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 focusing on those who manufacture and distribute opioids.
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, Medicaid and Tricare for the procedures, which led to a federal investigation.
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.
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 investigation has allegedly led to evidence that he and others used these healthcare facilities to file fraudulent reimbursement claims.
The United States Department of Health and Human Services (HHS) recently announced it will invest $6.5 million into two commercial diagnostic labs. The agency has stated it expects the labs, one in Nashville, TN the other in Austin, TX, to use the funds to boost staffing and infrastructure with an ultimate goal of increasing their COVID-19 testing capacities.
As the government continues its crackdown on the opioid crisis, whether or not a pharmacy could find itself the center of a lawsuit for failing to fill an opioid prescription may seem like a surprising question. And yet, that is exactly what three big companies are currently facing. CVS, Walgreens and Costco were all named in a recent lawsuit for not filling opioid prescriptions. The lawsuit claims that because these pharmacy giants failed to fill these prescriptions, patients are unable to continue to manager pain from chronic conditions.
The Department of Justice (DOJ) is continuing its scrutiny of groups that provide Medicare Advantage plans. Just over a year ago, the Office of Inspector General reported that these plans led to billions in risk-adjusted payments that were not supported by specific services provided to patients - ultimately leading to allegations of health care fraud. This report has likely led to increased scrutiny of these programs, as recently highlighted in a case out of Texas.
The United States Centers for Medicare and Medicaid Services (CMS) has set a deadline for providers to begin repaying Accelerated and Advanced Payment Program (APP) loans provided through the Coronavirus Aid, Relief, and Economic Security (CARES) Act. In most cases, the repayment period was set to begin 120 days after the organization received payment. Unfortunately, many medical establishments continue to struggle to meet financial obligations as a result of the coronavirus pandemic.
The United States Department of Justice (DOJ) recently accused a group of 10 individuals of partaking in a health care fraud scheme that cost the government over $1 billion. The accused include hospital executives and diagnostic lab owners as well as billers.
The United States Centers for Medicare and Medicaid Services (CMS) recently released a publication outlining telehealth services that will be eligible for coverage in 2021. The agency’s list includes 39 telehealth-eligible services, such as: