CMS proposes new “incident to” rule

“Incident to” billing is a significant False Claims Act risk for Medicare and Medicaid providers. A new proposed rule will change how physicians and physician practices are supposed to bill for services provided in their offices. CMS Proposal to Limit Incident to Billing This week CMS released the proposed Medicare... Continue Reading →

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Another Circuit Rules on the Public Disclosure Bar

Today the Sixth Circuit Court of Appeals joined several other Circuit Courts in finding that an administrative review, and even a repayment to the appropriate government oversight entity, did not qualify as a “public disclosure” under the False Claims Act’s public disclosure bar.... Continue Reading →

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United States ex rel. Camillo v. Ancilla Systems, Inc.

2005 WL 1926559 (S.D.Ill. Case No. 03 CV 0024 DRH, Aug. 8, 2005) Defendant Kenneth Hall Regional Hospital, Inc., moved to dismiss the whistleblower’s amended complaint, as it was not an original defendant. As a result, the government had never reviewed the claims against it and made an intervention decision,... Continue Reading →

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United States ex rel. Tucker v. Nayak

2008 WL 907432, *2 (S.D.Ill. Case No. 06-CV-662-JPG, April 2, 2008) The FCA whistleblower moved to amend her complaint. The Defendant, Dr. Nayak, objected, arguing that amendment was futile as the amendment still failed to plead with the particularity required by Fed.R.Civ.P. 9(b). The Court, reviewing the proposed amended complaint,... Continue Reading →

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