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HHS-OIG Issues Favorable Advisory Opinion on Nursing Home Discounts for Medicare and Medicaid Beneficiaries Who Have Private Insurance

Posted on December 27, 2017, Medicare and Medicaid

On December 8, 2017, the Office of Inspector General of the U.S. Department of Health and Human Services (HHS-OIG) issued Advisory Opinion 17-08, in which it concluded that certain arrangements for nursing home discounts do not violate the federal Anti-Kickback Statute (“AKS”) or Civil Monetary Penalties Law (“CMPL”). The advisory opinion analyzed a proposed arrangement […]

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Federal Court Denies Plaintiff’s Attempt to Name CEO as Defendant In FCA Retaliation Suit

Posted on December 27, 2017, False Claims Act

On December 6, 2017, U.S. District Judge Andrew L. Carter Jr. (Southern District of New York) held that a False Claims Act (FCA) whistleblower could not name his boss as an individual defendant in a suit alleging unlawful retaliation. The plaintiff, Gerard Diffley, was the chief operating and compliance officer at Bostwick Laboratories. He obtained […]

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Government Agencies Allege That the 60-Day Rule Applies to All Federal Healthcare Programs

Posted on November 28, 2017, Health Care

On October 13, 2017, W. Stephen Muldrow, the Acting United States Attorney for the Middle District of Florida, announced that First Coast Cardiovascular Institute (FCCI) agreed to pay $448,821.58 to settle allegations that it knowingly delayed repayment of over $175,000 in alleged overpayments owed to federal healthcare programs in violation of the 60-Day Rule and […]

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Federal Court Assesses Damages Against Pennsylvania Health Clinic for Committing Sexual Orientation-Based Discrimination

Posted on November 28, 2017, Employment Law

On November 16, 2017, U.S. District Judge Cathy Bissoon, of the Western District of Pennsylvania, issued an order finding that a Pennsylvania Health Clinic is liable for $55,000 in back pay, compensatory damages, and punitive damages to a former employee who alleged that the clinic discriminated against him on the basis of his sexual orientation. […]

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Eleventh Circuit Holds That Medical Practice Did Not Discriminate Against Former Employee Because of Her Pregnancy

Posted on October 26, 2017, Employment Law

On October 18, 2017, the Eleventh Circuit Court of Appeals issued an opinion upholding a lower court’s grant of summary judgment to a medical practice in Florida that had been sued by a former employee who claimed she was discriminated against based on her pregnancy. In July 2014, plaintiff Kirby Mohammed, a licensed practical nurse, […]

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OIG Issues Report on Enhancing the Tracking and Collection of Medicare Overpayments Identified by ZPICs and PSCs

Posted on October 26, 2017, Health Care Medicare and Medicaid

The U.S. Department of Health & Human Services Office of Inspector General (“OIG”) recently published a report entitled “Enhancements Needed in the Tracking and Collection of Medicare Overpayments Identified by ZPICs and PSCs.” Zone Program Integrity Contractors (“ZPICs”) and Program Safeguard Contractors (“PSCs”) are private companies with which the Center for Medicare & Medicaid Services […]

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Coalition of 41 State Attorneys General to Investigate Opioid Manufacturers

Posted on September 22, 2017, Health Care White Collar Crime

On September 19, 2017, New York Attorney General Eric Schneiderman announced at a news conference that Attorneys General from 41 states have joined together to investigate major pharmaceutical companies over the production and distribution of opioids. The joint investigation was initiated by the service of subpoenas on five pharmaceutical manufacturers: Endo International, Janssen Pharmaceuticals, Teva […]

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Health System Settles Allegations that It Improperly Denied Overtime Payments to Home Health Clinicians

Posted on September 22, 2017, Health Care

Last month, Centegra Health System, which operates a chain of hospitals and clinics in the Chicago area, reached a settlement for an undisclosed amount with a proposed class of home health clinicians who claimed they were improperly denied overtime payments.  The settlement was reached via private arbitration. The suit begun in January 2017 when Laura […]

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Eleventh Circuit: Arbitration Compelled for Employment Claims that Arose Before Plaintiff Signed Arbitration Agreement

Posted on August 24, 2017, Health Care

  On August 7, 2017, the United States Court of Appeals for the Eleventh Circuit issued a unanimous 3-0 decision in Jones v. Waffle House, Inc. et al., holding that an arbitration agreement between the parties would be enforced even though the plaintiff signed the agreement after filing his original suit. In December 2014, William […]

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Department of Justice Establishes the Opioid Fraud and Abuse Detection Unit

Posted on August 24, 2017, Health Care

In response to the nationwide opioid epidemic, the U.S. Department of Justice (DOJ) has recently announced the creation of the Opioid Fraud and Abuse Detection Unit. The announcement was made on August 2, 2017, by Attorney General Jeff Sessions, who explained that for the next three years this new program will fund twelve experienced Assistant […]

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