A federal district court judge from the District of Columbia ruled in favor of the United States government in a False Claims Act case against former home health company Dynamic Visions, awarding the government $1.98 million.
The Memorial Hermann Endoscopy and Surgery Center of North Houston, an associated medical practice, and one of their physicians reached an agreement to settle with the Office of Inspector General of the Department of Health and Human Services for $1.5 million to settle allegations of Medicare fraud.
Four Houston-area hospitals affiliated with the Hospital Corporation of America (HCA) will settle allegations that they gave rights to transport Medicare and Medicaid patients to specific ambulance companies that paid to receive this business.
The Department of Health and Human Services Office of Inspector General found that Medicare contractors did not always refer cost reports that qualified for reconciliation of the hospital outlier payments, and the Centers for Medicare & Medicaid Services did not always ensure that the Medicare contractors performed the appropriate reconciliation, according a review of Medicare outlier payments performed between October 2003 and March 2011.
The Centers for Medicare and Medicaid Services recently announced a proposed rule to change the structure of the Comprehensive Care for Joint Replacement model, and cancel the Episodic Payment Model, and Cardiac Rehabilitation incentive payment model.
Pharma giant Mylan will pay $465 million to resolve False Claims Act allegations that Mylan misclassified EpiPen as a generic drug to avoid paying Medicaid rebates owed to it under the Medicaid Drug Rebate Program, according to the United States Attorney’s Office of the District of Massachusetts.
In July, the Department of Justice and the Department of Health and Human Services announced that they had charged more than 400 defendants from across the country in the largest healthcare fraud scheme ever uncovered by the agencies.