Date archive: December 2015

Hospitals Beware – Inpatient Kyphoplasty Procedures Remain a False Claims Act Target

Kyphoplasty is a minimally invasive procedure used to treat certain spinal fractures often due to osteoporosis.  Since the filing of a qui tam action, more than 130 hospitals have entered settlements with the Department of Justice (DOJ) totaling approximately $105 million to resolve allegations that they mischarged Medicare for kyphoplasty procedures. On December 18, 2015,…

Another $750,000 HIPAA Settlement – Focus on Need for Risk Analysis

The HIPAA Final Rule has been in effect since 2013, but HIPAA settlements following breaches continue to be reported. If you think the need for a risk analysis under HIPAA is not important, think again! On December 14, 2015, the Department of Health and Human Services (HHS) announced another $750,000 HIPAA settlement with the University…

False Claims Update: OIG Continues to Focus on Ambulance Services

Reduction of fraud and abuse remains a focus of the government’s efforts to ensure providers accountability.  Recently, the Department of Justice (DOJ) announced a $3.199 Million settlement of alleged False Claims Act violations resulting from an ambulance “swapping” arrangement between a skilled nursing home and ambulance service (Regent settlement). Once again, the Department of Justice…

Triple-S to Pay $3.5 Million Plus Adopt a Robust Corrective Action Plan

Office of Civil Rights (OCR) Director Jocelyn Samuels has made it clear that the “OCR remains committed to strong enforcement of the HIPAA Rules.” The latest settlement announced on 11/30/15 concerning Triple-S, an insurance holding company offering a wide range of insurance products and services, demonstrates just how committed the OCR is when it comes…

Anti-Kickback Update – HHS-OIG Settles Ambulance Swapping Case $3 Million Settlement from Nursing Home in Ambulance Swapping Case

Demonstrating the government’s commitment to combat health care fraud and keeping providers accountable, the U.S. Attorney’s office of Southern District announced that Regent Management Services L.P., a long term provider, agreed to pay approximately $3.199 Million to settle allegations that it received kickbacks from ambulance companies for referrals of Regent’s Medicare and Medicaid patients needing…

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