Data shows approximately half of all physicians will face a medical malpractice lawsuit at some point during their professional career. Top causes for a lawsuit include a failure to diagnose an illness or a poor outcome after a medical procedure.
Two physicians and an operating room technician filed a whistleblower lawsuit against a group of neurosurgeons and the medical facility where they operated. The whistleblowers accused the medical professionals of falsely inflating the number of spinal surgeries in an effort to increase their earnings and patient referrals. The hospital countered that the practices used were standard throughout the profession. If the whistleblower can support the claim, the allegations result in a violation of the Stark Law and the Anti-Kickback Statute (AKS).
Private practices in Texas must navigate federal, state and local health care regulations. They must stay current and make sure their businesses are in line with any changes to the law. As a result, private practices throughout the state are likely reviewing their billing practices to make sure they are in line with a newly passed law designed by lawmakers to limit surprise 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.
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.
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.
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.
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.
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.
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.