False Claims Archives

False Claims Act Settlements and Judgments Exceed $2.68 Billion in Fiscal Year 2023

Wow! The False Claims Act exceeded $2.68 billion in settlements and judgments in 2023.

Settlements and judgments under the False Claims Act exceeded $2.68 billion in the fiscal year ending Sept. 30, 2023, Acting Associate Attorney General Benjamin C. Mizer and Civil Division Principal Deputy Assistant Attorney General Brian M. Boynton announced today. The government and whistleblowers were party to 543 settlements and judgments, the highest number of settlements and judgments in a single year. Recoveries since 1986, when Congress substantially strengthened the civil False Claims Act, now total more than $75 billion.

“Protecting taxpayer dollars from fraud and abuse is of paramount importance to the Department of Justice – and these enforcement figures prove it,” said Acting Associate Attorney General Mizer. The impact of the False Claims Act exceeded $2.68 billion also demonstrates its effectiveness. “The False Claims Act remains one of our most important tools for rooting out fraud, ensuring that public funds are spent properly, and safeguarding critical government programs.” Read More

What to Do When Your Patient Records Contain Wrong Information

Errors in patient records can have serious consequences, but you have the power to correct them.

Patient records are the backbone of healthcare, guiding diagnoses, treatments, and insurance claims. But what happens when these records contain errors—wrong diagnoses, incorrect medications, or even fabricated information? These medical records errors can lead to compromised patient records causing misdiagnoses, improper treatments, and financial headaches. In this post, we’ll explore how to address inaccuracies in your medical records, including what to do if a provider refuses to correct them or if you’re no longer their patient.

Can Wrong Information in Patient Records Be Corrected?

Yes, under federal law, you have the right to request corrections to errors in your medical records. The Health Insurance Portability and Accountability Act (HIPAA) grants patients the right to access and amend their protected health information (PHI). According to the U.S. Department of Health and Human Services (HHS), you can request an amendment if you believe your records contain inaccurate or incomplete information.

Steps to Correct Errors:

1. Review Your Records: Request a copy of your medical records from your provider. HIPAA requires providers to give you access within 30 days, though some states have shorter timelines.
2. Identify Errors: Document the inaccuracies, noting specific details like incorrect dates, diagnoses, or treatments.
3. Submit a Written Request: Contact your provider in writing, clearly explaining the errors and providing evidence (e.g., lab results, second opinions) to support your correction. Include your contact information and a request for confirmation of the amendment.
4. Follow Up: Providers must respond within 60 days (with a possible 30-day extension). They may agree to amend, partially amend, or deny your request.

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Advanced Pain Management Allegedly Violating the Civil Monetary Penalties Law by Submitting Claims for Non-Covered Services

APM On October 13, 2020, Advanced Pain Management Specialists, P.A., (Advanced Pain), Fort Myers, Florida, entered into a $24,921.96 settlement agreement with OIG. Advanced Pain Management faces allegations of violating the Civil Monetary Penalties Law, as the settlement resolves allegations that Advanced Pain submitted claims to Medicare for specimen validity testing (SVT) in conjunction with claims for urine drug testing when SVT was a non-covered service. OIG’s Office of Audit Services and Office of Counsel to the Inspector General, represented by Senior Counsels Andrea Treese Berlin and Gregory Becker with the assistance of Paralegal Specialist Jennifer Hilton, collaborated to achieve this resolution. Source – Office of Inspector General

FBI News and Multimedia

Advanced Pain Management (“APM”) Agree to Pay $1 Million to Resolve Allegations They Violated the False Claims Act and Anti-Kickback Statute

United States Attorney Matthew D. Krueger announced today that Advanced Pain Management (“APM”) has agreed to pay $1 million to settle claims asserting violations of the False Claims Act by paying kickbacks and by performing medically unnecessary laboratory tests. APM is a collection of companies including Advanced Pain Management Holdings, Inc. (“APMH”), its wholly-owned subsidiaries APM Wisconsin MSO and Advanced Pain Management LLC, and Advanced Pain Management S.C. (“APM SC”). Read More

Medical Fraud Exposed

Category Archives: False Claims