Feds recently accused a physician practicing at a family medicine and aesthetics group in Jefferson County, Texas of partaking in a healthcare fraud scheme. Government officials stated the doctor would prescribe medications, such as scar creams, without the patient’s...
Year: 2020
What happens if CMS notifies my group of a Medicare overpayment?
The United States Centers for Medicare and Medicaid Services (CMS) defines a Medicare overpayment as one that exceeds a regulation and statute properly payment amount. Additional issues arise if the feds can establish that the provider was aware of the overpayment....
3 questions to ask before buying a healthcare group
Due diligence is important when looking to purchase a healthcare group. Whether looking at an entire facility or an individual private practice, it is important to ask the following questions before moving forward with a deal. #1: What are the financials? Get the...
Pharm companies may need to pay billions to settle opioid lawsuit
With the United States Centers for Disease Control and Prevention (CDC) reporting over 450,000 opioid overdose deaths in the country from 1999 to 2018, it should come as no surprise that the government continues its crackdown on opioid violations. The government is...
OIG calls on diagnostic labs to implement compliance plans
The Office of the Inspector General (OIG) of the Department of Health and Human Services (HHS) along with other federal agencies who enforce the regulations that apply to diagnostic labs have called on these healthcare facilities to implement compliance plans. What...
What if my private practice needs to reevaluate pay equity?
The #MeToo and #BLM movements have brought increased attention to the inequalities that are present within our communities and workplaces. These movements are fueling discussions and provide an opportunity to consider change. Pay equity is one example. How is pay...
How has the pandemic impacted nurse licensure?
The coronavirus pandemic has led officials to make changes to regulations that impact nurse licensure. Some changes impact operations, others impact legislation. The medical community describes some of these changes as long-overdue updates while others were simply a...
Is my physicians’ group ready for an audit?
Healthcare organizations with delegation agreements with private or government insurance programs are wise to prepare for, at a minimum, audits on an annual basis. Insurance providers use these audits to better ensure the healthcare business complies with the...
New York officials accuse doctor of selling opioids
New York officials recently arrested a local pediatric surgeon. The officials state they caught the medical professional attempting to illegally sell opioids. The physician, who also serves on an opioid task force, faces up to nine years imprisonment for the charges....
Medical device manufacturer accused of illegal kickbacks
The Department of Justice (DOJ) recently pursued a case against a medical device manufacturer. The federal agency claimed the healthcare business used illegal kickbacks to encourage medical professionals to use their products. The physicians would then bill Medicare,...