On October 8, 2019, a judge in the United States District Court for the Central District of California granted a stay and certified two questions for interlocutory appeal in relator Integra Med Analytics’ FCA suit against Providence Health & Services, its affiliates, and J.A. Thomas and Associates, Inc., a clinical documentation consultant. The case involves allegations that Providence perpetrated an upcoding scheme whereby it trained its doctors to describe medical conditions with language that would support increasing the severity levels of the DRGs that Providence reported to Medicare, leading to inflated Medicare reimbursements.
Regulations, Compliance, & Enforcement
Trending Now
Federal Contractor DEI Ban Under Fire Again: State Coalition Targets Agency Rollout • SBA Issues Proposed Rule Regarding Social Disadvantage Requirements for Individually-Owned 8(a) Applicants • DOJ to Fast-Track FCA Intervention Decisions • Trump Administration Issues Sweeping Executive Order on Customs Enforcement • DOJ Picks Up the Pace in False Claims Act Litigation: 5 Considerations for Employers Facing Fraud Allegations
Ninth Circuit Invited To Weigh In On Public Disclosure Bar, Falsity
Yavdat | Shutterstock
Track False Claims Act cases, audit trends, and compliance best practices with our Compliance & Enforcement newsletter, delivering up-to-the-minute intelligence Monday–Saturday — Subscribe here.