Federal prosecution of health care fraud.
نویسنده
چکیده
Volume 94 No. 9 September 2011 was sentenced to168 months in prison and ordered to pay $9.5 million in restitution for his part in the five-year long scheme. In December, the parent company of two New Jersey hospitals paid $7.9 million to resolve allegations that the hospitals wrongfully obtained excessive outlier payments. In March of 2010, a cancer center in Florida agreed to pay $12 million to resolve allegations that the center and one of its physicians improperly inflated claims by billing for services not rendered, services not supervised, duplicative and unnecessary services, and upcoded services. Finally, in Chicago, a medical center agreed to pay $1.5 million to resolve allegations that it had submitted false claims to Medicare and Medicaid by entering into an improper leasing arrangement for office space with certain physicians in violation of the Stark Law, which prohibits a hospital from profiting from patient referrals made by a physician with whom the hospital has an improper financial arrangement.
منابع مشابه
Medicare and State health care programs: fraud and abuse; OIG anti-kickback provisions--HHS. Final rule.
This final rule implements section 14 of Public Law 100-93, the Medicare and Medicaid Patient and Program Protection Act of 1987, by specifying various payment practices which, although potentially capable of inducing referrals of business under Medicare or a State health care program, will be protected from criminal prosecution or civil sanctions under the anti-kickback provisions of the statute.
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Mr. Rountree addresses the federal government's multi-pronged attack on health care fraud and focuses on the options available to health care providers who are under investigation by the government. The article proposes three potential responses to fraud investigations, including: (1) lobbying the government for relief; (2) suing the government; or (3) waiting to defend or settle the fraud acti...
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عنوان ژورنال:
- Medicine and health, Rhode Island
دوره 94 9 شماره
صفحات -
تاریخ انتشار 2011