medicaid fraud news from FierceHealthcare

In theory, having scores of whistle-blowers file cases identifying cases of potential fraud is a good thing. However, a recent surge in such cases has so overwhelmed staff at the federal Department Read more...

Drugmaker AstraZeneca has asked an Alabama judge to nullify a jury verdict that ordered it to pay the state $215 million in damages in a Medicaid drug-price fraud suit. The state's 2005 suit accused Read more...

An obstetrician and gynecologist has sued a California hospital, claiming his former bosses there are giving him bad recommendations in retaliation for his filing a complaint about conditions there. Read more...

Baptist Health South Florida has agreed to pay the federal government $7.75 million to settle allegations that it paid an oncology group excessive compensation to generate referrals for two of its Read more...

A new report from the Deloitte Forensic Center argues that it's getting increasingly difficult for hospitals to comply with state and federal anti-fraud rules given the surge in new anti-fraud Read more...

As every physician knows, there's a small but determined percentage of the population who will do whatever it takes to get their drug of choice--including seeing multiple doctors for the same Read more...

A Medicare auditing firm part-owned by the husband of a U.S. Senator has come under intense scrutiny by the California state legislature, dogged by claims that it's rejecting claims unfairly just to make profits for itself. The company, PRG-Schultz International, is contracted with CMS to examine reimbursements and identify inappropriate payouts. PRG-Schultz gets 30 percent of any overcharges it finds. The California Hospital Association has said that PRG-Schultz is on a rampage, …

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A Dallas-area anesthesiologist won a $6.3 million judgment this week against the anesthesiology firm where he once served as a shareholder. A jury awarded Dr. Neal Fisher $6.3 million from Pinnacle Anesthesia Consultants in the defamation and breach of contract case, which arose from Fisher's firing by the practice. Fischer had claimed that Pinnacle fired him after he expressed concern that Pinnacle services were being billed out-of-network. In the suit, Fischer said that when he …

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A Stamford, CT-based ophthalmologist has filed a federal lawsuit against the state's Department of Social Services (DSS) after being named as the first doctor the agency recommended for Medicaid fraud prosecution, claiming that he is the victim of a campaign of retribution by angry officials. Weber's suit also names the state attorney general's office, alleging, among other things, that assistant state's attorney Nancy Salerno acted "maliciously" in executing a search warrant during …

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Hoboken, NJ-based St. Mary's Hospital isn't in great shape. It lost almost $100 million over the last five years and seldom fills more than half of its 328 beds. Worse, as the oldest hospital in the state, it needs millions of dollars worth of upgrades and renovations. But when the hospital's owner, Bon Secours Health Care System, said it would close St. Mary's, state legislators worked out a plan to keep it afloat by funneling in state funds and turning over operations to the city. The …

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