Everything is bigger in Texas, and as far as the feds are concerned that old adage holds true for healthcare fraud in recent years. In the past, the feds could generally only pursue allegations of illegal kickbacks against providers who billed federal programs....
Year: 2021
Are payment assistance programs a violation of the AKS?
The Anti-Kickback Statute (AKS) is a federal law enacted by lawmakers to help reduce the risk that medical professionals would use financial motivation to guide medical decisions. This intent is good, but the application can go awry. One example involves the use of...
What should I do if my organization gets a letter from a RAC?
The United States Department of Medicare and Medicaid Services (CMS) uses a number of different resources to aid in the completion of its many operations. This includes contracts with different entities to help determine if the CMS made overpayments to health care...
Three tips to start a home health care business in Texas
Savvy business owners know that the market demand for home health services is only likely to increase in coming years. We have the aging boomer population to thank for this business opportunity, as more and more are choosing to stay at home as opposed to go into a...
TX BON warns nurses of license scam
The Texas Board of Nursing (BON) recently encouraged nurses to stay vigilant when they get a phone call that claims to be from their organization. The Board staff stated that fraudsters claiming to be from the TX BON are calling nurses and telling them they are under...
Physician groups: 3 things to know about provider funding
Physician groups throughout the country found themselves facing new obstacles during the COVID-19 pandemic. Private practices implemented new technology for virtual appointments, increased the personal protective equipment (PPE) needs and saw an increase in patients...
Three things medical practices should know about false claims
Billing Medicare and other insurance providers is not always straightforward. Some may struggle to keep up to date with the ever-changing language that guides billing practices while others are trying to run a medical practice with reduced staff. In any of these...
Home health & the AKS: Violation can lead to serious fines
There are times when a physician can best serve their patient by switching them to home health services. Physicians can sign off on these arrangements, but a failure to do so carefully can result in allegations of an Anti-Kickback Statute (AKS) violation. In a recent...
Hospital execs take note: If job in jeopardy, criminal charges could follow
Healthcare executives who have recently lost their job or who are currently under review are wise to take the matter seriously. In some cases, these actions are signs of a bigger problem: a federal investigation. The federal investigation could result in concerns of...
DOJ pursues EKRA charges against drug treatment facility
The United States Department of Justice (DOJ) recently announced it will pursue a conspiracy to violate the Eliminating Kickbacks in Recovery Act (EKRA) charge against a drug treatment facility owner. When faced with these charges, the owner, Dr. Akikur Mohammad,...