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Beginning May 1, 2013, claims for all covered Medicare Part B, durable medical equipment, orthotics, and supplies (DMEPOS), and Part A home health agency (HHA) services will be denied when the ordering or referring provider is not enrolled in Medicare, or the claim does not properly list the National Provider Identification (NPI) number for the Read more →

On March 28, 2013, in United States ex rel. Keltner v. Lakeshore Medical Clinic, Ltd., a federal district judge denied the Defendant medical clinic’s Rule 9(b) motion to dismiss the False Claims Act complaint for failing to plead fraud with particularity. The Relator in Keltner was a former billing department employee who alleged that the Read more →

After having been convicted a decade ago in a Medicare kickback case, and being subsequently excluded from participation in the Medicare Program, the health care provider engaged Nicholson & Eastin, LLP to assist him with seeking reinstatement to the Medicare Program. Reinstatement as a Medicare provider after exclusion is not automatic, and can in many Read more →

On March 21st, the Seventh Circuit Court of Appeals held in a matter of the first impression that a defendant found liable under the False Claims Act (FCA), 31 U.S.C. § 3729, must pay three times the amount of the Government’s “net loss,” calculated by applying offsets before trebling. United States v. Anchor Mortgage Corp., Read more →

In an important development in False Claims Act jurisprudence, the Fourth Circuit Court of Appeals recently clarified that the normal six year statute of limitations applicable to False Claims Act cases can be tolled pursuant to the Wartime Suspension of Limitations Act (WSLA), 18 U.S.C. § 3287, which generally tolls the statute of limitations in Read more →