Contact Us
Subscribe to this blog via RSS
Join us on LinkedInCategories
- Data Privacy
- Kentucky Consumer Data Protection Act
- Department of Health and Human Services' Office of Civil Rights
- Medical Residents
- DEI
- Medical Cannabis
- SB 47
- Workplace Violence
- Assisted Living Facilities
- EMTALA
- FDA
- Reproductive Rights
- Roe v. Wade
- SCOTUS
- Medical Spas
- medical billing
- No Surprises Act
- Mandatory vaccination policies
- Workplace health
- Coronavirus Aid, Relief and Economic Security Act
- Code Enforcement
- Department of Labor ("DOL")
- Employment Law
- FFCRA
- CARES Act
- COVID-19
- Nursing Home Reform Act
- SB 150
- Acute Care Beds
- Clinical Support
- Coronavirus
- Emergency Medical Services
- Emergency Preparedness
- Families First Coronavirus Response Act
- Family and Medical Leave Act (“FMLA”)
- KBML
- medication assisted therapy
- Department of Health and Human Services
- Legislative Developments
- Corporate
- United States Department of Justice ("DOJ")
- Employee Contracts
- Non-Compete Agreement
- Opioid Epidemic
- Sexual Harassment
- Health Resource and Services Administration
- House Bill 333
- Litigation
- Medical Malpractice
- Senate Bill 79
- Locum Tenens
- Senate Bill 4
- Physician Prescribing Authority
- Chronic Pain Management
- HIPAA
- Prescription Drugs
- "Two Midnights Rule"
- 340B Program
- EHR Systems
- Hospice
- Kentucky minimum wage
- Minimum wage
- Skilled Nursing Facilities (“SNFs”)
- Uncategorized
- Affordable Insurance Exchanges
- Drug Screening
- Electronic Health Records (“EHR")
- Fraud
- Health Care Fraud
- HIPAA Risk Assessment
- ICD-10
- KASPER
- Kentucky’s Department for Medicaid Services
- Mental Health Care
- Office for Civil Rights ("OCR")
- Primary Care Physicians ("PCPs")
- Qui Tam
- Stark Laws
- Urinalysis
- Accountable Care Organizations (“ACO”)
- Affordable Care Act
- Alternative Payment Models
- Anti-Kickback Statute
- Centers for Medicare & Medicaid Services (“CMS”)
- Certificate of Need ("CON")
- Charitable Hospitals
- Compliance
- Data Breach
- Department of Health and Human Services (HHS)
- Electronic Protected Health Information (ePHI)
- False Claims Act
- Federally Qualified Health Centers (“FQHCs”)
- Fee for Service
- Health Information Technology for Economic and Clinical Health Act (HITECH Act)
- Health Insurance Portability and Accountability Act of 1996 (HIPAA)
- Health Professional Shortage Area ("HPSA")
- Hospitals
- HPSA
- HRSA
- Kentucky Board of Medical Licensure
- Limited Services Clinics
- Medicaid
- Medical Staff By-Laws
- Medically Underserved Area ("MUA")
- Medicare
- Mid-Level Practitioners
- Office of Inspector General of the United States Department of Health and Human Services (OIG)
- Part D
- Patient Protection and Affordable Care Act (“ACA”)
- Pharmacists
- Physician Assistants
- Rural Health Centers (“RHCs”)
- Rural Health Clinic
- Telehealth
- American Telemedicine Association (“ATA”)
- APRNs
- Criminal Division of the Department of Justice (“DOJ”)
- Health Care Fraud Prevention and Enforcement Action Team (“HEAT”)
- Hydrocodone
- Kentucky Board of Nursing
- Kentucky Pharmacists Association
- Qualified Health Care Centers (“FQHC”)
- Telemedicine
- United States ex. Rel. Kane v. Continuum Health Partners
- Webinar
- Agreed Order
- All-Payer Claims Database ("APCD")
- Chain and Organization System (“PECOS”)
- Chiropractic services
- Clinical Laboratory Improvement Amendments of 1988 (“CLIA”)
- Compliance Officer
- Douglas v. Independent Living Center of Southern California
- Drug Enforcement Agency ("DEA")
- Emergency Rooms
- Enrollment
- Essential Health Benefits
- Hinchy v. Walgreen Co.
- ICD-9
- Jimmo v. Sebelius
- Kentucky Senate Bill 7
- Maintenance Standard
- Medicare Part D
- Minors
- Ophthalmological services
- Overpayments
- Physician Compare website
- Re-validation
- Texting
- Vitas Innovative Hospice Care
- "Plan of Correction"
- 2014 Medicare Physician Fee Schedule (“PFS”)
- 501(c)(3)
- Affinity Health Plan
- Appeal
- Arbitration
- Cadillac tax
- Centers for Disease Control and Prevention
- Chronic Care Management
- Community health needs assessment (“CHNA”)
- Compounding
- Condition of Participation ("CoP")
- CPR
- Daycare centers
- Decertification
- Denied Claims
- Department of Medicaid Services’ (“DMS”)
- Dispenser
- Division of Regulated Child Care
- Drug Quality and Security Act (“DQSA”)
- EHR vendor
- Employer Mandate
- Fair Labor Standards Act (FLSA)
- False Billings
- Federation of State Medical Boards (“FSMB”)
- Food and Drug Administratio
- Form 4720
- Grace Period
- Health Professional Shortage Areas (“HPSA”)
- HealthCare.gov
- Home Health Prospective Payment System
- Home Medical Equipment Providers
- Hospitalists
- House Bill 3204
- Individual mandate
- Inpatient Care
- Intermediate Sanctions Agreement
- Kentucky Health Benefit Exchange
- Kentucky Medical Practice Act
- Kindred v. Cherolis
- Kynect
- Licensed practical nurses (LPN)
- Licensure Requirements
- List of Excluded Individuals and Entities
- LLC v. Sutter
- Long-term care communities
- Long-Term Care Providers ("LTC")
- Low-utilization payment adjustment ("LUPA")
- Meaningful use incentives
- Medicare Administrative Coordinators
- Medicare Benefit Policy Manual
- Medicare Shared Saving Program (MSSP)
- Mobile medical applications ("apps")
- Model Policy for the Appropriate Use of Social Media and Social Networking in Medical Practice (“Model Policy”)
- National Drug Code ("NDC")
- National Institutes of Health
- Network provider agreement
- New England Compounding Center ("NECC")
- Nonprofit hospitals
- Nonroutine medical supplies conversion factor (“NRS”)
- Nurse practitioners (NP)
- Office of the National Coordinator for Health Information Technology (“ONC”)
- Outsourcing facility
- Part A
- Part B
- Payors
- Personal Service Entities
- Physician Payments
- Physician Recruitment
- Physician shortages
- Ping v. Beverly Enterprises
- Power of Attorney ("POA")
- Prescriber
- Provider Self Disclosure Protocol
- Qualified Health Plan ("QHP")
- Quality reporting
- Registered nurses (RN)
- Residency Programs
- Self-Disclosure Protocol
- Social Media
- Spousal coverage
- State Health Plan
- Statement of Deficiency ("SOD")
- Sustainable Growth Rate (“SGR”)
- Upcoding
- UPS
- “Superuser”
- Advanced Practice Registered Nurses
- Audit
- Autism/ASD
- Business Associate Agreements
- Business Associates
- Call Coverage
- Compliance Programs
- Critical Access Hospitals (“CAHs”)
- Doe v. Guthrie Clinic
- Employer Group Health Plans
- ERISA
- Essential Health Benefits (“EHBs”)
- Genetic Information Nondiscrimination Act ("GINA")
- Group Purchasing Organizations ("GPO")
- Health Reform
- House Bill 104
- Kentucky House Bill 159
- Kentucky House Bill 217
- Kentucky Primary Care Centers (“PCCs”)
- Managed Care Organizations (“MCOs”)
- Medicare Audit Improvement Act of 2012
- Patient Autonomy
- Patient Privacy
- Personal Health Information
- Recovery Audit Contractors (“RAC”)
- Senate Bill 39
- Senate Finance Committee Report
- Small Business Health Options Program (“SHOP”)
- State Medicaid Expansion
- Sunshine Act
- Trade Association Group Coverage
- Abuse and Waste
- Center for Disease Control
- Consumer Operated and Oriented Plan programs (“CO-OPS”)
- Employee Agreement
- Free Conference Committee Report
- Health Care Fraud and Abuse Control Program
- Healthcare Information and Management Systems Society (HIMSS)
- House Bill 1
- House Bill 4
- Kentucky Cabinet for Health and Family Services
- Kentucky Health Care Co-Op
- Kentucky Health Cooperative (“KYHC”)
- Kentucky “Pill Mill Bill”
- Occupational Safety and Health Administration (“OSHA”)
- Pain Management Facilities
- Health Care Law
- Health Insurance
- Healthcare Regulation
McBrayer Blogs
Showing 3 posts in Qui Tam.
The False Claims Act - the Basics Every Provider Should Know, Part Two
On Tuesday, we discussed the history and basic elements of a violation of the False Claims Act. Today’s post will explore the penalties and enforcement of the Act. More >
The False Claims Act – the Basics Every Provider Should Know, Part One
The federal False Claims Act (“FCA”)[1] casts an incredibly long shadow, covering every transaction between the federal government and a private party seeking payment from it. Enacted at the height of the Civil War in 1863, the law was designed to keep military suppliers honest in their dealings with a government already strapped from fighting a war. Since then, the FCA has served as an almost nuclear deterrent to those who would attempt to defraud the government when requesting payment for services. In 2014, the Department of Justice managed to recover $5.69 billion under the law. False claims in federal healthcare programs accounted for $2.3 billion of that figure, which makes the FCA, as well as its interaction with other laws such as the Affordable Care Act, fraught with difficulty for unwary healthcare providers. More >
The DOJ Increases Scrutiny of Whistleblower False Claims Act Suits
Posted In Criminal Division of the Department of Justice (“DOJ”), False Claims Act, Fraud, Health Care Fraud, Health Care Fraud Prevention and Enforcement Action Team (“HEAT”), Health Care Law, Qui Tam
The Criminal Division of the Department of Justice (“DOJ”) recently announced that it will review all complaints filed under the qui tam provisions of the federal False Claims Act (“FCA”) to determine if a parallel criminal investigation is appropriate. This announcement came during a September 17, 2014 speech by the recently-confirmed Assistant Attorney General for the Criminal Division of the DOJ, Leslie Caldwell, at the Taxpayers Against Fraud Education Fund Conference in Washington D.C. This DOJ announcement signals a departure from prior policy, which allowed, but did not require, the Criminal Division to investigate Civil Division claims. In the past, the decision to open a criminal investigation was left to the discretion of each U.S. Attorney’s Office. More >
