampa, Florida-based provider of managed care services, and its related corporate entities (collectively “Freedom Health”), agreed to pay $31,695,593 to resolve allegations that they violated the False Claims Act by engaging in illegal schemes to maximize their payment from the government in connection with their Medicare Advantage plans, the Justice Department […]
New York City: According to a recent OIG report, Mount Sinai Hospital failed to comply with Medicare’s billing requirements for 110 outpatient and inpatient claims reviewed by the office of Inspector General for the audit period of January 1st, 2012, through December 31st, 2013.
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