The U.S. Department of Justice announced that it has taken action to end a healthcare fraud scheme in Arizona that preyed on elderly patients and defrauded health payers $1.6 billion.
The DOJ announced it had charged 193 people with healthcare fraud in the sweep, all affiliated with companies Apex Mobile Medical LLC, Apex Medical LLC,...Arizona News
Tennessee-based Community Health Systems' (CHS) operational practices are the subject of a new investigation by the U.S. Department of Justice (DOJ). The investigation was made public in a Securities and Exchange Commission (SEC) filing.
The filing said that CHS received a Civil Investigative Demand in January and that the company was...National News
The U.S. Department of Justice (DOJ) Civil Rights Division will soon propose new rules that will include guidance on how providers that are operated by state and local governments can meet Americans with Disabilities Act (ADA) standards for advanced medical items.
The items include exam tables, scales, dental chairs, X-ray scanners...Arizona News
The United States alleged that the home health agency operator Bayada purchased two of Watermark’s properties in Arizona to induce referrals of Medicare beneficiaries. A former Bayada executive earned about $3.8M for blowing the whistle.
Based in Tucson, Watermark manages 79 senior retirement homes but the scheme was designed around...National News
Last week, the Fifth Circuit Court of Appeals in New Orleans issued a decision that restricts the use of mifepristone, a medication that is used in abortion. The U.S. Department of Justice, which is defending the Food and Drug Administration in the case, said that it would appeal the decision to the Supreme Court.
The three-judge...Arizona News
On Tuesday, the U.S. Department of Justice filed a complaint in a lawsuit against the Arizona company Modern Vascular and its founder, chiropractor Yury Gampel.
Gampel and Modern Vascular's labs are accused of violating federal laws including Stark Law, the Anti-Kickback Statute and the False Claims Act by paying illegal kickbacks to...
Although day-to-day life in the U.S. has largely moved on from COVID-19, the Biden administration is continuing to pursue coordinated efforts to combat the COVID-19 pandemic and urge Congress to increase funding for antiviral treatments and preparation for future surges.
In Arizona, there were 2,350 new cases of COVID-19 and 99 new...
As COVID-19 restrictions relax and business practices return to normal guidelines, a large number of negligence and wrongful death suits have been filed due to a repeal of liability protections and statutory deadlines. Johnson & Johnson was unable to overturn a ruling in a deceptive marketing case regarding transvaginal mesh...
Optum, a subsidiary of UnitedHealth Group, has spent the last several years building out a provider network and expanding into ambulatory surgical centers. As the company moves to expand into primary care, it faces two major legal hurdles: a challenge from the U.S. Department of Justice (DOJ) to acquire a data analytics firm and a class...National News
Throughout 2021, The Department of Justice (DOJ) cracked down on healthcare fraud, with special emphasis on fraud related to Medicare and Medicaid. As the population ages, Medicare Advantage plans have increased in popularity, leading to a direct increase in Medicare related fraud. The Department of Justice’s focus on healthcare fraud...National News
On Tuesday, the U.S. Department of Justice announced that it garnered more than $5.6 billion in judgements and settlements from False Claims Act cases, the largest since 2014. Over $5 billion of those claims are related directly to the healthcare industry.
From the DOJ press release:
Health care fraud was once again the leading...National News
The Department of Justice (DOJ) requested information about Oak Street Health's relationships with third-party marketing agents and the start-ups provision of free transportation to adult Medicare beneficiaries. Meanwhile a company specializing in orthopedic products settled with the DOJ for allegedly paying kickbacks to a Colorado-based...
Across the county, accusations of fraud related to Medicare, Medicaid, and Medicaid Advantage have increased and Arizona has not escaped involvement. While, nationally, complaints against Kaiser Permanente and UnitedHealthcare have been filed or escalated, in Arizona, 27 individuals and business entities have been indicted on criminal...
Throughout September and well into October, a large number of Medicare and Medicaid related fraud cases have come to public light. This week, it's time to double back on cases that have stayed in the wings for the past two months.
In late September, the U.S. Department of Justice (DOJ) announced criminal charges for 42 providers...
Chandler-based drug manufacturer Insys Therapeutics, infamous for the questionable marketing practices of its highly-addictive opioid fentanyl spray Subsys, announced plans to sell off assets to Wyoming-based BTcP Pharma and London-based Hikma Pharmaceuticals in a series of U.S. Securities and Exchange Commission filings.
After...Arizona News
Provider directories for Medicare Advantage (MA), the private alternative to traditional fee-for-service Medicare, have historically shown to be highly unreliable and audits performed by the Centers for Medicare and Medicaid Services (CMS) reinforced that notion by reporting inaccuracies in nearly half of all MA online provider...Arizona News
A panel of three federal judges for the Fifth Circuit Court of Appeals heard 90 minutes of oral arguments on Tuesday defending or refuting a Texas district judges ruling of the Affordable Care Act (ACA) as unconstitutional in December. Millions of Americans depending on the ACA for healthcare are at risk of losing coverage if the...National News
In a surprise move, the DOJ has changed its stance on Texas v Azar and is "not urging any portion of the district court's judgement be reversed" but, in Dec. 2018 the agency told the court that while it agreed the individual mandate was not valid it would defend other parts of the Affordable Care Act, just not community rating and...Arizona News
Last week on Oct. 12, 33-year-old Nicholas White and 60-year-old Jeffrey White, father and son duo pleaded guilty to defrauding Affordable Care Act (ACA) programs out of $27 million across at least 12 states--including Arizona. Both were healthcare professionals out of Twin Peaks, California.
According to the Department of Justice...Arizona News
Last week the Department of Justice gave CVS and Aetna approval for their $69 billion merger on the condition that Aetna sells off its Medicare Part D prescription drug business. Insurers cozying up with the pharmaceutical industry is a growing trend, think: OptumRx and UnitedHealth, or the recent Cigna-Express Scripts...
