DOJ

2014 HCFAC Report — $27.8 Billion Recovered for Medicare

(March 23, 2015): Last week, the Department of Justice (DOJ) and Department of Health and Human Services (HHS) announced that they had recovered more than $27.8 billion to the Medicare Trust Fund due to the efforts of the Health Care Fraud and Abuse Control Program (HCFAC). As set out in the 2014 HCFAC Report, in […]

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Liles Parker Welcomes Paul Weidenfeld to the Firm

(June 15, 2011): Liles Parker is pleased to announce that attorney Paul Weidenfeld has joined the Firm as “Counsel” at the Firm. In joining the Firm, Mr. Weidenfeld has further broadened the scope of Liles Parker’s litigation expertise. Prior to entering private practice, Mr. Weidenfeld served as “National Health Care Fraud Coordinator” at the Executive

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Predictive Modeling: ZPICs Using Data Mining to Identify Medicare Fraud

(April 15, 2011): Over the last decade, the Centers for Medicare and Medicaid Services (CMS) and its contractors (Zone Program Integrity Contractors (ZPICs), Program Safeguard Contractors (PSCs) and Recovery Audit Contractors (RACs)), have steadily assembled an extensive database of the coding and billing practices of Medicare providers around the country. Analyzing this data, contractors have

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2011: The Year of Compliance – Medicare Payment Suspension Actions

(January 26, 2011): Medicare payment suspension action can prove disastrous for your practice or home health agency. How did we get to this point? The recent debate over healthcare in this country has drawn attention to healthcare costs as well as the relationship between healthcare providers and the Federal government. With healthcare costs steadily on

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HEAT Investigations of Health Care Fraud in South Texas

(January 6, 2011): Three Houston-area residents, one of whom is a physician, were sentenced to prison on January 4th for their roles in a multi-million dollar durable medical equipment (DME) Medicare fraud scheme. Each of the three defendants were also ordered to pay restitution to the Federal government, in amounts ranging from $29,052 to $1.4

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Top Ten Health Care Compliance Risks for 2011

(December 31, 2010): In case you missed it, Congress, President Obama and the healthcare regulators had a banner year with respect to regulatory activism in 2010. Over the next several weeks we will be releasing a series of articles on our website addressing the compliance risk areas facing your organise dramatic changes and the compliance

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HEAT Strike Force Enforcement Takes an International Turn

(October 17, 2010): Medicare’s HEAT Strike Force is actively tracking down wrongdoers. The FBI has announced the arrest of 73 defendants, a number of which are allegedly members of an international organized crime organization, as part of one of the largest criminal health care fraud cases ever brought. It is estimated that these individuals are

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South Texas Home Health Fraud Case Results in Nurse Prosecution

(October 9, 2010): The U.S. Attorney’s Office for the Southern District of Texas recently issued a Press Release announcing the conviction of a South Texas nurse who worked for a home health company. She allegedly admitted falsifying and forging encounter forms used when providing care for Medicare beneficiaries. This case is merely the latest example

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Robert W. Liles Invited to Speak at the WDTX DOJ Working Group for Health Care Fraud Meeting

(September 12, 2010): Robert W. Liles, Managing Partner at Liles Parker, has been asked to serve as the main speaker at the quarterly DOJ Working Group conference sponsored by the U.S. Attorney’s Office for the Western District of Texas. The Working Group consists of Federal civil and criminal Prosecutors, FBI agents, HHS-OIG agents and investigators,

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The AHA Expresses its Concerns with Recent False Claims Act Kyphoplasty Cases

(September 11, 2010): The American Hospital Association (AHA) has expressed its concern that the Department of Justice (DOJ) and its law enforcement partner, the Department of Health and Human Services, Office of Inspector General (HHS-OIG) may be overreaching in its use of the False Claims Act in kyphoplasty cases. As set out in the AHA’s

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