With the United States Centers for Disease Control and Prevention (CDC) reporting over 450,000 opioid overdose deaths in the country from 1999 to 2018, it should come as no surprise that the government continues its crackdown on opioid violations. The government is...
Health Care Investigations
Medical device manufacturer accused of illegal kickbacks
The Department of Justice (DOJ) recently pursued a case against a medical device manufacturer. The federal agency claimed the healthcare business used illegal kickbacks to encourage medical professionals to use their products. The physicians would then bill Medicare,...
Gov’t increases focus on healthcare fraud and telehealth services
The Department of Health and Human Services (HHS) Office of Inspector General (OIG) has increased its focus on healthcare fraud schemes involving telehealth services. The OIG began this increased focus in 2016. These efforts contributed to a massive takedown in...
Study finds errors in HRRP leading to faulty penalties
The Centers for Medicare and Medicaid Services (CMS) oversees the Hospital Readmissions Reduction Program (HRRP). Lawmakers developed this program to help better ensure the provision of quality, value-based care. To help achieve this goal, the HRRP reviews...
Nursing home administrators: Be on the watch for this new scheme
A new COVID-19 related testing scheme is the latest in a series of attempts to defraud nursing home residents. Nursing home administrators are wise to be aware of this latest scheme to help better ensure the safety of their residents.Details of this scheme Nursing...
What does my medical practice need to know about HIPAA violations?
The Health Insurance Portability and Accountability Act (HIPAA) applies to sensitive patient health information. Medical practitioners are wise to understand how this federal law impacts their practice. Three important facts about this law include: #1: Not everyone is...
Whistleblower begins FCA case against dentist
A former employee recently filed a claim against a dentist. In this claim, the worker does not allege that they were personally injured. In fact, the claim does not even directly involve the worker. Instead, the claim states the dentist and oral surgeon fraudulently...
Lessons from record setting HIPAA fine
The United States Department of Health and Human Services (HHS) recently announced a $6.85 million settlement with Premera Blue Cross, a private health insurance provider, to settle claims the company violated the Health Insurance Portability and Accountability Act...
Is my physician group patient-centric?
The term patient-centric is a popular, sometimes overused, catch phrase within the healthcare industry these days. Although overuse is problematic, there is value to reviewing your practice’s business plan to make sure the culture provides a positive patient...
TX pharmacy owner arrested for healthcare fraud
Government officials have accused a Texas pharmacy owner of filing more than $5 million in fraudulent claims to several healthcare programs. The entrepreneur owned multiple pharmacies in Southern Texas, most notably in the Houston and Pharr areas. A government...