Fraud and Abuse

On the heels of the Supreme Court decision in Xiulu Ruan v. United States, wherein the Supreme Court held that the government must prove beyond a reasonable doubt that

Continue Reading Creation of New Opioid Strike Force, Following Decision in Xiulu Ruan v. US, Signals Investigations of Physicians Will Intensify

Medical record requests by payors are commonplace for health care providers. Typically, these requests are received by a front desk employee who responds to the inquiry in short order.  Yet,
Continue Reading THE ABC’S OF THE S.I.U.: What Providers Need to Know

Called by some the “King of Nursing Homes” for his many low-income nursing home patients in northeast Illinois, Dr. Venkateswara Kuchipudi was recently convicted for referring patients to Sacred Heart
Continue Reading Nursing Home Fraud Scam Results in Conviction for “King of Nursing Homes”

The Affordable Care Act (ACA) requires Medicare providers to return overpayments within 60 days of the date they are identified in order to avoid liability under the False Claims Act. 
Continue Reading CMS Finally Makes Reasonable Changes to 60-Day Overpayment Rule