The United States Department of Justice (DOJ) continues to crackdown on its fight against illegal kickbacks. The feds are clear in their belief that what it considers bribes within the healthcare industry for medical services or equipment taint the ability to provide...
Health Care Investigations
Healthcare leaders take note: Billing error can lead to AKS violation
Private practices, hospitals and other healthcare facilities balance an enormous workload. Many of these professionals entered the healthcare field to help patients manage their health. They likely find themselves also balancing business needs and reviewing practices...
Feds announce telemedicine healthcare fraud scheme
The United States Department of Justice (DOJ) recently announced seven guilty pleas in connection to a telemedicine healthcare fraud scheme. The agency first announced the scheme in December 2020. According to the prosecution, individuals connected to pharmacies were...
2 lessons about collaborative care and the AKS from recent case
The Department of Justice (DOJ) recently announced success in the prosecution of a case involving allegations of fraud within pharmacies located throughout New York and New Jersey. The government accused the pharmacy owners of paying kickbacks to doctors and...
Is this the dawn of a new value-based care era?
One can argue that value-based care is clearly in the patient’s best interest. Such arrangements allow for the patient to receive care from multiple specialists and reduce the financial burden that may come with visiting more than one physician. However, lawmakers...
HHS’ price transparency rule: Could it come at a worse time?
The United States Department of Health and Human Services’ (HHS) hospital price transparency rule went into effect January 1, 2021. Lawmakers intend the rule to help better ensure Americans have clear information about the cost of hospital items and services before...
How can healthcare execs defeat a whistleblower claim?
The federal government has a system in place that encourages current and former healthcare employees to report wrongdoing. This is achieved through qui tam, or whistleblower cases. The government benefits from this system because workers within healthcare...
3 ways HIPAA could change in 2021
The United States Department of Health and Human Services (HHS) recently recommended the government consider making a number of modifications to the Health Insurance Portability and Accountability Act (HIPAA). HHS states the recommendations are part of the agency’s...
Will CMS change how they handle nursing homes?
Those who run nursing home facilities must balance patient care, the needs of medical professionals serving these patients, the operations of the facility and the overall comfort of their residents within the confines of an array of federal, state and local...
Feds gain momentum with EKRA as doc takes plea deal
A group of medical professionals recently accepted plea deals in connection to a healthcare fraud scheme that operated through the country. The group had operations set up in multiple states, including New Jersey, Maryland, California. According to feds, the group...