The False Claims Act: A Case Study

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Stark is enforced by the Centers for Medicare and Medicaid Services (“CMS”). However, the vast majority of Stark claims are brought as a qui tam realtor suits under the False Claims Act (“FCA”) by the Department of Justice (“DOJ”). The DOJ then decides to intervene or to let the relator, bringing the suit, proceed on his own. The harsh reality of a Stark violation coupled with a colorable claim under the FCA can be clearly seen in the case of Tuomey Healthcare System, Inc. In July of 2015, it incurred civil monetary penalties levied in excess of $237 million. In his concurring opinion Circuit Judge James Wynn stated the “troubling picture the case paints: An impenetrably complex set of laws and regulations that will result in a likely death sentence for a community hospital in an already medically underserved area.” …show more content…
In 2014 there were an estimated fifty-four million people enrolled in Medicare programs. Despite the increase in Medicare enrollees since 1990, the number of inpatient hospital beds has decreased by forty-five percent. As part of its initial mandate the Centers for Medicare and Medicaid Services (“CMS”) stated that the initial law did not “authorize any Federal officer or employee to exercise any supervision or control over the practice of medicine or the manner in which medical services are provided or over the selection, tenure, or compensation…of any institution, agency, or person providing health

False Claims Act Case Study

number of False Claims Act (FCA) (31 Ci.S.C. § 3729-3733) healthcare cases continue to revolve around the traditional fraudulent activities such as billing for goods or services not rendered, upcoding,1 violations of Anti-Kickback Statute (42 U.S.C. §1320[a]-[7b] )2, Physician Self-Referral or Stark Regulations (42 U.S.C.S. §1395nn; 42 C.F.R. §411.350-411.389)” (Mattie, et al, 2014, para. 2). Many entities complain about their reimbursement from the government takes too long or that the claims they submitted…

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Customer's Right And Enterprises Social Responsibility And Ethics

young and infant. Though this group has the protection from the law which has been made such as customer protection act, food safety law and minors protection act, because of the lag of the law practice, it has brought great bad effects to them. Only the enterprises raise their social responsibility and business ethic practice, the harm to customers will avoid. Here I choose two cases to illustrate my topic. One is Nestlé Subsidiary involves drink for Kids Is agency which first challenging deceptive…

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The Pros And Cons Of Natural Balance

Natural Balance is not in violation of any laws in its dealing with the retailers. In the opinion, they are violating any acts such as the Sherman Act, the Clayton Act, or the Robinson-Patman Act. It would be legal if Natural Balance get the proper licenses to sell their products with government approval, but it is unethical for the company to bribe an official of the government to distribute their product outside the proper channels. The FDA (Food and Drug Administration) and Federal Trade Commission…

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Study Guide To Accompany Canadian Business And The Law

Study Guide to accompany Canadian Business and the Law, 5th edition Chapter 12 CHAPTER 12 OTHER TORTS Objectives After studying this chapter, you should have an understanding of • the range of torts that are relevant to business organizations • how torts arise from the use of property • how torts arise from business operations • how a business can manage the risk of liability in tort Learning Outcomes • • • • • • • • • Recognize that business activity can result in tort action (page 261) Recognize…

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Nt1310 Unit 4

3, 2015 HS-101-01 Professor Shantel Anderson Unit 4 Assignment Unit 4 Case Study-Life and Death Issues 1. There are four types of advanced directives listed in your text. Please list and describe three of them. The four types of advanced directives are a DNR or Do Not Resuscitate Order, a Living Will, a Power of Attorney and Healthcare Proxy (medical power of attorney) and the Uniform Anatomical Gift Act (organ donation). The DNR order is the abbreviation for do not resuscitate. A…

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week2assignment Essay

1. Ethics is the study of (Points : 1) propositional knowledge. right and wrong. beauty. truth. none of the above. Question 2. 2. A sound-thinking deontologist might use which statement to support a woman’s right to vote? (Points : 1) The happiness of 50% of the population being allowed to vote outweighs the pain that might come out of the other 50%. Humans are autonomous beings that inherently have the same capacities.…

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510 Research Paper

The Food and Drug Administration Modernization Act of 1997 authorized the FDA to recognize standards developed in an open and transparent process, such as those developed by ANSI-accredited standards developing organizations as well as the International Organization for Standardization (ISO) and the…

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An Endless Imbroglio Is Consequences And Duty

and effectively with colleagues, supervisors, and parents; and, lastly, failure to maintain adequate discipline and supervision of students who have been recognized as disobedient and juvenile, and thus disruptive to classroom progression. In the case of incompetence, Frank has not been teaching the students the designated curriculum because he has simply been leading irrelevant discussions on current political topics and sports. Additionally, Frank has done this consistently and thus has forfeited…

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LAW TEST ONE Essay

Understand the fundamentals of the Privacy Act Instructions: Answer all questions in the spaces provided. Student : MARGIE T. GARCIA ID NO. : A6875 Signature : Assessment Date : Result : 1. (i) Discuss the following statement: “The ‘law of New Zealand’ comprises laws and rules made informally by the citizens of New Zealand.” The statement is false because New Zealand’s laws and rules are made by the parliament and sometimes on a case-to-case basis court judges made some laws that are…

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The Case Of Frank Lee Smith

gy paper The Case of Frank Lee Smith Johnnie Daniels Psychology and Law Case Summary The case of Frank Lee Smith was a very interesting one and yet at the same time, a very sad one. An innocent man that was wrongfully convicted gave up 14 years, and eventually his life inside of a prison for a crime that he did not commit. Later it was found that he was actually telling the truth about the whole thing. According to the innocent project Frank…

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