Health Care Fraud Report Index-Summary

NATIONAL PRACTITIONER DATA BANK (NPDB)

– HHS final rule, 112
– Hospital's suspension of doctor reportable (11th Cir.), 800

NATURAL DISASTERS

– Hurricanes, wheelchair claims

– – Loss and damage, false claims, sentence (S.D. Tex.), 619
– – Patient recruiters plead guilty (S.D. Tex.), 805
– – Relief claim modifier, supplier sentenced (S.D. Tex.), 340

NEBRASKA

– Limitations period for state false claims extended, 347

NEGLIGENCE

– Medicaid contractors need not seek reimbursement in malpractice cases (8th Cir.), 659
– Nursing home not criminally liable for death of resident due to workers' conduct (Mass.), 442

NEVADA

– Patient dumping, disparate screening claims go to jury (D. Nev.), 578

NEW JERSEY

– Adult day care center fined for services not provided, 516; penalty set, 811
– Auto insurance, data demand from medical providers limited (N.J. Super. Ct.), 856
– Chiropractor with expired license, pain center owner fined (N.J. Super. Ct,), 465
– Hospitals

– – Price inflation, settlement (D.N.J.), 26
– – Whistleblower claims over outlier payments settled (D.N.J.), 247

– Medicaid

– – Home health care, agency owners (N.J. Super. Ct.), 669
– – Penalties and sentencing law signed, 588
– – State inspector general's office abolished, 588

– Mental health and substance abuse center owner indicted (N.J. Super. Ct.), 427
– Pharmaceuticals

– – Cash substituted for AIDS drugs, sentences (N.J. Super. Ct.), 463
– – Methadone clinics, $51.5M sought, 84
– – Technicians, guilty plea billing (N.J. Super. Ct.), 85

– Pharmacists

– – False claims restitution ordered (D.N.J.), 670
– – Federal employees' health plan defrauded, guilty plea (D.N.J.), 514
– – Forged/prescriptions, pharmacist protection, 86

– Qui tam suits

– – Government claims required (D.N.J.), 452
– – State guidelines, 85

– State regulations

– – Medicaid and FamilyCare beneficiaries, 672
– – Prescription blanks, 224

– Wheelchairs, supply firm manager arrested (D.N.J.), 341; indicted, 746

NEW MEXICO

– Personal care services, false documents, indictments (N.M. Dist. Ct.), 221

NEW YORK

– AIDS and HIV, $8.5M scheme, doctors charged (S.D.N.Y.), 122
– Ambulance firms settle qui tam charges (E.D.N.Y.), 505
– Auto insurance claims, doctor and acupuncturist, sentence (S.D.N.Y.), 134
– Budget, stopgap bills to reduce spending approved, 517
– Civil fraud unit established in southern district, 286
– Conflicts of interest, state and federal regulators, 112
– Dermatologist, falsely obtained certification, settlement (S.D.N.Y.), 507
– False claims

– – DME, pharmacy owner settles charges (S.D.N.Y.), 801
– – PPACA and state self-disclosure duties overlap, official says, 761
– – State law strengthened, bill signed, 708

– Home health care

– – Brooklyn, N.Y., clinic pleads guilty to grand larceny, 630
– – Untrained personnel, agencies settle, 37

– Hospitals

– – Auditor-caused false claims alleged, suit dismissed (S.D.N.Y.), 755
– – Bad faith pleading, hospital may seek sanctions (W.D.N.Y.), 216; sanctions imposed, 511
– – Brooklyn, claims untimely filed (S.D.N.Y.), 252
– – Floating Hospital, NYC nonprofit, settles billing charges (S.D.N.Y.), 506
– – Health care network settles false claims case (S.D.N.Y.), 751

– Marketing restrictions, drug and devices firms, 132
– Medicaid

– – Coding errors, state to reimburse city (N.Y. Ct. Cl.), 176
– – Drug prices, inflated, state law (D. Mass.), 124
– – Dual eligibles, overpayments reported, 812
– – “Excluded persons” listings, preparations urged, 499
– – Fraud control unit, record convictions in 2009 noted, 347
– – Inspector General office criticized, 35; task force appointed, 131
– – Overpayment to providers, report, 36
– – Processing errors, state overpaid hospitals, report, 426
– – Reform repayment rules, N.Y. official explains, 497
– – State senate report offers ways to fight fraud, 257

– Medicare

– – HMO fined for MA sales agent licensing and prompt payment violations, 393
– – Outlier payments inflated, hospital settles claims (D.N.J.), 211
– – Physical therapy clinic, patient recruiting kickbacks charged (E.D.N.Y.), 422
– – Physician, NYC, arrested for fraud (E.D.N.Y.), 799

– Mental health

– – Patient care conditions, NYC hospital changes (E.D.N.Y.), 18
– – Psychiatrist, guilty plea (N.Y. Sup. Ct.), 35

– Plastic surgeons, misbranding drugs as Botox (N.D.N.Y.), 180
– Podiatrist, $1M settlement (S.D.N.Y.), 81
– Rebates, health care credit card probed, 670
– Small businesses, health insurer fine, 134
– State insurance plan, billing fraud, 180

NONPHYSICIAN PRACTITIONERS

– Billing fraud

– – Arthritis and allergy injections, charges settled (D. Conn.), 803
– – Hospital settles (E.D. Mich.), 28
– – Unlicensed provider charged (D. Colo.), 621

– Chiropractors

See CHIROPRACTIC SERVICES

– Dentists

See DENTAL CARE

– Foot care clinic, unqualified staff, podiatrist sentenced (S.D. Tex.), 512
– Home health care, convictions (C.D. Cal.), 612
– Mental health services

– – Counseling center, Houston (S.D. Tex.), 217
– – Unlicensed staff, director sentenced (D. Idaho), 454

– Pain injections, Ala. doctor charged (N.D. Ga.), 702
– Physical therapists

See PHYSICAL THERAPY

– Unlicensed staff, Alton clinic, indictments (S.D. Tex.), 254

NONPROFIT ORGANIZATIONS

– Billing, NYC Floating Hospital settles charges (S.D.N.Y.), 506
– Kickbacks

– – Drug cost assistance program approved, IG, 500
– – Grants and DME allowed, IG, 788

– Medicare fraud, Cal. hospital settles charges (S.D. Cal.), 806

NORTH CAROLINA

– Ambulance services, medical necessity, office manager sentenced (E.D.N.C.), 294
– Chiropractic clinics, unperformed services billed, guilty pleas (E.D.N.C.), 513
– Home health care, two providers sentenced (W.D.N.C.), 555
– Medicaid fraud, new initiatives implemented, 300; providers asked to display tip-line poster, 517; payments for patient referrals banned, 669
– Mental health services firm, billing, owner sentenced (E.D.N.C.), 757
– SNF, Medicare safety rules, penalties (4th Cir.), 117
– State regulations, professional employer organization trusts, 431

NOTICE

– Medicare Part D sponsors, formulary changes, 16
– Terminated providers under PPACA, CMS, 547

NPDB

See NATIONAL PRACTITIONER DATA BANK (NPDB)

NURSES AND NURSING

– Home health care

– – Falsifying patient forms, nurse indicted (S.D. Tex.), 758
– – Scheme, guilty pleas (S.D. Fla.), 661

– Wrongful discharge, nurse need not report unlawful acts to licensing board (Md.), 428

NURSING HOMES

– Compliance violations, self-reported, lower penalties proposed, 570
– Death of resident due to workers' negligence, home not criminally liable (Mass.), 442
– EMTALA, illegal transfer case against hospital dropped (3rd Cir.), 383
– Inadequate care, St. Louis facilities (E.D. Mo.), 19
– Kickbacks

– – Drug manufacturer to pharmacy firm (D. Mass.), 69
– – Omnicare solicitation, nursing home chains settle (D. Mass.), 209

– Long-term care

See LONG-TERM CARE

– Overpayments

– – La. to repay CMS $122M, 286
– – Medicare Part B, 2006, IG, 569

– Patients' rights, suing for violations (U.S., rev sought), 32; (briefs filed), 118; (rev den), 167
– Poor performance, CMS compliance, GAO report, 379
– PPACA, comments sought on fraud and other provisions, 380
– Prevention of patient wandering inadequate, petition for review dismissed (5th Cir.), 754
– Retaliation, patient abuse reported (5th Cir.), 169
– Surveys

– – CMS, accuracy, 14
– – Federal and state, differences in findings, report, 449

NUTRITIONAL SUPPLEMENTS

See VITAMINS AND DIETARY SUPPLEMENTS