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Dozens charged in sprawling $1.2B telehealth and genetics fraud crackdown

Healthcare IT News - Telehealth

billion in alleged fraud involving telehealth, phony genetic testing and durable medical equipment. Meanwhile, the Centers for Medicare and Medicaid Services' Center for Program Integrity also announced that it has taken administrative actions against more than 50 healthcare providers alleged to be involved in similar schemes.

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Federal Jury Convicts New York Doctor of Healthcare Fraud Scheme

Med-Net Compliance

A federal jury convicted a New York ENT doctor for defrauding Medicare and Medicaid by causing the submission of false and fraudulent claims for surgical procedures that were not performed. Medicare and Medicaid data demonstrated that he was identified as an outlier and the highest biller for this procedure in New York State.

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Nursing Home Psychologist Convicted of Healthcare Fraud Scheme

Med-Net Compliance

A federal jury convicted a licensed Illinois psychologist of defrauding Medicare over the course of several years by causing the submission of fraudulent claims for psychotherapy services he never provided. The psychologist was convicted of four counts of healthcare fraud.

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Everything You Need To Know About NPI Numbers

Verisys

The NPI improves the Medicare and Medicaid programs, other federal and private health programs, and the overall effectiveness and efficiency of the healthcare industry by simplifying administration and enabling the efficient electronic transmission of health information. Providers also need an NPI to enroll in Medicare.

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Florida Woman Lands Herself 6.5 Years in Prison, Owes $45 Million for Medicare Fraud Scheme

Pharmacy Law Blog

On November 22, 2017, a Florida woman who was accused of a $45 million Medicare fraud, received a six-and-a-half-year prison sentence, following a 2016 U.S. This came after a 2016 guilty plea to a charge of conspiracy to commit health care fraud. By George F. Indest III, J.D., Board Certified by The Florida Bar in Health Law.

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SafeCo No More: The Changing Landscape of Scienter under the False Claims Act

Health Law RX

The Prior SafeCo Standard Until yesterday, defendants could seek dismissal of fraud claims based on the absence of scienter by relying on the two-part test codified by the Court in SafeCo Ins. A mistake is still a mistake, not fraud. of America v. 3] That test posed two questions. per 30-day supply). [9] per 30-day supply). [10]

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Everything You Need To Know About NPI Numbers

Verisys

Providers also need an NPI prior to enrolling in Medicare. In July 1993, the Centers for Medicare and Medicaid Services ( CMS ) undertook a project to develop a healthcare provider identification system to meet the needs of the Medicare and Medicaid programs and the needs of a national identification system for all providers.

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