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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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Senate Report Recommends Changing RAC Payment Structure, Streamlining Contractors
July 23
Medicare Paid $1.7 Billion in Questionable Clinical Lab Claims in 2010, OIG Report Says
July 23
Industry Stakeholders Oppose OIG Efforts to Expand Exclusion Authority
July 23
OIG: Limited Submission of Medicaid Data Contributed to Improper Payments
July 23
DOJ, HHS Release ‘Road Map' Against Elder Abuse, Legal Training Guides
July 23
Dignity Health Pays $1.55M to Resolve Mishandling of Controlled Substances
July 23
Federal Audit Finds Florida Paid For Drugs Prescribed by Excluded Providers
July 23
Hospital Group Files for Summary Judgment Against HHS Over Medicare Appeals Backlog
July 23
Halifax Hospital to Settle Remaining FCA Claims With Whistle-Blower for $1M
July 23
Four Patient Recruiters Plead Guilty In $20 Million Home Health Fraud
July 23
Florida Man Sentenced to Four Years In $10.5 Million Physical Therapy Scam
July 23
Medtronic Pays $2.8 Million to Settle Allegations Involving Infusion Pumps
July 23
FCA Action Against Billing Company, Dentist Dismissed on Pleading Deficiencies
July 23
Defendants Get New Trial on Conspiracy Charges for Delay in Turning Over Evidence
July 23
U.S. Intervenes in FCA Action Against Hospitals Over Medicaid Overpayments
July 23
MAC Denial of Power Wheelchair Coverage Reversed, Decision Unsupported by Evidence
July 23
Whistle-Blower Action Against Dermatology Practice Over Medicare Billings Dismissed
July 23
FCA Action Against Mental Health Clinic Dismissed for Repeated Pleading Defects
July 23
Government FCA Action Against Nursing Home to Continue
July 23
OMHA Chief Judge: More Funds Needed To Eliminate Medicare Appeals Backlog
July 23
FedEx Indicted for Shipping Drugs for Illegal Pharmacies
July 23
Operators of Illinois Home Health Agency Indicted on Medicare Fraud Charges
July 23
California Man Sentenced to 10 Years For Medicare Fraud, Identity Theft
July 23
Alabama Health-Care Providers Settle False Claims Case for $24.5 Million
July 23
Doctor Admits to Accepting Bribes For Referring Tests to New Jersey Lab
July 23
Pharmacist Sentenced to 37 Months, Fined $1 Million for Illegal Narcotics Sales
July 23
Conn. Doctor Charged With Exceeding Scope Of License to Dispense Controlled Substances
July 23
X-Ray Company Executive Pleads Guilty to Health-Care Fraud Scheme
July 23
ALJ Upholds Supplier's 10-Year Exclusion Based on Fraud and Conspiracy Conviction
July 23
New Massachusetts Law Prohibits Physician Self Referral to Clinical Labs
July 23
Indian Generic Drugmaker Ranbaxy Settles Fraud Allegations With Oregon AG
July 23
Long-Term Care Insurer Can Sue Insured, Domestic Partner for Fraud and Conspiracy
July 23
Grand Jury Indicts Three Californians For $50 Million Insurance Fraud Scheme
July 23
List of HHS OIG Audit and Inspection Reports
July 23
HHS OIG Program Exclusions
July 23
CONFERENCES
July 23
U.S. Supreme Court Will Address FCA's First-to-File Bar, Wartime Claim Tolling Rule
July 9
OIG Says Lab Processing and Registry Arrangements May Violate Anti-Kickback Law
July 9
ACA Insurance Marketplaces Failed to Fix Inconsistencies in Applicants' Data, OIG Says
July 9
OIG Finds Pennsylvania Complied with ACA ‘Credible Allegations of Fraud' Requirements
July 9
Seattle Hospital Owes Almost $1 Million In Medicare Overpayments, OIG Audit Finds
July 9
Calif. Improperly Claimed Reimbursement For Some Nonemergency Patient Transports
July 9
Backlash Against RACs May Be Near Tipping Point, Congressional Aide Says
July 9
Proposed Hospital Outpatient Pay Rule Adds Measures to Boost Overpayment Collections
July 9
Physician Pay Rule Would Remove Some Sunshine Act Reporting Exemptions for CME
July 9
Lawmakers Grill Officials Over Medicare Program Integrity Lapses, Call for Action
July 9
SEC Seeks Documents From Biomet Related to Company's Overseas Operations
July 9
Consumer Group Urges Joint Commission Investigation of Firm's Accreditation Claims
July 9
Drug Distributor Settles for Failure To Report Suspicious Oxycodone Orders
July 9
Medically Unnecessary Cardiac Procedures Among Fraud Hot Spots, OIG Official Says
July 9
Patient Education Pivotal to Fixing Health-Care System, Senator Says
July 9
CMS Official Says Three Studies Completed By Healthcare Fraud Prevention Partnership
July 9
Study Examines Cost Differences in Employer, Government Health Costs for Impact of ACA
July 9
No Evidence of Medicare Upcoding Amid Fears, Growth in EHRs, Study Says
July 9
Health, Business Groups Lobby Supreme Court on FCA Penalties
July 9
Omnicare Will Pay $124M to Settle Kickback Allegations, DOJ Says
July 9
DME Supplier Can Sue Government For Breach of Medicare Contract
July 9
Federal Claims Court Says Government Breached Contract With Equipment Supplier
July 9
Medicare to Postpone Awarding Three RAC Contracts Until Aug. 15, Court Says
July 9
Court Says Details of Upcoding Incidents Clear FCA's Rule 9(b) Bar
July 9
Former HIV Clinic Owner Pleads Guilty To $31 Million Medicare Fraud Scheme
July 9
Physician Pleads Guilty to Role In $7M Detroit-Area Medicare Fraud Scheme
July 9
Doctor Pleads Guilty to Criminal Charges, Will Pay $6M to Settle Civil Fraud Allegations
July 9
Recruiter Pleads Guilty in $6.5 Million Home Health Medicare Scam in Florida
July 9
U.S. Attorney Says Doctor's Estate Will Repay $4M in Medicare Case
July 9
Prison, $16.2M Restitution Ordered For Hospice Owner in Medicare Scam
July 9
Court Rejects Hospital's Timeliness Defense In Suit Alleging Patients Improperly Admitted
July 9
Philadelphia-Area Ambulance Company, Owners Charged With Bilking Medicare
July 9
Pennsylvania Ambulance Company Manager Gets Prison Term in Health-Care Fraud Case
July 9
Court Refuses to Dismiss Charges Alleging Physicians Accepted Kickbacks
July 9
Federal Court Orders Par Pharmaceutical To File Answers in Unlawful Marketing Action
July 9
Court Dismisses Whistleblower's Lawsuit Alleging Error-Ridden Claims Violated FCA
July 9
Prison, Restitution Ordered for Owner Of Ambulance Firm in Medicare Fraud Case
July 9
First-to-File Rule Means Only One Relator Shares in Qui Tam Proceeds
July 9
Guilty Pleas Entered in Unapproved Drug Case Involving Kentucky Clinic
July 9
Suit Alleging Hospitals Paid Clinics to Refer Undocumented Mothers for Delivery Proceeds
July 9
Indictment Alleges Nursing Home Operators Billed Medicare, Medicaid for Deficient Care
July 9
Fourth Circuit Upholds Fraud Conviction Of Rescue Squad Chief Falsifying Statements
July 9
Physician Involved in Cash-for-Referrals Scheme With Lab Sentenced to Two Years
July 9
Maryland Pain Doctors Indicted on Fraud Charges
July 9
State Medicaid Program Should Collect Provider Overpayments, Audit Says
July 9
N.Y. Attorney General Files FCA Suit Against Three Health Systems
July 9
Medicaid IG Releases Compliance Guide On Common Risks in Habilitation Settings
July 9
Georgia Man Gets Two-Year Sentence In Speech Therapy Medicaid Fraud
July 9
New Law Requires Health Providers, Others To Report Suspected Elder Abuse as of July 1
July 9
Three More Sentenced in Georgia Youth Counseling Center Medicaid Scam
July 9
Listing
July 9
List of HHS OIG Audit and Inspection Reports
July 9
Changing Tactics at the DOJ Stand to Permanently Alter the Face of Qui Tam Litigation
July 9
Top 10 RAC Mistakes and How to Avoid Them: Centralizing Your RAC and Audit Processes Smooths Workflow
July 9
CONFERENCES
July 9
Supreme Court Grants Review in APA Case With Potential Implications for Providers
June 25
CMS Seeks Comments on Disclosure Rule For Referring Patients for Ancillary Services
June 25
CMS Imposes About $1 Million in Penalties Among Six Private Medicare Part C, D Plans
June 25
New ICD-10 Compliance Date Could Be Released Soon in Final CMS Rule
June 25
House Panel Approves Bills On Rx Drug Abuse, Timely DEA Scheduling
June 25
Senate Finance Committee Leaders Seek Ideas to Improve Data Transparency
June 25
CMS Should Increase Efforts Against Improper Medicaid Managed Care Payments
June 25
AMA Objects to CMS Medicare Claims Data Releases; Calls Process ‘Misleading’
June 25
AMA Calls for Providing New Mechanisms On Pricing Strategies for Medical Services
June 25
OIG Determines Market Shares for Mailed Diabetes Test Strips for Competitive Bidding
June 25
Ten Suppliers Account for Large Amount Of Medicare Market Share, Report Finds
June 25
Inconsistent Definitions Cost Medicare Over $1 Million for Confined Beneficiaries
June 25
Ohio Hospital Owes $9.8 Million In Medicare Overpayments, Audit Finds
June 25
Senior Medicare Patrol Lead to $9 Million In Medicare, Medicaid Recoveries in 2013
June 25
HHS Reports Data Breach, HIPAA Rule Enforcement Trends to Congress
June 25
Attorneys Outline Requirements Of Sunshine Act for Hospitals and Doctors
June 25
Consultant Warns of New DOL Audits On Compliance With Main Parts of ACA
June 25
Jury Orders Clinical Testing Lab Millennium To Pay $14.7 Million to Competitor Ameritox
June 25
5th Cir. Affirms Dismissal of FCA Action Against Planned Parenthood Location
June 25
11th Cir. Upholds Nursing Home Operator's Conviction for ‘Worthless’ Services
June 25
Supreme Court Denies Whistle-Blowers Last Chance at $38M Fraud Award
June 25
Home Care and Hospice Group Sues To Block CMS Documentation Rule
June 25
Government Gets Partial Victory In Fraud Case Against Home Health Provider
June 25
Woman Pleads Guilty to Kickbacks In $7 Million Medicare Fraud Case
June 25
Florida Doctor Gets Prison Term In $2.5 Million Fraud, Pain Pill Case
June 25
Florida Man Sentenced to 27 Months For Bogus Outpatient Medicare Scheme
June 25
Patient Recruiter Involved in $205M Mental Health Scheme Pleads Guilty
June 25
Home Health Agency Owner in Miami Pleads Guilty in $6.5 Million Fraud Case
June 25
Former Owners of DME Shops, Recruiter Sentenced in $3.2 Million Wheelchair Scam
June 25
Court Quashes Subpoenas Seeking Files From Whistle-Blower's Prior FCA Actions
June 25
Hospice Denied Repayment Reprieve On Overpayments a Second Time
June 25
Advocacy Group Says Due Process Rights Violated by Appeals Denials
June 25
Government Intervenes in FCA Action Against Hospitalist Company for Upcoding Scheme
June 25
Medicare Contractor's Overpayment Extrapolation Upheld Over Expert's Objections
June 25
Former Ambulance Company Owner Gets Eight Years for Medicare Fraud Scheme
June 25
Drug Supplier Omnicare Must Face Whistle-Blower's FCA, Kickback Claims
June 25
Jury Convicts DME Owner for Involvement In Multi-Million Dollar Wire Fraud Scheme
June 25
Doctor Convicted in Cash-for-Patients Scheme Sentenced to 20 Months in Prison
June 25
Owners of Mobile Diagnostic Testing Business Charged With Defrauding Medicare
June 25
Power Air Mattress Saleswoman Admits To Falsifying Patient Skin Condition Reports
June 25
Illinois Businessman Pleads Guilty In Misbranded Botox, Juvederm Case
June 25
Tennessee Cancer Clinic Owners Fined, Receive Probation Over Misbranded Drugs
June 25
ALJ Affirms Five-Year Exclusion Based on Drug-Related Felony
June 25
ALJ Upholds $3,500 Penalty for Failure To Train Staff to Evacuate Obese Resident
June 25
Chiropractor Pleads Guilty to Destroying Records
June 25
FCA ‘Implied False Certification' Liability Rejected
June 25
GSK to Pay West Virginia $22M to Resolve Allegations of Improper Drug Marketing
June 25
Pennsylvania Supreme Court Throws Out Money Award to BMS in Drug Pricing Case
June 25
State Arrests 13 in Connection With Alleged New Jersey Imaging Center Kickback Scheme
June 25
State University to Repay New York For Excess Medicaid Dental Billings
June 25
New York State Legislature Approves Whistleblower Protections for Employees
June 25
Noncompliance With Criminal Screening Rule Isn't Violation of N.M. Medicaid Fraud Act
June 25
Pharmacy Chains Win Dismissal of Medicaid Fraud Claims in Michigan Supreme Court
June 25
Georgia Youth Counseling Provider Faces Seven Years in Jail for Medicaid Fraud
June 25
Small Chain of Nursing Homes, CEO To Pay $750,000 to Settle Poor Care Probe
June 25
HHS Anti-Fraud Award Goes to Va. Enforcement Unit
June 25
Listing
June 25
List of HHS OIG Audit and Inspection Reports
June 25
Impending Qui Tams and False Claims Act Cases Involving Health Exchanges
June 25
CONFERENCES
June 25