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
Audit‑Dominated Risk Oversight Leaves Boards Blind to Modern Risks • Contractors Trying to Comply with the Pentagon’s Anthropic Restrictions Are Running into an Unexpected Problem • Judd Wire Pays $1.014M to Settle False Claims Act Charges Over Untested Navy Cable • Federal Grant Recipients Face New Funding Delays and Compliance Uncertainty Under Senate FY 2027 Continuing Resolution • Customs Enforcement Heats Up: What Importers Need to Know
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.