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A healthcare system recently reached a settlement agreement with the federal government to resolve a whistleblower suit. One of the primary charges in the case involved allegations of improper compensation. The government, through the whistleblower, claimed that over...
Physicians need to navigate the relationships that are built within the profession carefully to maintain patient trust and uphold professional integrity. Conflicts of interest can occur when a physician’s personal or financial interests intersect with their duty to...
Those who run healthcare facilities or private practices likely conduct regular internal audits to better ensure operations are in line with applicable regulations. Ideally, these audits will spot any potential issues before the rise to the level of a violation. On...
Officials recently pursued allegations of healthcare fraud against a neurologist from Houston, stating his neurology group falsely billed Medicare Part B for services that were either not medically necessary or provided by untrained and unlicensed technicians. In...
Healthcare regulation is an ever-evolving landscape, and the Stark Law serves as a prime example of this progression. Originally enacted to prevent conflicts of interest in physician referrals and close a loophole in the Anti-Kickback Statute, the Stark Law has...
The federal government, along with state and local authorities throughout the nation, have made it clear that they intend to continue their crackdown on illegal healthcare fraud. Although the goal is noble, these broad and sweeping statements can result in overly...
Merger and acquisition deals are big in the healthcare industry. Whether looking to combine forces to provide higher quality care or outsource more administrative tasks, these deals can be advantageous to everyone involved. Unfortunately, a single misstep can mean an...
Psychiatrists provide important care. Like any other form of medical care, these services are often billable to insurance companies, both private and federal. As such, the practices fall under many forms of federal and state regulations. Four of the most important...
The United States Centers for Medicare and Medicaid Services (CMS) has strict rules when it comes to business relationships between healthcare providers who file claims for payment from Medicare. Two primary examples are the Anti-Kickback Statute (AKS) and the Stark...
The Anti-Kickback Statute (AKS) is a federal law that lawmakers intend to help better ensure physicians and other medical professionals focus on quality healthcare over financial gain. The law makes it illegal to file false or fraudulent claims for payment with...