» Professional Whistleblower Nabs Another Hospital for False Outlier Payments

Professional Whistleblower Nabs Another Hospital for False Outlier Payments

Friday, March 5, 2010

Hospital billing consultant knew exactly how to blow the whistle — and gets $613,000 for his trouble. Brookhaven Memorial Hospital Medical Center in Long Island, NY will pay the federal government $2.92 (excluding interest) to settle…

Infusion Drug Coding Error Ends in Settlement for Overbilling

Thursday, March 4, 2010

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CEO says human error played a role in the alleged violation. What may have been only one coder’s mistake has ended with Connecticut-based Johnson Memorial Hospital paying the federal government $191,193 to settle allegations of fraud, the US…

15-Bed Hospital, Physician Settle Medical Necessity Qui Tam Case

Monday, January 11, 2010

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Faulty physician documentation was an Achilles heel in the case. Three patients who stayed multiple days in Wheaton Community Hospital in Wheaton, MN as inpatients — yet received only oral pain meds and PT during their hospital stays — is an…

DOJ: 2 SNF Chains & Their Principles Named In Omnicare, Risperdal Complaint

Monday, November 9, 2009

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At issue: The antipsychotic drug Risperdal & fair market value. Last week, the Department of Justice announced that nation’s largest nursing home pharmacy, Omnicare Inc., will pay $98 million to settle False Claims Act allegations. IVAX Pharmaceuticals (now a subsidiary of…

HEAT in Houston & Other Urban Areas

Tuesday, July 21, 2009

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Texas Medical Center Lesson Learned: Health care providers in medical centers harbor fraudsters in their midst —and increased federal scrutiny. If you’re a health care provider near a university medical center…

Medical Device Kickbacks: Surgical Ablation Devices for Atrial Fib

Friday, July 17, 2009

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J. Heuser: Atrial fib ECG compared to sinus rhthym Here comes more kickback allegations involving medical device makers. Salespeople who used to work for certain medical device makers allege that their…

Does ‘The Consultant Told Me to Do It’ Hold Up in Court?

Tuesday, June 2, 2009

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Snake charming? No, thank you. Texas hospital pays nearly $10 million for inflated outlier charges If your health system has increased charges to potentially increase outlier reimbursement, you’d better have the documentation…

HC Compliance Essentials

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