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Medicaid Fraud Investigation Against Nurse Practitioner Closed with No Charges

Posted on Firm News, Fraud Investigation October 2, 2018 by Robert Nicholson

The Firm successfully defended the Firm’s nurse practitioner client against allegations that the nurse practitioner had submitted false claims to the Medicaid Program in connection with medical and diagnostic services provided at the client’s medical clinic.  After a lengthy investigation, the Medicaid Fraud Control Unit closed the investigation with no action being taken against the Read more →

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Government Procurement Fraud Investigation Resolved for $1,000 Fine

Posted on Fraud Investigation February 12, 2018 by Robert Nicholson

In connection with the Firm’s defense of a Department of Defense procurement fraud investigation concerning the sale of confidential government contract information, the Firm was able to negotiate a resolution of the case to a misdemeanor plea with a $1,000 fine.  As anyone who practices in the area of Federal Criminal defense can attest, misdemeanor Read more →

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Department of Justice Obtains $400k Settlement Based Upon Failure to Timely Repay a Known Overpayment

Posted on Firm News November 14, 2017 by Robert Nicholson

On October 13, 2017, the Department of Justice announced a False Claims Act settlement with First Coast Cardiovascular Institute, a Florida based health clinic, under which the practice will pay $448,821.58 for failing to timely refund $175,000 in overpayments to Medicare, Medicaid, TRICARE, and the Department of Veterans Affairs. The settlement is noteworthy because it Read more →

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D.C. Circuit Court Reverses Directives to HHS Regarding Appeals Backlog

Posted on Health Care Law News September 16, 2017 by Robert Nicholson

In a 2-1 Decision, the D.C. Circuit Court of Appeals reversed the district court’s order to HHS to clear the backlog of administrative appeals within four years. The appellate court found that the district court failed to adequately test HHS’s assertion that this mandate was impossible. After considering the merits of a group of hospitals Read more →

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CMS Announces New Audit Strategy

Posted on Health Care Law News August 16, 2017 by Robert Nicholson

On August 14, 2017, CMS announced a significant change in its claims audit strategy for Medicare Administrative Contractors (MACs).  Under the new strategy — called Targeted Probe and Educate — MACs “will select claims for items/services that pose the greatest financial risk to the Medicare trust fund and/or those that have a high national error rate.”  Read more →

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