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April 2019 Archives

Texas Medical Examiner's Office accused of fraud

The Texas Medical Board (TMB) has reportedly extended an investigation well past the usual 180-day limit. A forensic anthropologist serving on a contract basis at a local Medical Examiner's Office was one of many individuals who came forward with complaints about the facility's techniques.

TX uses new tool to charge doctors with health care fraud

The medical profession's first concern should be the welfare of the patient. Most physicians, nurses and other medical professionals go into this field because they share a similar belief. However, as is true in any profession, there are some who stray and find the lure of financial rewards too much to ignore.

Request for medical billing records can trigger payment problems

Health insurance companies may request a copy of billing records to substantiate claims for payment. If not provided in a timely manner, the company could report physicians who fail to comply to the state medical licensing board. Unfortunately, additional problems can arise if the requested records are provided but put together poorly.

TMB questions doctor's prescription methods, restricts license

The Texas Medical Board's (TMB) disciplinary panel announced the temporary restriction of a Houston physician. The group accused the physician of administering opioids at a high volume. The TMB further chastised the physician, stating he not registered as a pain management clinic as required due to the nature of his practice.

DOJ pursues healthcare fraud case, alleges billions in violations

The Department of Justice (DOJ) released the federal indictments for a group of individuals charged in one of the largest cases of healthcare fraud in recent history. The case is the result of a joint operation involving many agencies including the Federal Bureau of Investigation, U.S. Department of Health and Human Services Office of Inspector General and the Internal Revenue Service Criminal Investigation as well as various state agencies throughout the country.

What laws govern healthcare fraud and abuse?

The Centers for Medicare and Medicaid Services (CMS) take violations to healthcare laws very seriously. A conviction can come with hefty penalties that may include exclusion from federal healthcare programs, fines and, in severe cases, imprisonment.

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