Nov 10th, 2017
Lately it seems that the Office of Inspector General’s (OIG) focus is on fraud and abuse of federal healthcare dollars via the False Claims Act; however, a case in Newark, N.J., has proven that the Anti-Kickback Statute also is being enforced in a big way. A Staten Island doctor, Ahmed El Soury, has been sentenced ...
In CMS
Feb 28th, 2017
New compliance program guidance has been issued by the Fraud Section of the Department of Justice (DOJ), according to an article published in the AHLA Weekly. Although the “Evaluation of Corporate Compliance Programs” (Guidance) is not specific to the healthcare industry, it does provide a practical set of benchmarks against which the audit & compliance committee, in ...
Jan 20th, 2017
The American Health Lawyers association reported the following in its weekly Fraud and Abuse update: The government won or negotiated more than $2.5 billion in healthcare fraud judgments and settlements in fiscal year (FY) 2016, the Departments of Health and Human Services (HHS) and Justice (DOJ) said in their Health Care Fraud and Abuse Control Program Annual ...
Jul 15th, 2016
Civil monetary penalties (CMPs) for violating the False Claims Act (FCA) are increasing substantially under an interim final rule that the Department of Justice (DOJ) published June 30 (81 Fed. Reg. 42491). The Federal Civil Penalties Inflation Adjustment Improvement Act of 2015, which was enacted as part of the Bipartisan Budget Act of 2015, mandated ...
The Yates Memo provides a renewed focus on individual accountability in corporate misconduct. By Robert Pelaia, Esq., CPC, CPCO, and Jamie Ewing Note from Editor: There is a follow-up article to this article. On September 9, 2015, Sally Q. Yates, the current deputy attorney general for the United States Department of Justice (DOJ), issued a guidance ...