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Austin Texas Legal Issues Blog

TX court allows relief for malicious medical peer review

In addition to years of schooling and practical education, countless examinations and continued education courses throughout one's medical professional life, doctors must also keep their medical license active and in good standing in the state they practice. A failure to do so can end their career.

TX nurse accused of health care fraud, faces 5 years jail time

Officials with the Eastern District of Texas charged a local nurse of violating the federal Anti-Kickback Statute (AKS). According to the allegations, the registered nurse owned a health care services company that provided home health services to patients. The prosecution stated the nurse ran afoul of the law when she made payments to community liaisons to encourage Medicare beneficiaries to use her services.

CMS rule: A closer look at affiliation reporting for managers

As noted in a previous post, the Centers for Medicare and Medicaid Services (CMS) has a new rule that allows the agency to penalize those who fail to disclose affiliations with those who have had enrollment to Medicare or Medicaid previously revoked or denied.

Medical professionals and those within the health care industry have voiced many concerns over this new rule. Many of these concerns center around the agency’s definition of an “affiliation.” To help provide some clarity, the CMS responded to some of these questions. Some of the more notable discussions included those who serve in managerial positions over labs and medical professionals.

CDC: What nurses & doctors need to know about COVID-19

The new coronavirus was recently officially labeled a pandemic. As the number of confirmed cases throughout the country continues to grow, the odds health care professionals will come into contact with COVID-19 become more likely.

As such, the United States Centers for Disease Control and Prevention (CDC) has released a publication that provides information on the new coronavirus. The main goal of the publication is to help better ensure patients receive the proper treatment without jeopardizing the health of medical professionals.

Nurses, the front line against coronavirus: What you need to know

The new coronavirus has resulted in concern throughout the country. People are taking precautions to help reduce their risk of exposure, but no one faces greater risk then those on the front lines, those who willingly deal with this and other dangerous illnesses on a daily basis.

Nurses and other health care workers knowingly put themselves on this front line to help better ensure the wellbeing of their patients. But how can they ensure their own health? The following information can help.

Rule gives CMS authority to act against affiliates of bad actors

The Centers for Medicare and Medicaid Services (CMS) have a new rule that allows a more proactive approach to enforcement efforts. Lawmakers wrote the rule to provide another tool against health care fraud. According to the Federal Register, the Program Integrity Enhancements to the Provider Enrollment Process, has two main provisions.

Diagnostic lab accused of improper dealings with TX hospitals

The government has strict regulations when it comes to relationships between hospitals and diagnostics labs. These regulations were recently highlighted when the Department of Justice (DOJ) reached a multi-million-dollar settlement with a diagnostic lab over allegations the lab improperly billed federal healthcare programs.

Houston police department charges two nurses with felonies

Two nurses had set out to take a trip together. Upon their return, airport authorities flagged the two for a search. During the search, authorities claim to have found approximately 700 Tramadol pills.

Case claims doctor billed millions for "nonexistent procedures"

The government recently accused a doctor of fraudulently billing Medicare, Medicaid and private insurance providers for office visits totaling over $26 million. The government claims the physician billed insurance providers for "nonexistent procedures." If supported, the allegations could lead to serious financial penalties and, depending on the details of the accusations, potential imprisonment.

Feds accuse Texas doctor of False Claims Act violation

The federal government recently accused an orthopedic surgeon from Texas of False Claims Act violations. The health care fraud crimes the physician face allegedly included illegal kickbacks. More specifically, the Department of Justice (DOJ) accused the specialist of taking payouts from OK Compounding in exchange for prescribing on of their medications for a span of approximately two years.

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