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West Virginia hospital to pay $1.5M to resolve alleged Stark Law violations
Weirton (W.Va.) Medical Center has agreed to pay $1.5 million to resolve allegations that it violated the False Claims Act and Stark Law by knowingly submitting or causing the submission of claims to Medicare that violated the Stark Law. -
Chicago hospital can sue Illinois over alleged Medicaid reimbursement shortfall
A federal appellate court ruled that Chicago-based safety-net hospital St. Anthony Hospital can sue Illinois over an alleged shortfall in Medicaid reimbursements, the Cook County Record reported July 6. -
Feds recovered $5B from healthcare fraud cases in 2021: 8 things to know
The U.S. Justice Department and HHS brought in more than $5 billion in healthcare fraud settlements in fiscal year 2021, according to a report jointly released by the agencies July 5. -
Healthcare billing fraud: 9 recent cases
From the conviction of a former healthcare management company leader in a $1.4 billion billing scheme, to a Kentucky physician agreeing to pay more than $500,000 to settle allegations he submitted more than $3 million false claims to Medicare, here are nine healthcare billing fraud cases that have made headlines since June 10: -
Florida nursing home chain to pay $1.75M to settle COVID-19 vaccine false claim allegations
West Palm Beach, Fla.-based MorseLife Nursing Home Health System agreed to pay $1.75 million June 30 to settle claims that they vaccinated hundreds of ineligible people for COVID-19 at a clinic as part of the CDC's Pharmacy Partnership for Long-Term Care Program. -
Detroit hospital housekeepers fired for blowing whistle on unsanitary conditions, lawsuit says
Two women contracted as housekeepers at Detroit's Harper University Hospital and Hutzel Women's Hospital filed a lawsuit June 30, claiming they were fired in retaliation for reporting concerns about what they described as dirty operating rooms and other unsanitary conditions, according to court documents obtained by Becker's. -
MCG Health faces lawsuit after data breach affecting patients at 8 hospitals
A lawsuit was filed against clinical guidance software vendor MCG Health over a March data breach that has affected at least eight healthcare organizations. -
Supreme Court won't hear challenge to New York COVID-19 vaccination mandate
The Supreme Court on June 30 decided it would not hear a challenge to New York's COVID-19 vaccination mandate for healthcare workers that does not include a religious exemption, according to The Washington Post. -
Florida pharmacies to pay $830K to settle billing fraud claims
Three Florida pharmacies have agreed to pay more than $830,000 to resolve allegations that they conspired to fraudulently bill Medicare and Medicaid for unlawfully prescribed medications. -
Iowa man gets 27 months in prison for sharing VA patient's health info
An Iowa man has been sentenced June 29 to more than two years in prison for wrongfully accessing and disclosing information from patient records at the Veterans Affairs Medical Center in Des Moines, Iowa. -
Pharmaceutical exec gets 5 years in prison for $74M Medicare, Tricare fraud
The general manager of California-based pharmaceutical company NHS was sentenced to five years in prison and agreed to pay a $950,000 civil settlement for his role in a fraud scheme that cost Medicare and Tricare nearly $75 million. -
WVU Medicine sued by former employee for wrongful termination
Morgantown, W.Va.-based WVU Medicine faces a lawsuit filed by a former employee who alleges she was wrongfully fired, the West Virginia Record reported June 23. -
Georgia medical clinic owner gets 3 years in prison for fraud scheme
An Alpharetta, Ga.-based medical clinic owner was sentenced to three years in prison for a healthcare fraud scheme that also allegedly involves a former Georgia insurance commissioner, the Atlanta Journal-Constitution reported June 28. -
Former hospital executive convicted in $1.4B billing scheme
The former leader of a rural hospital chain has been convicted for his role in an elaborate pass-through billing scheme, the Justice Department announced June 27. -
Louisiana healthcare office worker charged with billing fraud
A woman who worked as a denial specialist for a New Orleans healthcare organization is facing a federal healthcare fraud charge. -
States add protections for healthcare providers who perform abortions for out-of-state residents
States where abortion remains legal are acting to legally protect healthcare providers who perform abortions and reproductive health services for out-of-state residents who live where the procedure is banned or restricted and travel to recieve services. -
Ex-healthcare CFO sentenced for role in fraud scheme
The former CFO of Pacific Hospital's physician management arm was sentenced to 15 months in prison June 24 for a tax offense related to a kickback scheme, according to the Justice Department. -
UPMC sued over COVID-19 test that canceled patient's wedding
UPMC faces a lawsuit filed by a patient whose incorrect COVID-19 diagnosis resulted in the cancellation of his summer 2020 wedding, The Tribune-Review reports. -
Supreme Court backs HHS on Medicare payment to hospitals serving low-income patients
The Supreme Court upheld the HHS approach to calculating certain Medicare payments to hospitals that serve a large number of low-income patients, CNN reported June 24. -
UPMC settles data breach lawsuit for $450K
University of Pittsburgh Medical Center agreed to a $450,000 settlement to resolve allegations relating to a 2020 data breach that compromised the protected health information of about 36,000 patients, The National Law Review reported June 16.
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