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Showing 4 posts in Upcoding.

Carolina Physical Therapy and Sports Medicine, Inc. Settles False Billing Allegations and Agrees to Pay $790,000

US Attorney Sherri A. Lydon announced on May 9 that the United States Attorney's Office for the District of South Carolina has resolved claims of health care fraud with Carolina Physical Therapy and Sports Medicine, Inc. ("Carolina PT"). Carolina PT had nine physical therapy practices in South Carolina, in Columbia, Irmo, Lexington, Sumter, and Mount Pleasant respectively. More

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Sutter Health Settles False Claims Act Allegations for $30 Million

Sutter Health, based in Sacramento, California, agreed to pay $30 million to settle allegations that the health system submitted inflated diagnosis codes to the Center for Medicaid Services (CMS) for Medicare Advantage beneficiaries.  The Department of Justice (DOJ) announced this in a press release on April 12, 2019.    More

Common False Claims Act Cases in the Heath Care Industry

upcoding health care fraud

The health care industry includes some of the biggest violators of the False Claims Act. In fact, since January 2009, the Justice Department has recovered more than $19 billion through False Claims Act cases, with more than $13.4 billion of that amount recovered in cases involving fraud against federal health care programs. Fraud, waste, and abuse in the health care industry is such a problem that, when the Department of Health & Human Services released its budget for fiscal year 2015, it listed fraud prevention and the reduction of improper payments as “top priorities” for the current administration. More

Government Intervenes in Lawsuit against IPC The Hospitalist and other Whistleblower News (December 13, 2013)

The whistleblower attorneys at Goldberg Kohn are committed to fighting fraud against the government and protecting the rights of whistleblowers. Below are summaries of recent developments pertaining to whistleblower, qui tam, and False Claims Act actions throughout the United States. More

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