Posts Tagged ‘False Claims Act’

U.S. Intervenes in False Claims Act Lawsuit Against Fla. Home Health Care Company and Its Owner

July 22, 2013

The government has intervened in a whistleblower lawsuit against A Plus Home Health Care, Inc., a home health care company in Fort Lauderdale, Fla., and its owner, Tracy Nemerofsky, the Justice Department announced today. The government alleges that A Plus offered referring physicians’ spouses sham marketing positions with the company to induce the physicians to refer Medicare patients for home health care services. (more…)

Feds Announce Record-Breaking Recoveries From Efforts to Combat Health Care Fraud

February 12, 2013

healthcare_fraud_imageWASHINGTON – Attorney General Eric Holder and Health and Human Services Secretary Kathleen Sebelius yesterday released a new report showing that for every dollar spent on health care-related fraud and abuse investigations in the last three years, the government recovered $7.90. This is the highest three-year average return on investment in the 16-year history of the Health Care Fraud and Abuse Program.

The government’s health care fraud prevention and enforcement efforts recovered a record $4.2 billion in taxpayer dollars in Fiscal Year (FY) 2012, up from nearly $4.1 billion in FY 2011, from individuals and companies who attempted to defraud federal health programs serving seniors and taxpayers or who sought payments to which they were not entitled. Over the last four years, the administration’s enforcement efforts have recovered $14.9 billion, up from $6.7 billion over the prior four-year period. Since 1997, the HCFAC Program has returned more than $23 billion to the Medicare Trust Funds. (more…)

CMS Issues Record Retention Requirements for HHAs

September 19, 2012

The Centers for Medicare & Medicaid Services released Transmittal 431/Change Request 7890, which provides instructions to its contractors for enforcing regulations that require providers, supplies, and physicians to maintain ordering and certifying documentation for home health and certain other services for seven years. (more…)

CMS Accepting Comments on Proposal Rule Related to Reporting and Returning Overpayments

April 12, 2012

The Centers for Medicare & Medicaid Services (CMS) is currently accepting comments on a proposed rule related to Medicare overpayments to providers. If finalized, the proposal would require providers to report and return overpayments within 60 days of identification, and gives CMS the authority to look back 10 years into providers’ claims to review potential overpayments. Click here to review the proposed rule. Providers and stakeholders can submit comments on the proposal through April 16. (more…)

Health Care Fraud Prevention and Enforcement Efforts Result in Record-Breaking Recoveries Totaling Nearly $4.1 Billion

February 14, 2012

WASHINGTON – Attorney General Eric Holder and Department of Health and Human Services (HHS) Secretary Kathleen Sebelius today released a new report showing that the government’s health care fraud prevention and enforcement efforts recovered nearly $4.1 billion in taxpayer dollars in Fiscal Year (FY) 2011. This is the highest annual amount ever recovered from individuals and companies who attempted to defraud seniors and taxpayers or who sought payments to which they were not entitled. (more…)