Scenario 1: A pharmacy chain hires a value consultant to review its Medicare and Medicaid billing practices for ways to optimize the coding of drug reimbursements to maximize profits. Drugs that had historically been charged...more
2/3/2023
/ Billing ,
CFOs ,
False Claims Act (FCA) ,
Federal Acquisition Regulations (FAR) ,
Federal Contractors ,
Health Care Providers ,
Medicaid ,
Medicare ,
Reasonableness Factors ,
Reimbursements ,
SCOTUS
In United States ex rel. Silver v. Omnicare, Inc., et al. (D.N.J. No. 11-cv-01326), a whistleblower relator consistently alleged that certain pharmaceutical service providers have engaged in an illegal kickback arrangement...more
5/12/2021
/ Anti-Kickback Statute ,
Centers for Medicare & Medicaid Services (CMS) ,
Department of Justice (DOJ) ,
False Claims Act (FCA) ,
Healthcare ,
Kickbacks ,
Medicaid ,
Medicare ,
Nursing Homes ,
Pharmaceutical Industry ,
Prescription Drugs ,
Relators ,
Whistleblowers