The new coronavirus was recently officially labeled a pandemic. As the number of confirmed cases throughout the country continues to grow, the odds health care professionals will come into contact with COVID-19 become more likely.
The government recently accused a doctor of fraudulently billing Medicare, Medicaid and private insurance providers for office visits totaling over $26 million. The government claims the physician billed insurance providers for "nonexistent procedures." If supported, the allegations could lead to serious financial penalties and, depending on the details of the accusations, potential imprisonment.
There are certain federal laws that impact a physician no matter where they practice medicine. One example is the False Claims Act (FCA). This law essentially makes it illegal to submit claims for payment from Medicare or Medicaid that the physician knows or should have known was a false or fraudulent claim.
Software companies marketed electronic health record (EHR) programs as a way to help better ensure quality patient care. In theory, the software would provide accurate, up to date patient records that were readily available to the treating physician. In reality, flaws in some EHR programs led to dangerous errors.
A Texas neurologist recently filed a lawsuit against the Texas Medical Board (TMB) due to its failure to remove a disciplinary filing against him from the federal National Practitioner Data Bank (NPDB). The physician argues this filing should be removed as he was exonerated. The TMB states removal is "beyond its authority."
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.
A group of researchers, led by experts with Johns Hopkins Armstrong Institute for Patient Safety and Quality, found three major disease categories are responsible for the majority of diagnostic errors. The group hopes that education about these categories will reduce the rate of diagnostic errors.
The Texas Medical Board recently took away a local oncologist's medical license. Two former patients accused the physician of "improper behavior." As a result, the board severely restricted his ability to practice medicine.
The Department of Health and Human Services (HHS) has stated that changes to the physician self-referral system are likely in the near future. The Trump administration is considering changes to the Stark law with a goal of encouraging coordinated care. An official with the Trump administration expects changes by the end of the year.
It is not uncommon for physicians to receive compensation from pharmaceutical and medical device manufacturers. In many cases such compensation is legal. However, a misstep can lead to allegations of wrongdoing potentially including the illegal use of kickbacks to support the use of a medical device.