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Showing 16 posts in Fraud & Abuse.

Walgreens Agrees to Record $80 Million Settlement with DEA

WalgreensOn Tuesday, June 11, 2013, the Drug Enforcement Administration (“DEA”) announced that it had reached an $80 million civil settlement agreement, the largest in DEA history, with Walgreen Co. (“Walgreens”) to resolve allegations involving an “unprecedented number” of record-keeping and dispensing violations under the Controlled Substance Act (“CSA”). According to the DEA’s Press Release, Walgreens negligently allowed controlled substances, including Oxycodone and other prescription painkillers, to be diverted into the black market. Read More ›

Categories: Compliance, Fraud & Abuse, Hospitals, Pharmacy, Physicians, Regulatory

Health Care Fraud and Abuse Enforcement - It's Not Just Hypothetical Anymore

health care fraud and abuse enforcementOn February 11, 2013, the Departments of Justice and Health and Human Services jointly released a report stating that the government recovered $4.2 billion in fiscal year 2012 and for every dollar spent on health care-related fraud and abuse investigations in the last three years, the government recovered $7.90. The report indicates that this is the highest 3-year average return on investment in the 16 year history of the Health Care Fraud and Abuse program. The Health Care Fraud Prevention and Enforcement Action Team (“HEAT”), which has operations in Detroit, was instrumental in this recovery effort. Read More ›

Categories: Fraud & Abuse, Health Care Reform

Recap from the Health Law Institute

health law instituteOn March 8 and 9, 2012, the members of Foster Swift's Health Care Law Group attended the 18th Annual Health Law Institute.  This two-day institute, which is co-sponsored by the Institute for Continuing Legal Education and the Health Care Law Section of the Michigan State Bar, focused on recent legal developments in health care law.  Specific topics addressed at this year's Health Law Institute included: Read More ›

Categories: Compliance, Fraud & Abuse, Regulatory

OIG Alert – Physicians May Be Liable for False Claims Submitted by Entities Receiving Reassigned Medicare Payments

Medical BillThe Office of Inspector General ("OIG") for the Department of Health and Human Services recently issued an alert, which warned that “physicians who reassign their right to bill the Medicare program and receive Medicare payments by executing the CMS-855R application may be liable for false claims submitted by entities to which they reassigned their Medicare benefits.”  The OIG stressed that physicians remain liable for claims submitted using their provider numbers, even when the claims for services are submitted by another party under a contractual arrangement.  The potential for liability also exists for other types of practitioners who enter into reassignment agreements. Read More ›

Categories: Billing/Payment, Compliance, Employment, Fraud & Abuse, Medicare/Medicaid, Physicians

Doctors Going to Jail for Medicare Scams

Handcuffs & StethoscopeThe month of June has been flush with medical professionals heading to jail for Medicare fraud.

Most recently, a Miami-Dade county doctor, Dr. Rene de los Rios was given a lengthy 20 year sentence for his participation in a Medicare fraud scheme.  Dr. de los Rios falsified hundreds of patient records to the tune of $46.2 million for HIV therapy.  Many of his patients received kickbacks.  While, Dr. del los Rios' attorney argued for a shorter sentence (given his client's 72-years of age), the U.S. District Judge refused and instead chastised Dr. del los Rios for violating his medical oath, stealing from the vulnerable government program, and disgracing himself. Read More ›

Categories: Fraud & Abuse, Physicians

New Medicare Screening Requirements for Providers

In conjunction with a step-up in other fraud and abuse enforcement activities, CMS recently announced new screening procedures, which will be applicable to newly enrolling providers and suppliers as well as to providers and suppliers who are currently enrolled in Medicare, Medicaid and CHIP who revalidate their enrollment information.  Read More ›

Categories: Fraud & Abuse, Medicare/Medicaid, Regulatory

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Best Lawyers® 2021

Congratulations to the attorneys of the Health Care practice group at Foster Swift Collins & Smith, PC for their inclusion in the Best Lawyers in America 2021 edition. Firm-wide, 44 lawyers were listed. Best Lawyers lists are compiled based on an exhaustive peer-review evaluation and as lawyers are not required or allowed to pay a fee to be listed; inclusion in Best Lawyers is considered a singular honor. Health Care practice group members listed in Best Lawyers are as follows:

To see the full list of Foster Swift attorneys listed in Best Lawyers 2021, click here.