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Long Term Care & Senior Living Blog

We offer updates on national on regional issues such as malpractice defense, regulatory compliance, labor and employment issues and estate planning.

Long Term Care & Senior Living Blog
June 29, 2016

Massive National Health Care Fraud Takedown

Last week, the OIG reported charges against 301 individuals for approximately $900 Million in false billing as part of the largest false claim takedown. The takedown focused on a broad range of providers including home health companies, physicians, physical and occupational therapy clinics, infusion clinics, mental health providers, DME suppliers, and compounding pharmacies. Of importance, the takedown focused on staying “a step ahead of emerging fraud trends, including drug diversion, and fraud involving compounded medications and hospice care.”

Long Term Care & Senior Living Blog
May 4, 2016

Elder Fraud in Health Care Targeted by the DOJ

The U.S. Department of Justice (“DOJ”), in trying to initiate quicker enforcement actions and prosecutions, has created several Elder Justice Task Forces to target health care providers who commit crimes in the service of the elderly. The Task Forces are comprised of representatives from federal, state and local law enforcement, the U.S. Department of Health and Human Services, state adult protective services agencies, long-term care ombudsman programs, U.S. Attorneys’ offices, state Medicaid fraud control units, and state and local prosecutors.

Long Term Care & Senior Living Blog
December 1, 2015

Anti-Kickback Update - HHS-OIG Settles Ambulance Swapping Case $3 Million Settlement from Nursing Home in Ambulance Swapping Case

Demonstrating the government’s commitment to combat health care fraud and keeping providers accountable, the U.S. Attorney’s office of Southern District announced that Regent Management Services L.P., a long term provider, agreed to pay approximately $3.199 Million to settle allegations that it received kickbacks from ambulance companies for referrals of Regent’s Medicare and Medicaid patients needing transport in exchange for free or reduced transport costs for its other patients from those ambulance companies.

Long Term Care & Senior Living Blog
December 16, 2014

HEAT Settlement Resolves Alleged Inducement of Medicare and Medicaid Business

Next time you wonder how seriously the Department of Justice (DOJ) and its Health Care Fraud Prevention and Enforcement Action Team (HEAT) takes fraud and abuse, be assured they are very serious. This recently announced settlement arose from allegations the DOJ received from a whistleblower that Rite Aid provided gift cards to Medicaid and/or Medicare beneficiaries as an “inducement” to transfer their prescriptions to Rite Aid. Stephanie Yonekura, the Acting U.S. Attorney for Central District of California was quoted as saying the “settlement holds Rite Aid accountable for exerting undue influence on individuals when they make important healthcare decisions about where and when to fill prescriptions.” As part of the settlement, the whistleblower who filed the allegations will receive $508,300 of the settlement.