FCA Alert

FCA Alert

Tag Archives: Hospital

Florida District Court Rejects Hospital District’s Eleventh Amendment Defense to FCA Action

Posted in Articles
In United States ex rel. Baklid-Kunz v. Halifax Hospital Medical Center, et al., No. 6:09-cv-1002-Orl-31DAB (M.D. Fla. June 6, 2011), the Middle District Court of Florida denied a defendant’s motion to dismiss False Claims Act (FCA) and other federal statutory claims on grounds of Eleventh Amendment immunity.  The defendant, Halifax, is a public hospital district … Continue Reading

Court in Southern District of New York Dismisses Relator’s False Claims Act Complaint Because No Law or Regulation Prohibited Hospital’s Billing Method

Posted in Decisions Interpreting FCA Elements
A former independent consultant to Beth Israel Medical Center (“BIMC”), Cleuza Colucci, brought a False Claims Act action against the hospital, alleging that it billed for and received inflated Medicare payments by purchasing Kings Highway and Doctors Hospital and then taking advantage of rate increases resulting from consolidation with BIMC for purposes of billing Medicare. The … Continue Reading

Oklahoma District Court Rules that Violation of Minimum Care Requirement May Trigger an Implied False Certification Claim Under the False Claims Act

Posted in Decisions Interpreting FCA Elements
In United States ex rel. Sanchez-Smith v. AHS Tulsa Regional Medical Center, LLC, No. 05-CV-442-TCK-PJC, 2010 WL 4702270 (N.D. Okla. Nov. 10, 2010), a federal district court in Northern Oklahoma held that the failure to provide the minimum number of therapy hours to psychiatric patients required under state health care regulations can provide grounds for … Continue Reading

DOJ Settles With Seven More Hospitals To Resolve Medicare Claims For Kyphoplasty

Posted in Articles
The DOJ announced today that it has reached $6.3 million in settlements with seven more hospitals to resolve allegations that the hospitals overcharged Medicare for kyphoplasty procedures. A kyphoplasty is a surgical procedure to treat spinal compression fractures associated with osteoporosis and cancer. As we reported earlier, in 2008, the DOJ settled a qui tam … Continue Reading

Update: AHA’s Continued Efforts To Persuade The DOJ To Reconsider The Hospital Kyphoplasty Initiative

Posted in Articles
Several months ago, we reported that the American Hospital Association (“AHA”) sent a letter to U.S. Attorney General Eric Holder and Kathleen Sebelius, Secretary of Health and Human Services, requesting a review of the so-called kyphoplasty initiative being pursued by the Office of the United States Attorney for the Western District of New York. Earlier … Continue Reading

Hospitals Ask U.S. Attorney to Reconsider HEAT Enforcement Initiatives

Posted in Investigations
Earlier this month, the American Hospital Association sent a letter to U.S. Attorney General Eric Holder and Kathleen Sebelius, Secretary of Health and Human Services, requesting a review of a so-called kyphoplasty initiative being pursued by the Office of the United States Attorney for the Western District of New York. The AHA’s letter, and the concerns … Continue Reading
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