$3 Million Settlement for Hospital Upcoding Allegations
Key Points: Whistleblower to receive nearly $1 million dollars. Improper bundling and upcoding described in whistleblower’s complaint. The Department of…
Reminder That COVID-19 Fraud and Related Schemes Still Abound
Key Points: DOJ and OIG continue to issue warnings about fraud schemes. Consumers should remain alert. The Department of Health…
New FBI Cybersecurity Warning
Tips to protect against cyberattacks. The Federal Bureau of Investigation (FBI) issued a cybersecurity alert calling for increased vigilance in network…
$160 Million Medicare Fraud Settlement for Diabetic Testing Supplier
Whistleblower to receive $28.5 million of recovery. The Department of Justice (DOJ) announced that Arriva Medical LLC (Arriva), which was once the…
CMS Has Insufficient Authority to Ensure Hospitals Are Prepared for Emerging Infectious Diseases
The Department of Health and Human Services Office of the Inspector General (OIG) conducted an audit to determine whether the Centers…
Federal Court Finds That CMS Overpayment Rule Does Not Violate Medicare Requirements
Key Points: The D.C. Circuit Court of Appeals has reversed a lower court opinion that vacated the Center for Medicare…
DOJ Intervenes in Whistleblower Suits Against Kaiser Permanente
Six complaints allege submission of inaccurate diagnosis codes. The Department of Justice (DOJ) intervened in multiple whistleblower complaints alleging that…
Bipartisan Group of Senators Proposes Amendments to False Claims Act
Key Points: Amendments would result in significant modifications to statutory language. Burden of justifying dismissal of cases would be codified.…
DOJ Reports Sentencing of Two Physicians to Prison for Prescription Fraud
The United States Department of Justice (DOJ) announced that two Arkansas physicians were sentenced to a combined 12 and a…
CMS Lacks Consistent Oversight of Networked Device Cybersecurity in Hospitals
The OIG recommends that CMS address cybersecurity of networked medical devices in its quality oversight of hospitals. Networked medical devices…
Millions of Dollars in Overpayments Identified for ESRD Monthly Capitation Payments
CMS claims processing controls were inadequate. An audit conducted by the Department of Health and Human Services Office of the…
The Scripps Health 2021 Ransomeware Attack
Key Points: Scripps Health (Scripps), a health system based in San Diego, was subject to a cyberattack in which unauthorized…