I am so happy to be here. For those of you who watched the live version of last week’s Monitor Monday, I suffered a seizure during my segment. I am so thankful to Dr. Hirsh for recognizing the signs and
Potomac Law Group Blogs
Latest from Potomac Law Group
Health Care Executives: Does Your D&O Policy Protect You Enough?
Today I want to talk about Directors and Officers’ Liability Insurance (D&O), which becomes extremely important if a relator alleges your hospital or health care company billed Medicare or Medicaid for false claims. False claims accusations in qui tam lawsuits
The End of Chevron Deference: How Loper Bright Could Help Defendants Challenge Materiality in False Claims Act Cases
The U.S. Supreme Court’s decision in Loper Bright Enterprises v. Raimondo marked a pivotal shift in administrative law by ending the longstanding doctrine of Chevron deference. This change, which limited judicial scrutiny of agency interpretations of ambiguous statutes, has significant
Dodging the Audit Ghouls: A Win in the World of Medicaid Overpayments!
Gather around and let me tell you a Halloween-worthy tale of victory from the spooky side of Medicaid overpayments. Last week, my team and I emerged victorious from a harrowing Medicaid managed care audit that demanded over $5 million. Yes,
OIG Spooked by Possible Fraud in Remote Patient Monitoring! MA Companies Horrified by Senate Report!
It’s getting scary. On September 24, 2024, the U.S. Department of Health and Human Services, Office of Inspector General (“OIG”) posted a report entitled, “Additional Oversight of Remote Patient Monitoring in Medicare is Needed.” You know what that means? Primary
Knicole Emanuel Appears on Podcast, Stark Integrity!
Click the above to listen!
One of my partners, Bob Wade, hosts a podcast entitled, “Stark Integrity,” on which he presents as “Captain
Knicole Emanuel to Present at HCCA Conference on October 16, 2024!
The Eleventh Circuit’s Game-Changing Ruling in a $400 Million Fraud Case
The Eleventh Circuit Court of Appeals has ruled that a lower court made a significant misstep by excluding crucial evidence in a case involving a staggering $400 million health insurance fraud scheme. Buckle up, folks—this case is packed with legal
Knicole Emanuel Gets Another Win for a Medicaid Provider!
An oral surgeon was accused of owing an alleged overpayment to the Florida Department of Health (DOH) by its contracted auditor, Public Consulting Group (PCG). PCG conducted a post-payment review on the oral surgeon’s company. The oral surgeon hired me,
Medicare Auditors Point to EMR Usage as Documents Being Too Similar and Perhaps…Fraudulent?
To template or not to template? About a decade ago, the Centers for Medicare & Medicaid Services (CMS) implemented its Electronic Health Records (EHR) Incentive Program—also known as Meaningful Use or MU. Nowadays, EHR or EMR (Electronic Medical Records) is