false claims
publication date
Payer
Centene to Pay MassHealth $14M for Medicaid OverchargesCentene allegedly used its subsidiary PBM to overcharge the Bay State's Medicaid program.
Revenue Cycle
House Seeks HHS Probe of HCA ER Admissions PracticesThe House Subcommittee on Oversight raises concerns about the for-profit health system's billing practices and reports of chronic understaffing.
Clinical Care
NY-Presbyterian/Queens Hospital Pays $2.5M to Settle Self-Disclosed Fraud AllegationsA former physician at the prestigious health system endangered patients when he unnecessarily replace batteries for implanted difibrillators.
Telehealth
OIG Audit Backs Medicare Telehealth IntegrityHowever, 'high risk' providers billed the program for $127.7 million for telehealth services in the first year of the pandemic.
Revenue Cycle
Vision Quest Industries to pay $2.25M to resolve false claims act allegationsVision Quest Industries, Incorporated (VQ) has agreed to pay the United States $2.25 million to resolve False Claims Act allegations...
Post-Acute
Nursing Homes Found to be Underreporting Pressure UlcersFindings indicates an ?urgent need? for an alternative approach to measuring patient safety in nursing homes, researchers say.
Revenue Cycle
U.S. attorney’s office recovers over $5.5 million in civil false claims settlement with American senior communitiesAmerican Senior Communities, L.L.C. (ASC), a provider of skilled nursing and long-term care services throughout Indiana, has agreed to pay...
Strategy
Union-backed Investors File SEC Complaint Against HCA HealthcareHCA denies the allegations and calls the new complaint 'a rehash of claims this group purported in 2020.'
Revenue Cycle
Molina Healthcare Settles False Claims Act Violation for $4.6MThe company allegedly submitted fraudulent Medicaid reimbursements while violating licensing and supervision of staff regulations.
Payer
Federal Investigation Into Spine Surgeries Uses Mob Laws to Target Healthcare FraudOrthopedic surgeons have raked in billions through ties to medical device companies via consulting deals, royalties or ownership stakes, while...
Payer
UCSD Health Pays $3M to Settle False Claims AllegationsDOJ had alleged that from December 2015 to October 2019, UC San Diego Health submitted claims to Medicare for the...
Payer
HHS OIG Updates Healthcare Fraud Self-Disclosure ProtocolThe revision unveiled this week incorporates legal changes made since the last revision to the SDP in 2013.