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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False Memory Research Paper

know about false memories? False memories are defined as a recollection of incorrect or misleading details of an event. This term is also used for the recollection of an event which in reality did not occur. Studies demonstrate that older people shows inaccuracy of the memory more than youngers. Thus, they mislead and misrepresent an event of the past. Moreover, older people insist that their recollection of the past event should be considered as accurate and precise. The examples of false memories…

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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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Should Police Officers Wear Body Cameras Research Paper

expensive. However, it could also improve the officers behavior. For instance, studies have shown that police officers tend to exhibit more professional behavior when wearing body cameras. Knowing that their actions are being recorded can lead to a decrease in the use of excessive force, de-escalation of tense situations, and adherence to departmental policies and procedures. wouldn’t it be better to use a body camera instead of false accusations and/or excessive force used by police officers and judges taking…

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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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