The Centers for Medicare and Medicaid Services (CMS) recently released information about new efforts to reform its repayment structure to better address the growing public health crisis of antimicrobial resistance. Why the need for change? The agency's current...
Health Care Investigations
Lessons from government investigation of UNC Hospital
Any number of events can trigger a government investigation of a medical facility. The government may receive an anonymous tip, billing practices may lead to a red flag or, as recently highlighted in a case involving the University of North Carolina's (UNC) Congenital...
Feds accuse NY doc of taking illegal kickbacks: 3 things to know
The federal government recently accused a New York doctor of partaking in a health care fraud scheme that spanned throughout the country. The alleged scheme involved prescriptions for a pain cream in exchange for illegal kickbacks from a pharmacy located in Oklahoma....
CMS investigates MD Anderson, finds “serious care deficiencies”
MD Anderson Cancer Center is known throughout the country for its cancer treatment. This facility often takes on some of the most difficult cancer cases in the country. The cancer center’s reputation recently took a hit after a government agency conducted...
Children, mental illness & insurance: A study on ED admissions
Does health insurance impact whether a child will get emergency medical care? According to researchers who recently finished a study into the matter, if the child has a mental disorder then the answer is a resounding yes. The researchers reviewed 9,081 acute mental...
Government cracks down on hospital accused of error
State inspectors recently conducted an unannounced inspection of a Connecticut hospital. As a result of this investigation, the state has accused the hospital of mixing up patients’ test specimens. What did the state find during the inspection? The mixed tests led to...
NY endocrinologist accused of health care fraud
A recent case out of New York highlights the government's continued crack down on opioid prescription abuse. The case involves an endocrinologist with offices in the Bronx and Yonkers. State officials accused the medical professional of prescribing over 50,000...
TX faith based health care provider faces allegations of fraud
The Texas Attorney General recently accused a faith-based health care provider of fraud. The state alleges the organization collected thousands of dollars in policy payments for coverage it deemed “worthless.” The allegations led the Attorney General to...
Look-back period extended for some Medicare overpayments
The Office of the Inspector General (OIG) recently conducted an audit of Medicare claims for a specific medical device. The agency found the majority of Medicare claims for this device, the positive airway pressure device and associated supplies, did not comply with...
Link between the college admission scandal and healthcare fraud
The college admission scandal was top of the news headlines just a few weeks ago. The scandal involved members of the Hollywood elite along with other wealthy parents paying bribes to get their children spots in prestigious universities. The fallout of the problem...

