DOJ & FTC Join Telemedicine Attack on Texas Medical Board

The U.S. Department of Justice and Federal Trade Commission have sided with Teledoc, Inc., one of the country’s biggest telemedicine companies, in its legal battle with the Texas Medical Board.  The two agencies filed a joint amicus brief with a double-barrel argument against the Board’s appeal to the Fifth …

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False Claims that Don’t Violate the False Claims Act

A recent Fourth Circuit decision answers this riddle, “How can a contractor knowingly submit a false claim to the government without violating the False Claims Act (FCA)?”  Give up?  The answer is blindingly obvious—once you’ve heard it. The answer is that a false claim doesn’t violate the FCA …

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Do CMS Ratings Punish Hospitals for Serving the Poor?

Does the CMS star rating system reward hospitals for serving the affluent and punish those that serve the poor?  The answer is a resounding yes, according to a recently published analysis by Bloomberg BNA.  The analysis compared star ratings of hospitals across the country with U.S. Census Bureau data for each …

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7th Cir. Demands Objective Standards in Whistleblower Complaint

On September 1 the Seventh Circuit affirmed dismissal of three of a whistleblower’s four fraud allegations against a mental health clinic, ruling that the allegations were based on the whistleblower’s subjective judgment rather than objective standards. Rose Presser worked at Acacia Mental Health Clinic as …

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Strangest Regulatory Interpretation of the Month

The Massachusetts federal district court is hands-down winner of the August award for strangest regulatory interpretation of the month. The interpretation came in the context of denial of Omnicare’s summary judgment motion in a False Claims Act (FCA) action brought against it by three whistleblowers.   The …

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California Physician Loses at Dating Game

A California appellate court has declared physician Visha Dev the loser in his dating contest with Blue Shield Life and Blue Shield California.  The contest arose when the Blues moved for summary judgment in Dev’s action against them for denying three reimbursement claims.  The Blues argued that the date when …

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