The Department of Justice (DOJ) is continuing its scrutiny of groups that provide Medicare Advantage plans. Just over a year ago, the Office of Inspector General reported that these plans led to billions in risk-adjusted payments that were not supported by specific...
Month: August 2020
What happens if a patient accuses a NY doctor of misconduct?
Regulating boards hold physicians to high standards. State law requires these medical professionals to provide quality care to their patients while staying abreast of changes within the medical profession. Patients who are unhappy with their care may file a complaint...
TMB threatens TX doc with reprimand for COVID-19 claims
The Texas Medical Board (TMB) recently issued a statement calling out a local physician for allegedly making false claims about the potential benefits of certain treatments for COVID-19. The TMB reminded the doctor and those within the medical profession at large that...
What happens if the government claims PPP fraud?
The United States Department of Justice (DOJ) recently announced the arrest of a Texas man accused of fraudulently obtaining over $1.6 million from the Paycheck Protection Program (PPP) loans and using the loans for improper expenses. The prosecution states the...
27 nurses reprimanded by NY Nursing Board in June
New York State's Office of the Professions, which oversees nurses who practice within the state, recently reprimanded 27 nurses. These reprimands were for the month of June alone and ranged in severity from probation and fines to the surrender of the licensee's...
Will CMS delay APP loan repayment deadlines?
The United States Centers for Medicare and Medicaid Services (CMS) has set a deadline for providers to begin repaying Accelerated and Advanced Payment Program (APP) loans provided through the Coronavirus Aid, Relief, and Economic Security (CARES) Act. In most cases,...
DOJ adds 3 more NFL players to health care fraud case
The government continues to crackdown on the commission of health care fraud throughout the country. In a recent case, the United States Department of Justice (DOJ) announced that it will expand the number of former National Football League (NFL) players it will take...
Timeline of a health care fraud case
Health care fraud cases generally follow the following timeline: the government becomes aware of a potential offense, an investigation occurs, and the government pursues criminal charges if the investigation leads to evidence to support the allegations. It may seem...
Did a NY hospital violate human trafficking laws?
The New York State Nurses Association recently accused the Albany Medical Center of violating human trafficking laws. The group claims the hospital violated these laws when it recruited almost 600 Filipino nurses to the hospital. The group has provided evidence to...