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Proof in Trial: Appellate Edition: Integra Med Analytics LLC et al v Providence Health & Services et al | Hogan Lovells

Subscribe and listen to Proof in Trial here: https://proofintrial.lnk.to/series A journalist facing a jail sentence for protecting her sources; a Native American tribe fig.

The Reverse False Claims Act: A Relatively Unknown, But Increasingly Used, Provision Of The FCA | Pietragallo Gordon Alfano Bosick & Raspanti, LLP

Volumes have been written about the False Claims Act as a tool to pursue fraud against the government in circumstances where the defendant has allegedly made false statements to receive.

Maggots, Rape and Yet Five Stars: How U S Ratings of Nursing Homes Mislead the Public

Note: Abuse citations include violations for failing to investigate and report potential abuse. At homes whose five stars masked serious problems, residents developed bed sores so severe that their bones were exposed. Others lost the ability to move. But the most important impact may be that the nursing home industry was ill equipped for the pandemic. The rating system allowed facilities to score high grades without upgrading the care they provided. “They were working to improve their ratings, but not their quality,” said Charlene Harrington, who sits on a board that advises C.M.S. on the ratings system. “The problems with the five-star system left these homes less prepared in the pandemic,” she said. “They were allowed to not have enough staffing, and they were allowed to ignore infection-control deficiencies, so they had poorer quality than the public knew about, and they were in the worst position to manage Covid.”

Maggots, Rape and Yet Five Stars: How U S Ratings of Nursing Homes Mislead the Public

Maggots, Rape and Yet Five Stars: How U S Ratings of Nursing Homes Mislead the Public
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United States Supreme Court Passes on Review of FCA Dismissal from Fifth Circuit Involving Alleged Medicare Overbilling | King & Spalding

To embed, copy and paste the code into your website or blog: On December 7, 2020, the United States Supreme Court declined review of the U.S. Court of Appeals for the Fifth Circuit’s affirmation to dismiss a $61.8 million False Claims Act case alleging Medicare overbilling against a Texas hospital system. The lawsuit, initially brought by relator Integra Med Analytics (Integra) against Baylor Scott & White Health (Baylor), alleged that Baylor engaged in a scheme to overbill Medicare by fraudulently increasing the use of certain “secondary” diagnosis codes for complications and comorbidities, which result in higher Medicare reimbursement on the claim. The Supreme Court’s decision not to undertake review of the Fifth Circuit’s decision signals that the nation’s highest court has no aims to alter the legal landscape of the False Claims Act’s pleading standard at this time.

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