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As a practicing New York physician, you know that when you render medical services to the victim of a motor vehicle crash and receive his or her assignment of benefits, you can make a claim for reimbursement from his or her insurance company. You also likely know that...
Investigators are reviewing allegations a Licensed Practical Nurse (LPN) illegally posed as a physician. The investigation began after a state agency received complaints about the individual. These complaints led to a search warrant and investigation of a medical...
The federal government takes health care fraud very seriously. In 1996, the passage of the Health Insurance Portability and Accountability Act (HIPAA) resulted in the development of a national program focused on the investigation and prosecution of those who commit...
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.Nursing is a noble career, and it is also one of the...
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....
The Department of Justice (DOJ) recently announced collection of over $2.5 billion dollars in judgments and settlements as a result of health care fraud cases. This is the ninth year in a row the government agency has collected over two billion dollars related to this...
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...
In past generations, physicians often ran solo practices and house calls were common. Since then, physicians have merged to work together in a private practice or work directly as employees of a hospital or other medical or educational facility. The health care...
Prosecutors recently accused a New York nurse of wrongfully taking pain medications from his employer. The hospital where he works stated he took the medication without proper authorization. The nurse was originally charged with multiple felonies, but through a plea...
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...