Attorneys Pay Heavy Price for Block-Billing

Lawyers are aware of the increasing sensitivity—and hostility—of clients to block-billing: lumping more than one activity into a single time entry.  A new Fifth Circuit decision shows that courts can be equally sensitive—and hostile—to the practice.  The court upheld an award of $739,000 in attorneys’ …

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Supremes Hear Argument on Implied Certification Theory

On April 19 the U.S. Supreme Court heard oral argument in Universal Health Services v. U.S. ex rel. Escobar.  That’s the case in which the First Circuit upheld a whistleblower suit brought against a mental health clinic that had treated their daughter.  Their theory is that the clinic’s reimbursement …

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Texas-Size Sentences for Texas-Size Medicare Fraud

They do things big in Texas.  The latest example is the punishments being handed out for a Medicare fraud scheme at Riverside General Hospital in Houston. Let’s start with the fraud scheme.  It was Texas-size, too, resulting in a whopping $158 million in false Medicare claims for partial hospitalization …

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OK to Exaggerate How Long Patients Need Device

Today’s riddle:  Why would a federal court approve a medical device manufacturer’s practice of persuading physicians to exaggerate the period of time Medicare patients need their devices?  The answer is so simple that you’ll be embarrassed that you didn’t get it right away. Whistleblower Jeffrey …

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Difference of Medical Opinions Doesn’t Prove One Was False

A federal court in Alabama dealt a blow to the theory that in matters of medical judgment, a false claim action can rest on expert opinion evidence alone. A patient is eligible for hospice if the prognosis is life expectancy of six months or less, assuming the terminal illness runs its course.  The government …

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U.S. Sides with Defendant Against Whistleblower—Sort of

Today’s riddle: why would the government take the defendant’s side against the whistleblower in a False Claims Act qui tam case?  Why would the government challenge the whistleblower’s claim that two defendants violated the Stark Law, insisting instead that they met a Stark exception? A Georgia federal …

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