Common use of Factual Background and Covered Conduct Clause in Contracts

Factual Background and Covered Conduct. On June 2, 2017, Respondent made a submission pursuant to OIG's Self Disclosure Protocol (Protocol), and OIG accepted Respondent into the Protocol on July 24, 2017. The OIG contends that Respondent knowingly presented to Medicare, Tricare, and VA claims for items or services that Respondent knew or should have known were not provided as claimed and were false or fraudulent. Specifically, the OIG contends that, in certain cases of three or more concurrent neurosurgical procedures performed at University Hospital Shreveport during the period November 1, 2011 through January 3, 2017, Respondent submitted claims for physician services by teaching surgeons when those services were supervisory services to the hospital rather than a physician service to individual patients. The OIG contends that the conduct described in this Paragraph (hereinafter referred to as the "Covered Conduct") subjects Respondent to civil monetary penalties, assessments, and exclusion under 42 U.S.C. §§ 1320a-7a and 1320a-7(b)(7).

Appears in 1 contract

Samples: Settlement Agreement

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Factual Background and Covered Conduct. On June 2, 2017, Respondent made a submission pursuant to OIG's Self Disclosure Protocol (Protocol), and OIG accepted Respondent into the Protocol on July 24, 2017. The OIG 010 contends that Respondent knowingly presented to Medicare, Tricare, and VA claims for items or services that Respondent knew or should have known were not provided as claimed and were false or fraudulent. Specifically, the OIG contends that, in certain cases of three or more concurrent neurosurgical procedures performed at University Hospital Shreveport during the period November 1, 2011 201 1 through January 3, 2017, Respondent submitted claims for physician services by teaching surgeons when those services were supervisory services to the hospital rather than a physician service to individual patients. The OIG contends that the conduct described in this Paragraph (hereinafter referred to as the "Covered Conduct") subjects Respondent to civil monetary penalties, assessments, and exclusion under 42 U.S.C. §§ 1320a-7a l 320a-7a and 1320a-7(b)(7).

Appears in 1 contract

Samples: Settlement Agreement

Factual Background and Covered Conduct. On June 2, 2017, Respondent made a submission pursuant to OIG's Self Disclosure Protocol (Protocol), and OIG accepted Respondent into the Protocol on July 24, 2017. The OIG contends that Respondent knowingly presented to Medicare, Tricare, and VA claims for items or services that Respondent knew or should have known were not provided as claimed and were false or fraudulent. Specifically, the OIG contends that, in certain cases of three or more concurrent neurosurgical procedures performed at University Hospital H ospital Shreveport during the period November 1, 2011 through January 3, 2017, Respondent submitted claims for physician services by teaching surgeons when those services were supervisory services to the hospital rather than a physician service to individual patients. The OIG contends that the conduct described in this Paragraph (hereinafter referred to as the "Covered Conduct") subjects Respondent to civil monetary penalties, assessments, and exclusion under 42 U.S.C. §§ 1320a-7a and 1320a-7(b)(7).

Appears in 1 contract

Samples: Settlement Agreement

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Factual Background and Covered Conduct. On June 2, 2017, Respondent made a submission pursuant to OIG's Self Disclosure Protocol (Protocol), and OIG accepted Respondent into the Protocol on July 24, 2017. The OIG contends that Respondent knowingly presented to Medicare, Tricare, and VA claims for items or services that Respondent knew or should have known were not provided as claimed and were false or fraudulent. Specifically, the OIG contends that, in certain cases of three or more concurrent neurosurgical procedures performed at University Hospital Shreveport during the period November 1, 2011 201 1 through January 3, 2017, Respondent submitted claims for physician services by teaching surgeons when those services were supervisory services to the hospital rather than a physician service to individual patients. The OIG contends that the conduct described in this Paragraph (hereinafter referred to as the "Covered Conduct") subjects Respondent to civil monetary penalties, assessments, and exclusion under 42 U.S.C. §§ 1320a-7a 1 320a-7a and 1320a-7(b)(7).

Appears in 1 contract

Samples: Settlement Agreement

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