Francesca R. Ozinal

Jun 27, 2024 | fcablog.sidley.com | Jaime Jones |Brenna Jenny |Francesca R. Ozinal

Recently, DOJ, the State of Florida, and the State of Minnesota reached a nearly $15 million FCA settlement to resolve allegations that a provider knowingly submitted claims for services related to the management of patients in assisted living facilities (“ALFs”), group homes, and memory care units that did not comply with applicable federal healthcare program (“FHCP”) requirements. This settlement is one of the first FCA settlements involving chronic care management (“CCM”) codes.

Jun 27, 2024 | today.westlaw.com | Jaime Jones |Brenna Jenny |Francesca R. Ozinal

(July 31, 2024) - Sidley Austin attorneys Jaime Jones, Brenna Jenny and Francesca Ozinal discuss an almost $15 million Department of Justice resolution of a False Claims Act whistleblower suit, one of the first settlements to involve alleged overbilling using chronic care management codes.

Jun 27, 2024 | lexology.com | Jaime Jones |Brenna Jenny |Francesca R. Ozinal

Recently, DOJ, the State of Florida, and the State of Minnesota reached a nearly $15 million FCA settlement to resolve allegations that a provider knowingly submitted claims for services related to the management of patients in assisted living facilities (“ALFs”), group homes, and memory care units that did not comply with applicable federal healthcare program (“FHCP”) requirements. This settlement is one of the first FCA settlements involving chronic care management (“CCM”) codes.

May 3, 2024 | fcablog.sidley.com | Jaime Jones |Brenna Jenny |Francesca R. Ozinal

Last week, DOJ and the State of California reached a $7,084,000 settlement with a California-based nursing home chain and two executives for allegedly misusing a pandemic-era waiver program by routinely submitting claims to Medicare for nursing home residents that did not have a qualifying prior hospital stay. This settlement is noteworthy because it is one of the first FCA settlements involving alleged abuse of this particular Centers for Medicare & Medicaid Services (“CMS”) COVID-19 waiver.

Apr 29, 2024 | lexology.com | Chad D. Ehrenkranz |Francesca R. Ozinal |Nicole Koshevatskiy

The Joint Commission, an independent healthcare accreditation nonprofit, recently announced a new telehealth accreditation program (TEL) applicable to eligible hospitals, ambulatory, and behavioral health organizations, among others, beginning July 1, 2024.