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Chicago, Illinois 60603-5792

Showing 5 posts in Unnecessary Medical Services and Procedures.

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False Claims Act and the Opioid Crisis: First-ever Civil Injunction Filed by Justice Department to Combat Opioid Over-Prescription

In August 2018, the U.S. Department of Justice announced allegations against an Ohio doctor for violating the False Claims Act (FCA) in addition to violating the Controlled Substances Act (CSA) for prescribing opioid prescriptions in excessive amounts or to those who are not in need of the medication. Although an FCA case is not the most traditional approach to these issues, it is clear that the Justice Department is making the opioid crisis a top priority and therefore potentially invoking the FCA more often in these cases. The government's focus on the opioid crisis has been consistently increasing and expanding from targeting manufacturers of opioids to targeting prescribers and healthcare providers that submit claims to federal health care programs or to the federal government. 

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US Government continues to combat health care fraud in Chicago

Both the False Claims Act and criminal health care fraud laws continue to be powerful tools for combating health care fraud—and many criminal health care fraud cases could also have been FCA cases, had a whistleblower come forward in time. More

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The High Cost of Ambulance Fraud: Billing the Government for Unnecessary Services

Ambulance fraud takes many forms.  Sometimes ambulance companies charge Medicare or Medicaid for unqualified rides, miles or services; sometimes those charges are inflated; sometimes the rides are not even provided. In all of these cases, the ambulance company pockets the additional, undeserved money, and taxpayers end up paying more than they should. When the government pays out money to unscrupulous business owners, there is less money available to serve those truly in need of care. These frauds place a particularly heavy burden on our healthcare system and increase costs for everyone. More

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Billing for Unnecessary Services: False Claims Act Allegations Against 21st Century Oncology

Recently, 21st Century Oncology Inc. a provider of cancer care, and its subsidiary, South Florida Radiation Oncology LLC, settled a legal claim with the U.S. government, agreeing to pay $34.7 million to resolve allegations that the companies billed for unnecessary services and medical tests. More

Fraud and Cardiac Stents: When Doctors and Hospitals Use Stents for Financial Gain

Cardiac stents fraud

Patients trust doctors to have their best interests at heart when making recommendations about medical treatment and the appropriate course of action. Unfortunately, this isn’t always the case, and doctors and medical professionals sometimes recommend medical treatment and procedures that are not needed. In fact, according to this article in USA Today, unnecessary surgeries might account for 10% to 20% of all operations in some specialties, including a wide range of cardiac procedures and many spinal surgeries. More

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