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Excluded Psychiatrist Results in Allegations of Violating the False Claims Act

Healthcare Compliance Blog

In 2006, the excluded psychiatrist was convicted in Florida of conspiracy to commit healthcare fraud. While he served as the clinical director, the psychiatry company and its owner billed and sought reimbursement from federal healthcare programs, including Medicare, Tricare, and the Railroad Retirement Medicare Program.

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How HHS-OIG, Regulators Enforce Vendor Compliance

Provider Trust

What the HHS-OIG says about vendor compliance. Additionally, check out this HHS-OIG 2016 report, Medicare: Vulnerabilities Related to Provider Enrollment and Ownership Disclosure , which revealed “vulnerabilities that could allow potentially fraudulent providers to enroll in the Medicare program.”. Case Study: S.

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What is HIPAA?

HIPAA Journal

Title II: Preventing health care fraud and abuse; administration simplification; medical liability reform. The provisions related to administrative simplification are discussed below, while the provisions for medical liability reform (of which there are few) only relate to whistle blower protection for reporting fraud and abuse.

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Seventh Circuit Clarifies “Authoritative Guidance” for the False Claims Act

Hall Render

However, some of the defendant’s customers typically paid less than the retail price for their medications through several discount programs that the defendant offered between 2006 and 2015. This footnote originated as a footnote in a memorandum issued by CMS in October of 2006. Practical Takeaways. Practical Takeaways.