Archives: False Claims Act

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CMS and OIG Ring in the New Year with Final Rules on EHR Donations

On December 27, 2013, the Centers for Medicare and Medicaid Services (“CMS”) and the Office of Inspector General of the Department of Health and Human Services (“OIG”) published final rules (“Final Rules”) regarding the electronic health records (“EHR”) donations Stark Law Exception (42 C.F.R. 411.357(w)) and Anti-Kickback Statute Safe Harbor (“AKS Safe Harbor”) (42 C.F.R. … Continue Reading

Fourth Circuit Requires Penalties for FCA Violations, Even Where No Government Economic Damage Found

Author: Rebecca A. Worthington, Esquire In a decision sure to generate comment during the new year, the Fourth Circuit ruled in United States ex rel. Bunk v. Gosselin World Wide Moving, No. 12-1369, 2013 U.S. App. LEXIS 25225 (Dec. 19, 2013), that penalties of some amount must be awarded for violations of the civil False … Continue Reading

District Court Deals Major Blow to Halifax in Bank Busting Qui Tam Suit

On November 13, U.S. District Court Judge Gregory A. Presnell of the Middle District of Florida partially granted the U.S. government’s summary judgment motion against Halifax Hospital Medical Center (“Halifax”).  Judge Presnell ruled that Halifax failed to demonstrate that bonus compensation arrangements it made with medical oncologists satisfied a Stark Law exception.  Judge Presnell found … Continue Reading

Government Finds More Medical Services Unnecessary

In the September 2013 edition of the Cleveland Bar Journal, Colin Jennings and Tom Zeno described the government’s determination to challenge medical decision making as medically not necessary.   To read the article, visit Uncle Sam Becomes a Doctor:  Government Challenges to Medical Necessity. Recent prosecutions have been born out of their prediction. In October 2013, … Continue Reading

Tuomey Ordered to Pay $237 Million

Capping a case that has drawn the attention of healthcare lawyers and hospital executives nationwide, the U.S. District Court for the District of South Carolina has ordered Tuomey Healthcare System, Inc. (“Tuomey”) to pay over $237* million for violations of the Stark Law and False Claims Act arising from certain employment agreements between Tuomey and … Continue Reading

South Carolina AG: Tuomey not Permitted to Indemnify Trustees or Officers

The hits just keep coming for Tuomey Healthcare System, Inc. (“Tuomey”).  Tuomey is not permitted to indemnify its trustees or officers according to an opinion published by the Attorney General of South Carolina (“SC AG”) on September 3, 2013.  In May, 2013, the government requested approximately $237 million in damages after a jury found Tuomey … Continue Reading

Whistleblowers Can Be Anyone – Even Consultants

At first glance, Shands Healthcare’s (“Shands”) agreement to pay $26 million to the federal government and the State of Florida appears to be like all the other recently reported health care fraud settlements of whistleblower complaints. Upon closer inspection however, one significant difference stands out: the relator who initially brought the case against Shands was … Continue Reading

Sixth Circuit Overturns $11.1 Million Judgment Against MedQuest for FCA Violations

On April 1, 2013, the United States Court of Appeals for the Sixth Circuit overturned the $11.1 million judgment against MedQuest for its submission of claims to Medicare for tests in diagnostic testing facilities that were not supervised by approved physicians.  The whistleblower action was initiated by a former MedQuest employee, alleging that MedQuest, a … Continue Reading
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