fraud

Two landmark cases fraught with False Claim Act (“FCA”) allegations of fraudulent billing for prescription drugs against food and pharmacy chains are making their way from the Seventh Circuit to

Continue Reading Is it Really Fraud? The Supreme Court Will Decide

The Department of Justice’s continued focus on prosecuting fraud related to pandemic relief programs has resulted in a new batch of criminal charges, convictions and penalties for those who have

Continue Reading The Federal Government’s Continued Focus on COVID-19 Aid Fraud Leads to New Charges, Convictions and Sentencings

Medical record requests by payors are commonplace for health care providers. Typically, these requests are received by a front desk employee who responds to the inquiry in short order.  Yet,
Continue Reading THE ABC’S OF THE S.I.U.: What Providers Need to Know

Commercial payors are actively looking for ways to reduce payments to out-of-network providers.  One area of focus is discounts and waivers of patient copayments and deductibles by out-of-network providers.  In
Continue Reading Offering Discounts (or Waivers) of Coinsurance/Copayments to Patients as an Out-of-Network Provider