Section 6401 of the Patient Protection and Affordable Care Act (PPACA) grants the Secretary of the Department of Health and Human Services (the “Secretary”) the authority to require health care providers to adopt compliance programs as a condition of participation in the Medicare, Medicaid and CHIP programs. Before the PPACA,…
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Florida Legislation to Increase Medicaid Antifraud Efforts
A bill in Florida’s Senate would target Medicaid fraud through the creation of a Fraud Strike Force and the expansion of the Medicaid Fraud Control Unit (MFCU) within the Florida Attorney General’s (AG’s) office. The Fraud Strike Force would direct state and local authorities to work together to more effectively…
Rush University Medical Center Agrees to $1.5 Million Settlement to Resolve Alleged FCA Violations
The U.S. Department of Justice (DOJ) and Rush University Medical Center agreed to settle a qui tam lawsuit alleging that Rush violated the Federal False Claims Act (FCA). The lawsuit, filed on July 12, 2004, alleged that Rush had violated the FCA by submitting certain false claims for payment to…
Health Professionals Petition the FTC for Relief from Red Flags Rule
On January 27, 2010, leaders of the American Dental Association (ADA), American Medical Association (AMA), American Osteopathic Association (AOA), and the American Veterinary Medical Association (AVMA) sent a letter to the Federal Trade Commission (FTC) Chairman Jon Leibovitz requesting that health professionals be excluded from the “Red Flags” Rule, a…