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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
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.

Long Term Care & Senior Living Blog
July 22, 2014

DOJ Files Suit Against Missouri Doctor For Anti-kickback Statute

The Justice Department is committed to combat fraud and abuse in federal healthcare programs. The most recent complaint filed by the DOJ is against Midwest Neurosurgeons LLC and its owner, Dr. Sanjay Fonn, MD, along with DS Medical LLC and its owner, Deborah Seeger. The defendants allegedly violated the Anti-Kickback Statute and False Claims Act by conspiring to solicit and receive commissions from medical device manufacturers related to the implant of spinal implants and supplies used for spinal fusion surgeries.

Long Term Care & Senior Living Blog
June 25, 2014

Learning the Hard Way – Omnicare to Pay $124M False Claims Settlement

False Claims Act (FCA) allegations are serious business. Anti-Kickback Statute prohibits offering, paying, soliciting or receiving remuneration to induce referrals of items or services covered by Medicare, Medicaid and other federally funded programs. Omnicare learned the hard way just how serious FCA actions can be when a whistleblower made allegations against it.

Long Term Care & Senior Living Blog
January 20, 2014

RehabCare settles FCA allegations for $30 Million

Next time you wonder how serious the government is about anti-kickback law, think about the latest False Claims Act settlement of $30 Million. This settlement was part of the government’s emphasis on combating health care fraud and marks another achievement for the Health Care Fraud Prevention and Enforcement Action Team (HEAT) initiative, partnering Department of Justice and Health and Human Services.

Long Term Care & Senior Living Blog
January 15, 2014

OIG, CMS release Final Rule for the Stark Exception, Anti-Kickback Safe Harbor for Electronic Health Records (EHR) Donation

While the donation of a valuable item such as an EHR program would raise fraud and abuse concerns, exemptions under Stark Law and Anti-Kickback Safe Harbor were designed to encourage the widespread implementation of EHR and to let smaller providers accept gifts of EHR software without violating the law or statute.