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Texas surgeon indicted for alleged role in fraud scheme

The United States Department of Justice (DOJ) recently accused a general surgeon out of Texas of partaking in a scheme to defraud government insurance agencies. According to the allegations, the physician is one of three doctors and 13 others allegedly responsible for over $39.7 million paid out in fraudulent claims.

The DOJ has accused the medical professional of taking kickback payments to refer patients to a healthcare agency that played a key role in the scheme. The general surgeon will need to build a defense against allegations that include three counts of health care fraud. The government has also accused the physician of conspiracy to defraud the government and conspiracy to commit health care and wire fraud.

TX woman accused of 2.5 million in home health care fraud

The Northern District of Texas’ Healthcare Fraud Strike Force has gathered evidence that led to the arrest of a Texas woman. The agency has accused the woman of healthcare fraud. If the government can support these accusations the woman could face a monetary fine of $250,000 and up to 10 years imprisonment.

What should a doctor do if accused of a missed diagnosis?

Doctors enter the medical profession for a number of reasons, but one of the foundational motivators is a desire to help others. In most cases, physicians are able to assist their patients with various medical ailments. Unfortunately, there are some situations when an honest mistake can result in an injury to a patient or a patient may misunderstand and blame a physician for his or her continued illness. This can lead to allegations of medical malpractice.

TX Emergency Department doctor convicted for health care fraud

It sounds like a dream job. A job that involves the review of some paperwork, a signature and a pay check for $400 per week. This type of job could serve as a transition between full-time work and retirement. Unfortunately for one physician that took the job, instead of helping him ease into retirement it may ease him into jail.

The issue began when a friend, a physician’s assistant, informed the former Emergency Department doctor about the position. The government claims the position was part of a complicated health care fraud scheme and built a case against the doctor.

Physician suspended, under investigation after patient compliant

We live in a time where social media is a part of our daily lives. The saying "you live in a fishbowl" has never been more accurate than it is today. At any moment, a neighbor, bystander, client or patient could take out a smartphone and begin live streaming or recording our actions.

This recently happened to a critical care specialist when a patient chose to record his physician's interactions during an emergency room visit.

CEO of Texas physical therapy group found guilty of healthcare fraud

The United States Attorney's Office for the Southern District of Texas announced in a recent publication the conviction of a CEO of a physical therapy business. The office succeeded in the conviction of the CEO for conspiracy, health care fraud, wire fraud and money laundering. Various government agencies worked together to gather evidence to support the charges against the CEO. This included agencies ranging from the United States Postal Service to the United States Department of Homeland Security and United States Department of Labor.

These agencies claim the CEO submitted claims for services patients never received. Examples of alleged services not provided included one-on-one physical therapy sessions. Instead, the agencies accuse the physical therapy business of having patients exercise independently on treadmills and other exercise machines while billing for the more individualized services.

Uterine cancer liability a concern for gynecologists

Gynecologists may underestimate the risk a patient has uterine cancer. That is the claim made by researchers with a recent study through Yale University. The claim is a serious one as the failure to diagnosis this disease prior to certain procedures can result in the spread of undetected uterine sarcomas.

In the past, the use of power morcellators to pulverize uterine tissue was blamed for the spread of this disease. Current data presented by these researchers finds all gynecological surgical devices can play a role in the spread of undetected uterine sarcomas.  

Investigations swirl around Texas doctor

The 65-year-old physician's history with the Texas Medical Board goes all the way back to 1990. The Fort Worth doctor has been disciplined more than once for "inappropriate prescribing practices," a recent news report stated.

He is under a Texas Medical Board supervision order and has also agreed not to practice under the workers' compensation program. Last year, the Drug Enforcement Administration raided his office and seized nearly $700,000.

Five face health care fraud charges for cosmetic procedures

The Department of Justice (DOJ) has accused five individuals of partaking in a multi-year scheme involving eight health insurance companies. Those charged in this case include a physician, office manager, insurance biller and former investigator for an anti-fraud unit within an insurance company. Each faces allegations of conspiracy to commit health care fraud and 13 counts of health care fraud.

Involvement of insurance investigator leads to additional accusations

Nurse takes 3 hospitals to court for False Claims Act violations

A registered nurse has taken three different hospitals to court for False Claims Act violations. The woman is listed as a registered nurse in Texas dating back to 1990. She has also earned a law degree and served in high level management positions in various hospitals.

One such position was the director of case management at Christus Health in Corpus Christi Texas. While serving in this role, the nurse reported a billing issue. She stated that the hospital was billing cardiac-blockage-removal procedures as inpatient procedures to Medicare when the procedures should have been billed as outpatient. She contends that this difference resulted in a $10,300 overpayment to the hospital for each procedure. The nurse further stated that she was “rebuffed” when she attempted to resolve the issue.

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