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Physicians and Group Practices Archives

How does the claim CMS overpaid $500 million affect your practice?

The United States Health and Human Services Department (HHS) Inspector General states the Centers for Medicare and Medicaid Services (CMS) overpaid claims by $502 million from 2011 through 2014. The error was allegedly due to a malfunction in the outlier payment review process.

TX physicians take note: New law may impact health care billing

The Texas Legislature has recently proposed a new rule that will limit health billing options. Lawmakers state the new law, scheduled to go into effect January 1, will help protect patients from surprise medical bills. But medical professionals have voiced concern the law may have unintended, negative consequences for patients.

Texas Medical Board suspends 7 physicians in October

The Texas Medical Board (TMB) has the power to decide who can and who cannot practice medicine in the state. The group regulates the practice of medicine by reviewing complaints and, in some cases, suspending the medical license of the accused. Unfortunately, such actions are not uncommon. The TMB suspended 31 physicians in 2018.

TMB agrees to review OB based on a complaint from the 80s

The case began when a 32-year-old woman began to investigate her family tree. She knew her parents had used a donor for conception, as they had struggled with fertility issues. When her own son began to suffer from severe health problems she began to investigate her family history to see if there was a genetic explanation.

2 TX doctors face repercussions from DOJ and TMB for false claims

Physicians and other medical professionals that face allegations of wrongdoing can find themselves dealing with more than just a government investigation. In many cases, these allegations can result in action by the state licensing board.

Two TX ORI clinics agree to settlement in Medicare fraud case

Seven Osteo Relief Institute (ORI) clinics from throughout the country have agreed to settle a Medicare fraud claim with the government. Two clinics are in Texas, one in Dallas the other San Antonio. The others are in Phoenix, Arizona, Lexington, Kentucky, Wall Township, New Jersey and Colorado Springs, Colorado. The United States Department of Justice (DOJ) states the clinics knowingly billed Medicare in violation of the False Claims Act.

Jury finds TX doctor guilty of health care fraud

The Department of Justice (DOJ) recently arrested a Texas physician based on allegations of conspiracy to commit health care fraud, conspiracy to solicit and receive health care kickbacks and false statements relating to health care matters. Overall, the government claims the physician falsely billed Medicare for approximately $16 million in unnecessary services or services that patients did not receive.

Defense tries to remove judge in opioid case

The country is in the midst of an opioid crisis. The government has come down hard on those connected with the over-prescription of these highly addictive medications to help hold those who played a role in the crisis accountable and deter similar errors in the future. As a result, the government has filed thousands of lawsuits against medical professionals, drug companies and pharmacies based on allegations of criminal wrongdoing connected to the prescription of opioids that include Anti-Kickback (AKS) violations.

Entrepreneurs & the TX healthcare industry: Tips for success

Investing in the health care industry is generally a profitable endeavor. In fact, a report by CNBC states the health care industry is one of the top five profitable franchises within the country. Getting into this market can result in large financial rewards … if done wisely.

Selling your private practice? 3 tips for a successful transition.

Putting together a private practice in the medical field is about more than just practicing medicine or starting a business. Those who put in the time and effort to establish a successful practice likely become a part of the community. As a result, when it comes time to retire or move on to other professional endeavors, private practice owners likely hope to set the facility up for a successful transition.

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