Texas health system beats $61.8M billing fraud case

A Texas federal judge dismissed a False Claims Act lawsuit alleging Dallas-based Baylor Scott & White Health overbilled Medicare by improperly upcoding claims, according to Law360. The whistleblower lawsuit, filed in 2017, alleges Baylor Scott & White Health submitted more … Read More

Kool Smiles clinics paying $23.9 million settlement

YUMA, Ariz. – The Justice Department announced on Wednesday that it has settled False Claims Act allegations against dental management company Benevis LLC (formerly known as NCDR LLC) and more than 130 of its affiliated Kool Smiles dental clinics for … Read More

$5 Million Settlement in False Claims Act Case

HOUSTON, Oct. 19, 2017 /PRNewswire/ — Joel M. Androphy and Janis Gorton of the Berg & Androphy law firm, along with the United States and the State of Texas, have reached a $5 million settlement in False Claims Act litigation … Read More

Whistleblower Nets $2.25M Exposing NM Medicaid Scheme

Santa Fe, New Mexico’s St. Vincent Regional Medical Center and its Irving, Texas-based partner Christus Health have agreed to pay $12.24 million plus interest to settle allegations that they made illegal donations to county governments under a discontinued state matching … Read More

Connecticut dentist barred from Medicaid participation

HARTFORD, Conn. (Legal Newsline) — Connecticut Attorney General George Jepsen announced June 6 that a Stamford-based dentist, Georgy Betser, his wife, Irina Betser, and their companies will forfeit $755,956.30 and be excluded from participation in the state’s Medicaid program for … Read More

OIG reminder: health care compliance obligations apply to physicians and institutions alike

On June 9, 2015, the U.S. Department of Health and Human Services Office of Inspector General (OIG) issued a Fraud Alert focused on compensation arrangements paid to physicians. See, “Physician Compensation Arrangements May Result in Significant Liability” [link:https://oig.hhs.gov/compliance/alerts/guidance/Fraud_Alert_Physician_Compensation_06092015.pdf]. The Fraud … Read More