SightLine Health LLC, a Texas radiotherapy center, recently took steps to end an ongoing investigation by the Department of Justice (DOJ). The DOJ was looking into allegations that the practice violated the Anti-Kickback Statute when it offered financial incentives to other medical practitioners in exchange for patient referrals.
Emergency Medical Services Alliance (EMSA) recently agreed to settle a claim based on allegations of Medicare fraud. Federal officials claimed that the ambulance service provider was submitting false claims for compensation from Medicare and Medicaid. This allegedly resulted in over $109 million in fraudulent payments.
A family operation faced accusations of healthcare fraud in Dallas. The operation, Anderson Optical & Hearing Aids Center, allegedly defrauded Blue Cross Blue Shield of Texas of over $16.7 million. A father and son run the facility. The father was convicted on 15 counts for healthcare fraud and identity theft. The son, 13 counts for the same crimes.
It is understandable that health care professionals and health care providers are under constant scrutiny for the service and work they provide. Medical care is highly specialized, and any mistake or issue that may arise could lead to serious complications for patients. But at the same time, medical professionals need to be protected from frivolous or otherwise unnecessary claims of malpractice, substandard care, or other violations of the law.
The Nursing Home Reform Law of 1987 states that a nursing home facility is not allowed to transfer or discharge a resident unless it can establish certain criteria. This law was passed as a result of complaints by residents throughout the country about evictions.
Scripps Health, a health care system based in San Diego, has agreed to settle federal False Claims Act allegations for $1.5 million. The Department of Justice accused the system of allowing unauthorized physical therapists to bill Medicare and TRICARE.
In a fact sheet released last year, the Obama administration touted its efforts in "reducing fraud, waste, and abuse across the government." But many observers believe the federal government still isn't doing enough to prevent fraud in Medicare and Medicaid.
Few people savor being cast in the role of David in a battle with Goliath. But just as the ancient story turned out favorably for the underdog, so too do more modern tales.
A recent sentence handed out by a federal judge in the Southern District of Texas has legal experts puzzled, news outlets report. The defendant is a 53-year-old Sugar Land mother of twin 7-year-old boys who had been found guilty of Medicare fraud in what has been described as a "relatively routine case."
It takes about four hours to drive north from Austin to Frisco, Texas. We are not sure how long it would take to walk those 220 miles, but we're pretty certain that you might need to visit a podiatrist after you arrive.