Bradley attorney Jason Mehta was interviewed by CBS News about questionable billing arrangements with rural hospitals. Insurance companies have been reimbursing rural hospitals at higher rates to help keep critical healthcare in rural communities -- making those hospitals an attractive target for schemes that have generated nearly half a billion dollars in fraudulent billing.
In one example, CBS News found a management company that had made deals with laboratories around the country to funnel billing for blood tests and drug screens to rural hospitals to collect higher reimbursement rates.
"The question's gonna be did the laboratories intend to cheat? Did they intend to trick? Did they mislead the insurance companies? Because simply making extra money isn't a crime in and of itself. It's the question of, was someone tricked? Was someone deceived?" said Mehta, a former federal prosecutor who specialized in healthcare fraud.
The complete interview appeared on CBS News on May 16, 2018.
Given the heightened regulatory scrutiny and corresponding prosecutorial actions, companies seeking to donate to Patient Assistance Programs (PAPs) must proceed with caution. But while PAPs remain under scrutiny, as discussed below, there are several practical steps to minimize donating companies’ risk. Read the full client alert on "Practical Advice for Patient Assistance Programs in the Wake of United Therapeutics’ $210 Million False Claims Act Settlement."