What happens when a patient, co-worker or other medical professional files a complaint about a physician's work? If the complaint involves allegations of misconduct, the New York Health Department's Office of Professional Medical Conduct (OPMC) and state Board for...
Year: 2020
Whistleblower begins FCA case against dentist
A former employee recently filed a claim against a dentist. In this claim, the worker does not allege that they were personally injured. In fact, the claim does not even directly involve the worker. Instead, the claim states the dentist and oral surgeon fraudulently...
DOJ announces criminal charges for over 100 doctors and nurses
The Acting Assistant Attorney General of the Justice Department's Criminal Division recently announced a "historic nationwide enforcement action" that resulted in criminal charges for over 100 doctors, nurses and other medical professionals. The charges are the result...
Tips to reduce liability for telehealth services
The Department of Health and Human Services has relaxed regulations under the Health Insurance Portability and Accountability Act (HIPAA), at least temporarily. This allows medical professionals to conduct communications with patients using technology like Zoom and...
3 things diagnostic labs need to know about regulatory compliance
Laws and regulations are present to better ensure diagnostic labs provide quality care. A failure to abide by these regulations can result in serious penalties. There are many government agencies that oversee these regulations. The United States Department of Health...
Lessons from record setting HIPAA fine
The United States Department of Health and Human Services (HHS) recently announced a $6.85 million settlement with Premera Blue Cross, a private health insurance provider, to settle claims the company violated the Health Insurance Portability and Accountability Act...
What should providers know about next wave of CARES Act relief?
The Department of Health and Human Services (HHS) will begin accepting applications for Relief through this package October 5th. The agency has stated the goal is to help cover approximately 2% of patient revenue lost as a result of the pandemic.The HHS is encouraging...
Cardiologist sues hospital officials for wrongful termination
The physician received his medical training at the University of Texas Southwestern Medical Center in Dallas and the Texas Heart Institute at Baylor St Luke's Medical Center in Houston. Hospital officials hired the specialist in 2018 to fill a variety of cardiology...
HHS states my physician group chose the wrong code. Now what?
The United States Department of Health and Human Services (HHS) has stated physician groups throughout the country are mistakenly choosing the wrong code when it comes to charging Medicare for services provided to stroke patients.What is the problem? According to a...
NJ healthcare insurance negotiation deal: 3 lessons
New Jersey healthcare company Humana Inc. recently adjusted its insurance offerings to expand in-network access for members. After much negotiations with local healthcare providers, the private insurance provider agreed to expand its terms to include additional...

