Blog - Archive for Fraud Investigation

The U.S. Attorney’s office for the Southern District of Florida has announced its pursuit of a fraudulent scheme whereby the administrators of three Florida nursing schools, along with employees at several nursing test prep academies in other states allegedly “created an illegal licensing and employment shortcut for aspiring nurses.” The scheme involved the selling of Read more →

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CMS recently proposed a revision to the 60-day overpayment rule that would impact Medicare participating providers and entities. Generally speaking, a provider must return an overpayment within 60-days after the date on which the overpayment was identified.  A person has identified an overpayment when the person has, or should have through the exercise of reasonable Read more →

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On September 15, 2022, Deputy Attorney General Lisa Monaco published a memorandum which laid out the Department of Justice’s (DOJ) new guidelines for policies regarding corporate investigations and voluntary self-disclosures. The DOJ announced it would expand and/or clarify its policies on voluntary self-disclosure, making it its goal to reward companies that have invested in compliance Read more →

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On Wednesday, July 20, 2022, the United States Department of Justice (DOJ) announced criminal charges against 36 defendants in 13 federal districts across the United States for more than $1.2 billion in alleged fraudulent telemedicine, cardiovascular and cancer genetic testing, and durable medical equipment (DME) schemes. In connection with the enforcement action, the department seized Read more →

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The Eliminating Kickbacks in Recovery Act, otherwise known as EKRA, is a fairly new federal law that targets patient brokering and recovery profiteering. EKRA broadly makes it a federal crime for anyone, with respect to services covered by any health care benefit program, to knowingly and willfully: solicit or receive any remuneration (including any kickback, Read more →

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