Seventh Circuit Reaffirms Worthlessness of Worthless Services Cases

In August the Seventh Circuit expressed its view that so-called “worthless services” cases don’t state a claim under the False Claims Act.  Last Friday the court reaffirmed its view by refusing to rehear the case en banc. The theory of a worthless services case is that a nursing home or other provider …

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And You Thought a One-Third Contingency Was High

On Tuesday a federal court in Illinois awarded fees of $200,000 to attorneys for a whistleblower in a False Claims Act action.  Not impressed?  Well, consider this: the whistleblower got a little less than $30,000.  Figured on a contingency basis, that’s an 87% fee. As usual, there’s more to it than …

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Hospital’s Extortion & Fraud Too Quick to Violate RICO

If a hospital’s extortion and wire fraud activity is brief enough, it can avoid RICO prosecution.  That’s one lesson in an October 2 decision by the federal court for the district of Idaho. Danielle Bennion and her co-plaintiffs filed a RICO (Racketeer Influenced & Corrupt Practices Act) action …

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FTC Attacks Toothless Regulation of Dentists

Yesterday the United States Supreme Court heard argument in a case of national importance to health professions and the state boards that regulate them.  The case, North Carolina Board of Dental Examiners v. FTC, addresses the question whether a state dental board can be guilty of antitrust violation. Remember …

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Seniors Needn’t Drive into the City to Get Overcharged!

Remember when you had to drive into the city to get overcharged?  Those days are over.  According to a report issued Wednesday by the Office of Inspector General of Health & Human Services, Medicare patients pay two to six times as much for outpatient care at rural critical access hospitals as for the same …

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Illinois Blues Won’t Let Hospitals Jointly Negotiate Unless They’re Married

Remember when Hollywood wouldn’t show an unmarried couple in bed together?  Blue Cross-Blue Shield of Illinois is taking that approach to contract negotiations.  If hospitals want to negotiate jointly with the insurer, they have to be merged.  Clinical integration isn’t sufficient.  It may be an …

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