Executive Summary On March 13, 2013, CMS concurrently released an immediately effective administrative ruling (“CMS Ruling 1455-R” or “Ruling”) and a proposed rule (“Proposed Rule”) reversing CMS policy precluding hospitals from billing on an outpatient basis for inpatient services denied payment on grounds the services should have been provided on... Continue Reading →Tags: CMS, denied, False Claims Act, inpatient, Medciare, outpatient, rebill, rule
Today the United States Supreme Court refused to hear the appeal of an Alabama whistleblower in a case against a hospital in Mobile. We first told you about the case when it was dismissed by the trial court. It was an unusual case to reach all the way to the... Continue Reading →Tags: certiorari, denied, dismissed, False Claims Act, fraud with particularity, materiality, qui tam, relator, whistleblower