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Health Care Fraud Report

BNA’s Health Care Fraud Report™ is the go-to source for health care fraud reporting, with in-depth information on government and private enforcement actions and strategies designed to fight fraud and abuse.

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OVERVIEW

Protect your company or clients with inside information on a variety of current fraud and abuse topics, complete with expert analysis.


EXPERT NEWS & COMMENTARY

Track the latest news on pertinent legislative, regulatory, and legal developments at federal and state level, as well as policy changes in the private sector. Follow the latest U.S. Deparment of Health and Human Services (HHS) Office of Inspector General (OIG) Advisory Opinions, fraud alerts, Special Advisory Bulletins, investigations, rules, audit reports, and compliance guidance documents.

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TRUSTED LEGAL ANALYSIS

Gain insights from analysis and perspective pieces by recognized experts and other special reports within the fastest growing legal specialties.


POWERFUL RESEARCH FEATURES

Access significant documents, including enforcement actions by state insurance departments, and consult original language to form your own interpretations with the right amount of data and detail on health care fraud and abuse — all in just one manageable, well-organized source.


SPECIFICATIONS

Product Structure 

Notification: current reports providing news and developments

Formats and Frequency

Print and Web notification formats are issued and available bi-weekly. Print current reports are indexed every six months, culminating annually. Web current reports are archived to 01.15.1997. 

Email summaries, providing the highlights and table of contents for each report, with URLs to full-text articles and documents are also available.


RECENT HEADLINES

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Fourth Circuit Affirms $237M Judgment Against Tuomey Hospital in Referrals Case
July 8
Drug, Device Companies Paid $6.49 Billion To Doctors, Hospitals in 2014, CMS Says
July 8
Medicare Outpatient Hospital Pay Includes RAC Auditing Changes
July 8
Inspector General Calls for Improved Billing Policies for Skilled Nursing Facilities
July 8
Civil Monetary Penalties Would Be Expanded Under Revised 21st Century Cures Legislation
July 8
HHS Adds New Legal Team Focusing on Monetary Penalties, Exclusions
July 8
Republican Doctors in House Seek To Preserve Medicare Self-Referral Exception
July 8
Accuracy Still a Concern After Release Of Drug, Device Company Payment Data
July 8
Experts: Providers Who Know Their Data Better Equipped for Fraud Inquiries
July 8
Lawmakers Want Information on CMS's Rising Medicaid Improper Payment Targets
July 8
DaVita Receives U.S. Civil Subpoena Amid Medicare Probe
July 8
Insurers Gaming Medicare Might Cost Washington Billions Annually
July 8
DaVita Finalizes $450 Million Settlement in Medication Waste Case
July 8
AstraZeneca, Cephalon Reach Agreements Resolving Medicaid Overcharge Allegations
July 8
Whistle-Blower Suit Against CVS Tossed; ‘Kickbacks' Were Publicly Disclosed in Ads
July 8
Fourth Circuit Asked to Rule On Pair of False Claims Act Issues
July 8
Florida Clinic Owners Plead Guilty To $2.5 Million in False Medicare Billings
July 8
Six Sentenced to Prison in Florida Managed Care Enrollment Fraud Case
July 8
Illinois Chiropractors Escape False Claims Lawsuit, but Whistle-Blower Allowed to Refile
July 8
Fifth Circuit Cuts Down Health-Care Fraud Restitution Order on Appeal
July 8
Pain Medication Prescriber Pleads Guilty To Receiving Kickbacks in Medicare Case
July 8
John Muir Health System Resolves Medicare Radiology Billings Case
July 8
Former DME Supplier Gets Eight Years For Scheme to Defraud Medicare, Medi-Cal
July 8
Two Southern California Residents Get Prison Time in $71 Million Insurance Fraud Scheme
July 8
Pharmacy Pays New York $2.5 Million To Settle Charges it Falsely Billed Medicaid
July 8
New York Chiropractor Pleads Guilty In Alleged $7 Million Medicare Scheme
July 8
Texas Mental Health Clinic Must Repay $6 Million to Medicare, Court Says
July 8
New Jersey Doctor Sentenced In Biodiagnostic Lab Kickback Scheme
July 8
Emergency Medical Technician Pleads Guilty to Ambulance Fraud Scheme
July 8
Co-Founder of Device Maker OtisMed Receives Prison Term
July 8
St. Louis Area Doctor Sentenced to Four Months in Prison for Health-Care Fraud
July 8
ALJ Sustains 18-Year Exclusion Due to Significant Aggravating Factors
July 8
New York Medicaid Spending Hits 13-Year Low Per Person, Governor Says
July 8
Listing
July 8
List of HHS OIG Audit and Inspection Reports
July 8
CONFERENCES
July 8
Federal Agencies Charge 243 Individuals In $712 Million Medicare Fraud Crackdown
June 24
Medicare Has Paid Providers $1.3 Billion In Settled Appeals Under 2014 Policy
June 24
Government Report Questions Accuracy Of $2.8B in Subsidy Payments to Insurers
June 24
Over 1,400 Pharmacies Submit Questionable Medicare Claims in 2014, HHS Agency Finds
June 24
No Kickback Sanctions From Medigap Discount Arrangement With Hospitals
June 24
HHS Issues Proposed Rule On 340B Drugmaker Penalties
June 24
Congress Seeks GAO Review Of Medicare Fraud Prevention System
June 24
Covenant Hospice in Florida to Repay $10.1 Million for Billing Errors
June 24
Appeals Court Kicks Back Physicians' Lawsuit to HHS on Medicare Regulation
June 24
Teva Subsidiary Cephalon Can't Dodge False Claims Lawsuit on Cancer Drug
June 24
Children's Hospital Pays Nearly $13M To Resolve False Claims Act Case
June 24
Anesthesiologists Win Victory In Medicare False Claims Case
June 24
California Doctor's Conviction, Sentence For DME Scam Affirmed by Ninth Circuit
June 24
Louisiana Home Health Operators' Convictions Affirmed by Fifth Circuit
June 24
First Circuit Rejects DME Provider's Appeal of Medicare Fraud Conviction
June 24
6th Cir. Affirms Dismissal of Case, Finds ‘Direct Knowledge’ of Fraud Claim Lacking
June 24
Medicare Hospital Fraud Defendants File Appeals of Their Lengthy Prison Sentences
June 24
Former Texas Hospital CFO Sentenced In Medicare Electronic Health Record Case
June 24
Four Individuals in Calif. Charged In $2.7 Million Medicare Fraud Scheme
June 24
Court Kills Whistle-Blower Suit Against Gilead Alleging FDA Quality Violations
June 24
Court Certifies Nationwide Class of Medicare Beneficiaries on Claims Appeal Issue
June 24
Eleventh Circuit Reverses Sentence Enhancement for Fraud Conspirator
June 24
Florida Plastic Surgeon Resolves Allegations Over Skin Cancer Billings
June 24
Florida Nursing Home Group Agrees To $17M Settlement in Kickback Case
June 24
Business Owner Sentenced to Prison, Ordered to Repay Medicaid $990,100
June 24
Inspire Pharmaceuticals to Pay $6M In Eye Treatment Off-Label Marketing Case
June 24
New York Doctor Sentenced to 54 Months In Prison in Oxycodone Prescription Scam
June 24
Biodiagnostic Lab Salesman Sentenced To 37 Months for Funneling Bribes to Doctors
June 24
Vanguard Health Services to Pay $2.9M in False Claims Act Settlement
June 24
Health Diagnostic Laboratory Files For Bankruptcy After Whistle-Blower Case
June 24
ALJ Affirms CLIA Certificate Revocation And Cancellation of Medicare Payments
June 24
Appellate Division Reverses FFP Disallowance for Some New York Claims
June 24
National Dental Firm to Pay $450,000 In Probe Alleging Illegal Control of Practices
June 24
Listing
June 24
List of HHS OIG Audit and Inspection Reports
June 24
HHS OIG Program Exclusions
June 24
Bloomberg BNA Q&A: Peter Budetti, Former CMS Deputy Administrator
June 24
CONFERENCES
June 24
OIG Fraud Alert Highlights Risks In Physician Compensation Arrangements
June 10
Medicare Program Issues ACO Final Rule With New Risk Model for Providers
June 10
OIG Issues Updates for FY 2015 Work Plan, Including New Review of Part D Program
June 10
Government Says No Sanctions for Patient Subsidies From Medical Device Maker
June 10
Charity Group's Proposed Patient Assistance Wouldn't Lead to Sanctions, IG Opinion Says
June 10
Medicaid Not Doing Enough to Screen Beneficiaries and Providers, GAO Says
June 10
GAO Recommends Medicare Take New Look at Contracting Procedures
June 10
Florida Pharmacy Pays $3.78M To Settle Referral Allegations
June 10
Government Touts $1.8B in Health-Care Recoveries During First Half of FY 2015
June 10
Medicaid Plans Would Include Fraud Costs In Medical Loss Ratios Under Proposed Rule
June 10
States Have One Year to Screen High-Risk Medicaid Providers, CMS Says
June 10
Lawmakers Angered by Rising Medicaid Improper Payments Rate
June 10
Texas Medicaid Made $191M in Improper Payments Over Three Years, Report Says
June 10
High Court Rules on FCA Limitations, ‘Pending' Litigation; Health Care Affected
June 10
Supreme Court Denial Means HMA Faces Medicare Whistle-Blower Lawsuit
June 10
Purdue Pharma to Face Whistle-Blower Lawsuit After Supreme Court Denial
June 10
3rd Circuit Affirms Fraud Conviction Sentence in Hospice Care Scheme
June 10
Mental Health Provider Beats Allegations Of Medicaid Fraud From Whistle-Blower
June 10
Allergan Faces Kickback Allegations In False Claims Whistle-Blower Lawsuit
June 10
Health Fraud Conviction Expunged To Boost Petitioner's Employment Prospects
June 10
Physician Presence for Radiation Therapy Required by Colorado Law
June 10
Wheelchair Makers to Pay $7.5M To Settle False Claims Act Allegations
June 10
New Jersey Cardiologists to Pay $3.6M To Settle Alleged Medicare False Billings
June 10
Two N.Y. Doctors Sentenced to 20 Months In Biodiagnostic Lab Services Kickback Case
June 10
Court Allows Investigation Into Suspension Of Fraud Defendant's Medicare Payments
June 10
Former California Medical Supply Firm Owner Gets Seven Years for Medicare Scam
June 10
Jury Finds Calif. Medical Suppliers Guilty In $2 Million Medicare Wheelchair Scam
June 10
Two California Nursing Homes Settle Excessive Medication Allegations for $3.8M
June 10
Neurosurgeon Pleads Guilty to Fraud, Unnecessary Surgeries, Kickback Charges
June 10
State Farm's Complaint Against Providers Sufficiently Alleged RICO Violation, Fraud
June 10
Owner of Therapy Practice Sentenced To Prison Term for False Billing Scheme
June 10
Suburban Chicago Pharmacist Charged In $2.4 Million Prescription Drug Fraud
June 10
Tennessee Home Health Entity To Pay $6.5M to Settle False Claims Case
June 10
Oncologist Uses Consultation Exception To Win Partial Victory on Self-Referral Claim
June 10
Government Intervenes in Fraud Case Against Texas Provider Outreach Eyecare
June 10
ALJ Sustains Petitioner's Exclusion For Violations of Anti-Kickback Statute
June 10
List of HHS OIG Audit Reports
June 10
CONFERENCES
June 10
HHS Inspector General Warns States May Be Misusing ACA Funds
May 13
New House Bill Seeks to Replace RAC Contingency Fees With Fixed Payment
May 13
Lawmakers Introduce Bill That Would Prohibit Adoption of ICD-10 Codeset
May 13
Appeals Backlog Could Be Reduced By Restructuring Process, Wyden Says
May 13
OIG Says Medigap Deal With PPO, Hospitals Won't Result in Sanctions
May 13
OIG: Medicare Potentially Overpaid Physicians $33.4M Due to Coding Errors
May 13
Physician-Owned Hospital in Texas Asks CMS for Permission to Expand Facility
May 13
OIG: Government Inspections of Generic Drug Manufacturers Improve, but Work Remains
May 13
Patient Care Coordination Test May Expand To Other Medicare Programs, Officials Say
May 13
OMB Reviewing Final Rule On Accountable Care Organizations
May 13
FDA, CMS Officials Outline Efforts to Combat Opioid Abuse
May 13
16 Hospitals to Pay $15.7 Million To Resolve False Claims Act Allegations
May 13
Safety Scorecard Records Little Progress By Hospitals to Prevent Errors, Accidents
May 13
Health-Care Cyberattacks Now Most Prevalent Source of Breaches, Study Says
May 13
High Court Denies Hospital's Bid for Review Of Decision That Upheld Damages Award
May 13
DaVita Prepared to Pay Estimated $495M to Settle False Claims Lawsuit
May 13
Express Scripts Subsidiary to Pay $60M In Settlement for Novartis Kickback Scheme
May 13
Drugmaker Amarin Asks Court to Protect Free Speech Right to Discuss Off-Label Use
May 13
New York City Clinic Owner Convicted Of Running $165M Oxycodone Ring
May 13
Consulate Health Care Can't Block Statistical Sampling in Upcoding Case
May 13
Medicaid Fraud Alleged Against Indiana Transportation Services
May 13
Whistle-Blower Can Withdraw Lawsuit But Can't Hide Court Record From Public
May 13
Two Docs Sentenced for Taking Bribes For Referrals to New Jersey Lab
May 13
Dialysis Care Providers Agree to Pay $1.15M to Resolve Medicare Claims Case
May 13
Split Sixth Circuit Says Evidence Of Prior Medicare Fraud OK at Trial
May 13
CEO Who Admitted to Medical Billing Fraud At Nevada Clinic Sentenced to Year of Prison
May 13
Five Ambulance Companies to Pay $11.5M To End False Claims Act ‘Swapping’ Suit
May 13
DME Supply Company Owner Gets Prison Sentence for $7M Medicare Fraud Scheme
May 13
Miami Doctor Sentenced to Five Years In $5.5M Psychiatric Hospital Billing Scam
May 13
Florida Hospitals to Pay for Alleged Improper Claims for Ambulance Transport
May 13
Doctor, Employee Charged With Defrauding Medicare $5.2M in House Call Fraud Scheme
May 13
Doctor, Group Home Owner Indicted For Alleged Role in $5.2M Medicare Fraud
May 13
North Carolina Pharmacy Company Settles Kickback Allegations for $5M
May 13
Tennessee Hospital to Pay Government $1.3M to Resolve Improper Billing Allegations
May 13
Nebraska Pharmacist Indicted In $2.5 Million Medicaid Fraud Scheme
May 13
One-Year Prison Term for Podiatrist In Missouri Health-Care Fraud Case
May 13
ALJ Sustains Revocation of CLIA Certificate for Sending Testing Samples
May 13
Appellate Division Affirms ALJ Sustainment Of Application Denial Due to Moratorium
May 13
Los Angeles Sues Hospital For Alleged Skid Row ‘Patient Dumping’
May 13
Missouri Home-Health Provider to Pay $120K to Settle Medicaid-Fraud Allegations
May 13
Listing
May 13
List of HHS OIG Audit and Inspection Reports
May 13
HHS OIG Program Exclusions
May 13
As Second Open Payments Release Date Nears, Industry Feels Increased Burdens
May 13
CONFERENCES
May 13
Medicare Physician Pay Legislation Contains Fraud Prevention Provisions
April 29
OIG Guidance for Health-Care Boards Reflects Collaboration, Oversight Expectations
April 29
Health-Care Data a Top Target For Cybercriminals, FBI Official Says
April 29
To Aid Corporate Compliance, DOJ To Be More Transparent in Resolutions
April 29
OIG: Medicaid Fraud Control Units Recovered $300M From Criminal Cases in FY 2014
April 29
OIG: Recommendations Could Have Saved Medicare $251M on Infusion Drug Payments
April 29
OIG to Review Effect of Rising Prices For Generic Drugs on Medicaid Program
April 29
VA Whistle-Blowers Still Face Retaliation, Despite Some Progress, House Panel Told
April 29
CMS Adds Star Ratings For Hospital Compare Website
April 29
Hospitals, Others Prepare for Impact Of Reimbursement Cuts in Physician Bill
April 29
DOJ Sends Subpoena to Seek Exparel Marketing Documents From Pacira
April 29
Georgia Hospital to Pay $20M After Medicare Billing Investigation
April 29
Audit Shows Missouri Didn't Bill Drugmakers For Rebates for Physician-Administered Drugs
April 29
Colorado Paid 800,000 Medicaid Claims With Missing, Invalid Provider IDs, OIG Says
April 29
Smart Card Technology Won't Curb Medicare Fraud, GAO Says
April 29
Consumer Advocates See Privacy Issues In Efforts to Expand Access to Health Data
April 29
OIG EHR Audits are ‘Deep Dive' Into Security Procedures, Attorneys Say
April 29
Pittsburgh Retirement Center Pays $1.3M to Settle False Claims Act Allegations
April 29
Citing OIG Report, Florida Senator Calls for Medicare-Medicaid Rebate Parity
April 29
Former CMS Head Tavenner Joins LifePoint Hospitals Board
April 29
Sixth Circuit Denies Rehearing On FCA Public Disclosure Issue
April 29
Fifth Circuit Restitution Award of $37.7M Against Texas Doctors for Fraud Affirmed
April 29
Government Intervenes in FCA Actions Against ManorCare for Rehab Fraud
April 29
Medtronic Reaches Agreement With DOJ On Manufacturing Standards for Drug Pumps
April 29
Florida Eye Doctor Indicted on Fraud Charges, Billed $190 Million Over Six Years
April 29
U.S. Seizes $1.5M of Unapproved Drugs From Miami Pharma Company
April 29
Florida Home Health Owner Sentenced To Prison Term in $32M Medicare Scam
April 29
Court Levies $169K Attorneys' Fees Award Against FCA ‘Serial Relator'
April 29
Southern California Doctor Charged With $6.5 Million Medicare Fraud Scheme
April 29
Dermatology Business to Pay $3.2M To Settle Improper Referral Claims
April 29
Texas Doctor Sentenced to Prison For Health Fraud, Identity Theft Scheme
April 29
Texas Hospital to Pay $22M to Settle Charges It Paid Docs for Referrals
April 29
Texas Couple Convicted of Fraud Given Prison Sentence, Restitution
April 29
HealthSpring Subsidiary Defeats FCA Retaliation Lawsuit
April 29
Physician Involved in Medicare Fraud Pleads Guilty to $56M Home Health Scheme
April 29
Home Care Agency Owner Pleads Guilty in $7M Medicaid Fraud Scheme
April 29
Detroit Health Agency Owners, Operator Sentenced in $29M Medicare Fraud Case
April 29
Detroit Home Health Agency Owner Pleads Guilty in $2.6M Medicare Fraud Scheme
April 29
Psychiatric Hospital Beats FCA Action on Overflow Patient Allegations
April 29
Ten-Year Prison Term Ordered for Operator Of Two Chicago Home Health Firms
April 29
ALJ Sustains Revocation Because IDTF Not Operational
April 29
Appellate Division Remands Case To Consider All Hardship Evidence
April 29
Massachusetts Health System Pays $1.75M to Settle Medicaid Billing Claims
April 29
New York Comptroller Identifies Widespread Improper Payments, Medicaid Overpayments
April 29
Georgia Hospital Pays $2.95M To Settle State Medicaid Billing Allegations
April 29
Former Hospital CEO Hits Law Firms, ‘Non-Patients' With $30 Million Lawsuit
April 29
Listing
April 29
List of HHS OIG Audit and Inspection Reports
April 29
CONFERENCES
April 29