Diagnostic labs, like any business within the health care industry, are subject to federal regulations. A failure to abide by these rules can result in serious consequences, including steep financial penalties and, if the violation is severe, potential imprisonment. Because of the seriousness of these penalties, it is a good idea to have a basic understanding of the applicable regulations. Some of the more well-known include:
Pockets throughout the country are experiencing a jump in COVID-19 cases that require medical intervention. As a result, local facilities are finding themselves facing an onslaught of patients. This surge can lead to physically and mentally overwhelmed medical professionals working to provide quality care in a rushed and urgent environment -- not a combination that can prove successful over an extended period of time. As a result, it is not a surprise that medical leaders are voicing concerns about a potential for a spike in medication errors.
The government continues its crackdown on the use of bribes in the medical field. Although it is noble to better ensure physicians are motivated by patient need and not financial gain, the distinction between what is legal and what is not can be difficult to determine. A recent case provides an example of this distinction and the extreme penalties that can come with a violation.
The Department of Justice (DOJ) recently accused a Texas pharmacist of partaking in a scheme to defraud the government. The agency claimed the medical professional and his wife billed the federal government for over $20 million for medically unnecessary topical medications. A third medical professional also faces allegations of criminal activity but is not in custody. The police are still attempting to locate this individual.
The government recently accused a Texas woman of partaking in a health care fraud scheme that took place in Arkansas. The woman allegedly used her role recruiting patients for a company that marketed prescription medications for a Mississippi pharmacy.
Health care fraud is a broad term used to encompass different allegations of criminal activity. The types of allegations the government commonly prosecutes for health care fraud can vary year to year.
The medical profession's first concern should be the welfare of the patient. Most physicians, nurses and other medical professionals go into this field because they share a similar belief. However, as is true in any profession, there are some who stray and find the lure of financial rewards too much to ignore.
The Centers for Medicare and Medicaid Services (CMS) take violations to healthcare laws very seriously. A conviction can come with hefty penalties that may include exclusion from federal healthcare programs, fines and, in severe cases, imprisonment.
A trial this week involving the once-celebrated Dallas-based Forest Park Medical Center is said to be one of the biggest health care fraud trials in history. There are as many as 150 witnesses as part of the government's case against ten defendants, which include four surgeons and one pain doctor.
Lawmakers often pass or change laws with good intentions. In some cases, those intentions may not translate in the real world. An attempt to thwart wrongdoing can result in an unnecessarily confining situation.