The Texas Medical Board is scheduled to again meet here in Austin at the end of next month. The board will again discuss its budget and policies and then consider complaints filed against doctors, as it did in its most recent session.
Medical professionals are not the only ones that can face allegations of health care fraud. A recent case out of Alabama provides an example of a politician that found himself the focus of a federal investigation.
You have struggled through almost a decade of specialized schooling and training to get your nursing credentials. You love your job but realize that school did not prepare you for some of the hardships you now face.
Coverage by medical insurance is important for more than just patients—it is also important for those who operate in the health care industry. Businesses that operate in this market often depend on payments from insurance companies to continue operations. Without payment for the services provided, the business may not receive the funds it needs to operate.
The Recovery Audit Contractor Program is one group that contracts with the government ot correct inaccurate Medicare payments. Those who disagree with the program’s findings can appeal the process. However, one of the biggest critiques of the appeals process is the length of time it takes to reach a resolution. As of February 2015, the appeals process took an average of 572 days.
The Southern District of Texas recently accused a Texas pharmacy owner of an elaborate health care fraud scheme. During the investigation, the prosecution gathered evidence to support allegations a city official was also involved in the scheme. The accusations were serious and included involvement in an alleged scheme to receive over $1.7 million in false payments from Blue Cross and Blue Shield of Texas.