Posted on May 3, 2017 by Ruder Ware Alumni
Blog
Timeframes for Making Repayment to the Government The 60-day repayment rule adopted as part of the Affordable Care Act is a very strong arrow in the quiver of federal enforcement agencies. Under the 60-day rule a known overpayment can become a False Claim if it is not repaid or if a self-disclosure is not filed […]
Posted on April 11, 2017 by Ruder Ware Alumni
Blog
We hear a lot about potential liability under the False Claims Act (FCA) for the failure to repay overpayments within 60 days of discovery. Focus on the 60-day rule has taken focus away from the potential for criminal charges for retaining known overpayments. Section 1128B(a)(3) of the Social Security Act (42 U.S.C. § 1320a-7b(a)(3)) makes […]
Posted on February 28, 2017 by Ruder Ware Alumni
Blog
How Fraud and Abuse Cases Arise in a Medical Practice It is no secret many doctors work very long days. Some days are worse and some are better than others. As a compliance lawyer, my job is to attempt to prevent doctors from having Terrible, Horrible, No Good, Very Bad Days. In my experience, this […]
Posted on February 27, 2017 by Ruder Ware Alumni
Blog
Recent OIG Release Emphasizes Need for Compliance Policies Specific to Provider Risks The Office of Inspector General recently published results of its audit of Medicare claims for chiropractic services made by a chiropractic group in Kansas. The review concluded the groups received over $725,000.00 in overpayments in calendar years 2011 and 2012. In its report, […]
Posted on November 7, 2016 by Ruder Ware Alumni
Blog
If you are involved in any way in the health care system, it should be obvious by now that the government has committed ever increasing resources to the prosecution of fraud and abuse cases. Simply put, from a governmental standpoint, prosecuting fraud and abuse is good business. Every dollar the government puts into pursuing health […]