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The Federal Trade Commission (FTC), U.S. Department of Justice Antitrust Division, and offices of state attorneys general along with the Canadian Competition Bureau, European Commission Directorate General for Competition, and U.K.’s Competition and Markets...
In a recent win for hospitals throughout the state, the New York Department of Financial services recently stated insurance providers cannot deny hospital claims based on “administrative reasons.” More specifically, the letter states that insurance provers cannot deny...
UnitedHealthcare Services and UnitedHealthcare Insurance Company (plaintiffs) recently filed suit against a Dallas-based lab. In this suit, the plaintiffs claim the lab was making illegal kickback payments to increase the use of their facility. According to court...
The United States Department of Justice (DOJ) recently announced criminal charges against two pharmacy owners from New York. According to the feds, the two were part of a $30 million healthcare fraud scheme that included improper use of a new emergency code,...
An investigation by your state medical board is a big deal. It can lead to steep fines and even a revocation of your medical license, making it impossible to continue your practice in that state. Unfortunately, this could just be the beginning. In some cases, an...
Noncompete agreements are a source of debate throughout the country. On the one side, those in favor of these agreements argue they can help to better ensure talent developed within one organization does not leave to join a competitor, potentially taking important...
A U.S. District Judge recently sentenced a physician to ten years imprisonment for his role in a fraudulent billing scheme. The sentence also included three years of supervised release and a restitution payment of over $4.2 million. The case began in 2017 with a...
Diagnostic labs are a valuable part of the health care marketplace. These labs can offer a variety of services within hospitals and as stand-alone facilities. Those who are interested in joining this marketplace, or who are relatively new to the health care industry,...
The Department of Justice (DOJ) aggressively pursued cases alleging Anti-Kickback Statute (AKS) violations against pharmacies in 2020. In one example, the feds built a case against three pharmacy owners for false claims involving compounded medications. The feds...
The Manhattan U.S. Attorney recently announced civil and criminal health care fraud cases against a vascular surgeon out of Manhattan. According to the prosecution, the doctor fraudulently billed Medicare for vascular surgeries involving end-stage renal disease (ESRD)...