Ildefonso P. Mas

Ildefonso P. Mas

Ildefonso Mas is an associate in the Real Estate Practice Group. He has experience involving internal investigations of health care organizations and has defended organizations that have been involved in a qui tam lawsuit or other legal proceedings alleging fraud.

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What does the Escobar Decision Mean for Healthcare Providers?

Universal Health Services, Inc. v U.S. ex rel. Escobar

On June 16, 2016, the U.S. Supreme Court in Universal Health Servs., Inc. v. United States ex rel Escobar, No. 13-317, — S. Ct. — (June 16, 2016), confirmed that the implied certification theory may serve as a basis for liability under the False Claims Act (FCA), although it employed … Continue Reading

Efforts to Stop Health Insurance Fraud Through Use of Contractors Under Fire

In recent reports, from June 25, 2014 and August 13, 2014, the Government Accountability Office (GAO) highlights the mixed results achieved by the federal government’s increased efforts to crack down on health insurance fraud through the use of contractors. The government has spent upwards of $600 million a year to uncover and punish health care fraud and overpayments, but  some … Continue Reading

CMS Releases Unprecedented Amount of Medicare Billing Information, Increasing Risk Related to Fraud Lawsuits

On April 9, 2014, the Center for Medicare and Medicaid Services (“CMS”), a branch of the Department of Health and Human Services (“HHS”), released data showing utilization, payments, and submitted charges for services and procedures that were provided by physicians and other healthcare professionals to Medicare beneficiaries.  This unprecedented release of Medicare billing information seeks to improve transparency in the … Continue Reading

Affordable Care Act Update April 7, 2014: High Courts Vet Key Provisions of the Affordable Care Act Government Extends Enrollment Deadline

March 2014 has produced quite a bit of activity regarding the Patient Protection and Affordable Care Act (“ACA”).  On March 24, 2014, oral argument was held in the latest challenges to the ACA in Sebelius v. Hobby Lobby Stores, et al. before the United States Supreme Court, and in Halbig v. Sebelius before the United States Court of Appeals for … Continue Reading

Halifax Health and Government Settle False Claims Act Claims for $85 Million, But Case is Not Over

On March 10, 2014, Halifax Hospital Medical Center and Halifax Staffing, Inc. (collectively, “Halifax”) entered into a settlement agreement and a corporate integrity agreement (“CIA”) to resolve claims brought under the False Claims Act (“FCA”), alleging Halifax entered into improper incentive compensation arrangements with certain physicians in exchange for Medicare referrals. Halifax agreed to, among other things, pay $85 million … Continue Reading

California Supreme Court Expands Protections to Whistle-Blowers and Weakens Hospital Peer Review Systems

The recent decision by the California Supreme Court in Fahlen v. Sutter Central Valley Hospitals, No. S205568 , 2014 WL 655995 (Cal. 2014) may significantly weaken the efficacy of hospital peer review proceedings in California and may have implications for hospitals in other states. The court held that a physician is not required to exhaust peer review proceedings before … Continue Reading

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