The American population is aging. As the Baby Boomers begin to transition into a new phase of life, there will likely be a greater demand for home health care services. In an effort to help address this need, lawmakers passed the Patient-Driven Groupings Model (PDGM)....
Month: March 2019
Avoid these common compliance problems for pharmacies
Running a business of any kind takes diligence to ensure it satisfies all relevant regulations, from classifying employees to paying taxes. When your business is in the healthcare industry, such as running a pharmacy, the laws you must follow are even more numerous,...
Preventing upcoding and overbilling in your medical practice
As someone who owns or operates a health care business, you may know all too well that medical billing and coding can prove time-consuming and complex. You can land in serious trouble, however, if Medicare, Medicaid or an insurance company alleges that you were...
What is false incorporation in medicine?
The New York Court of Appeals has agreed to hear a case that delves into fraudulent incorporation of medical practices in the state.What is the issue? New York has a law that prohibits the corporate practice of medicine. Insurance providers can refuse to reimburse...
Insys prosecution continues: NY doc takes plea deal
The government continues to pursue Insys related healthcare fraud investigations. Insys Therapeutics (Insys), a pharmaceutical giant, is known for manufacturing Subsys, a fentanyl-based spray used for management of severe pain suffered by cancer patients. According to...
Counselor gets 3-years in jail for health care fraud
The government recently accused a professional counselor of taking part in a complex health care fraud scheme. The prosecution accused the counselor of filing false documents to incorporate the counseling business, completing unnecessary tests of patients receiving...
Nurse accused of health care fraud loses nursing license
A government investigation recently led to allegations a nursing assistant was involved in a multi-year scheme to defraud Medicare and Medicaid. The investigation resulted in enough evidence to support criminal charges.Based on this evidence, the woman agreed to a...