Health Care Fraud

Handling Whistleblower Cases Nationwide from Newport News, Virginia

Is Hospice Providing End-of-Life Care or Committing Medicare Fraud?

Since 1983 Hospice has been a Medicare benefit for individuals suffering with terminal conditions who have less than six months to live. In theory, the Medicare benefit allows patients to spend their last few months at home receiving comfort care until their death instead of enduring costly end-of-life care in a hospital setting. The program should have saved the government money while allowing patients to die with dignity in their own homes.

What is the Stark Law?

What is the Stark Law?

Congress enacted the Stark Law as part of the Omnibus Budget Reconciliation Act of 1989. The Stark Law, 42 USC Section 1395nn, also referred to as the Physician Self–Referral Law, has certain prohibitions when a physician or member of his or her immediate family has a direct or indirect financial arrangement or relationship with an entity:

(1) First, the physician may not make a referral to an entity that provides certain designated health services covered by the Medicare program or any other federal heathcare payor program; and

Health Insurance Companies and Health Care Fraud

The Federal Government and several major health insurers have recently announced a partnership that will take unprecedented steps to eviscerate fraud from the health care industry.  The two sides will share raw data, as well as investigative knowledge and expertise, as they aim to shut off billions of dollars in questionable payments made by the health care system each year.

While insurance companies grudgingly adhere to the requirements of President Barack Obama’s health care overhaul law, industry leaders point out that combating fraud remains atop the list of priorities.