Constantinecannon.com

Managed Care Risk Adjustment Enforcement Continues with …

Sutter Health will pay the Government $90 million under the False Claims Act for allegedly submitting inaccurate and unsupported medical information on tens of thousands of patients. The settlement in a case brought by a whistleblower represented by Constantine Cannon, together with co-counsel Keller Grover and Kleiman Rajaram, is the largest Medicare Advantage FCA settlement against a hospital

Actived: 5 days ago

URL: https://constantinecannon.com/whistleblower/managed-care-risk-adjustment-enforcement-continues-sutter-health-settlement-largest-ever-by-hospital/

Top Ten Healthcare Fraud Recoveries of 2021

WebHere are the top ten healthcare recoveries of 2021 by the numbers: Generic Drug Price-Fixing – in October, three generic pharmaceutical manufacturers, Taro …

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Top Ten Healthcare Fraud Recoveries of 2022

WebHere are the top ten healthcare recoveries of 2022 by the numbers: Biogen. In September, Massachusetts-based Biogen, agreed to pay a whopping $900 million to …

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Home Health Care and Hospice Fraud

WebHome health care has long been recognized as vulnerable to fraud, waste, and abuse. In 2015, Medicare reimbursed more than 11,000 home health care agencies approximately …

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Healthcare Fraud also Harms Private Insurers

WebRecent Private Health Insurance Fraud Cases. Palo Pinto General Hospital On March 8, 2019, the former CEO of Palo Pinto pleaded guilty to defrauding BlueCross …

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Top Ten Healthcare Fraud Recoveries of 2020

WebHere are the top ten healthcare recoveries of 2020 by the numbers: Purdue – In October, the creator and distributor of oxycontin, the world’s most lucrative opioid, …

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Top Ten Healthcare False Claims Act Recoveries for 2023

WebSet forth immediately below are the Top Ten False Claims Act healthcare recoveries for 2023: 1 — Precision Lens ( $490M ). A federal court in Minnesota ordered …

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Electronic Health Records (EHR) Fraud

WebAn electronic health record (EHR) is a digital version of a patient’s chart. The systems, in theory, allow for real-time sharing of patient-centered records including histories, orders, …

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Medically Unnecessary Procedures Harm Patients

WebUnnecessary procedures have long plagued the U.S. healthcare system, costing taxpayers billions and subjecting thousands of patients to invasive procedures …

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New York Doctor Indicted for $20.7 Million in Medicare Fraud and

WebOn February 21, 2024, a federal grand jury in New Jersey indicted Dr. Alexander Baldonado, of Queens, New York, for his alleged involvement in a complex health care …

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Nurse Practitioner Convicted in $200 Million Medicare Fraud Scheme

WebPosted September 28, 2023. In a landmark healthcare fraud case, a federal jury in Miami has convicted a nurse practitioner $200 million for her central role in a massive Medicare …

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Medically Unnecessary Services Healthcare Fraud

WebMedically Unnecessary Services. Government-funded healthcare programs will only pay for services, supplies or equipment that are reasonable and necessary for the diagnosis or …

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Pharmaceutical Fraud – The Common Types Reported by …

WebSome of the more common types of fraud occurring under the Medicare Part D program include: Billing for drugs not actually provided. Billing for drugs not covered by Medicare. …

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Colorado Law Offers Rewards for Whistleblowers Reporting …

WebAs lock-downs and business shutdowns continue in the U.S., essential workers continue to report to work, providing healthcare, putting food on our tables, …

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Hospital Fraud Whistleblower Lawyers

WebWhistleblowers have played a critical role in reporting hospital fraud under the False Claims Act and other whistleblower laws. A whistleblower may have information about hospital …

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Top Ten Financial and Healthcare Fraud Prison Sentences of 2021

WebAlberto Orian Gonzalez-Delgado was sentenced to 5 years in prison after pleading guilty to conspiracy to commit health care fraud and wire fraud. He was one of …

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OIG Identifies Fraud as Top Challenge in 2023 HHS Annual Report

WebThe Department of Health and Human Services (HHS) Office of the Inspector General (OIG) just released its 2023 Annual Report on its Top Management …

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Age Of The Whistleblower: Incentives And

WebAge Of The Whistleblower: Incentives And Protections - Law360 Page 1 of 4 LAW~ Portfolio Media. Inc. I 860 Broadway, 6th Floor I New York, NY 10003 I www.law360.com

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Fraudster of the Week

WebLast week, California state prosecutors charged 26 individuals, including 21 physicians and 2 pharmacists, in connection with a kickback scheme orchestrated by …

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New York Law Journal Volume 225, Number 42

Web3/5/2001 NYLJ 1, (col. 1) Page 1 3/5/2001 N.Y.L.J. 1, (col. 1) Copyright © 2001 The New York Law Pub. Co. New York Law Journal Volume 225, Number 42

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New York False Claims Act » Constantine Cannon

WebReturn to State & Local False Claims Acts Return to State & Local False Claims Acts | Contact Us (iii) declines to commence a civil enforcement action or designate such …

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