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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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Preventing Genetic Testing Fraud: 5 Actions for Health Plans

Healthcare IT Today

The following is a guest article by Erin Rutzler, Vice President of Fraud, Waste, and Abuse at Cotiviti In Delaware, more than 250 Medicare patients underwent unnecessary genetic testing based on telehealth consultations that often lasted less than two minutes— costing Medicare thousands of dollars per patient. In 2021, a U.S.

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Texas Adult Day Care Owner Sentenced for Healthcare Fraud Scheme

Healthcare Compliance Blog

in restitution for her role in healthcare fraud, wire fraud, and theft of government funds. Court documents show that between 2008 and 2016 the former owner defrauded the Texas Medicaid program by billing for items and services that had not been provided to the clients of the day care centers. US Attorney Ashley C.

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What Are The Current Regulatory Changes And Compliance Requirements That ASCs Need To Be Aware Of In Their Billing Practices?

Healthcare IT Today

Each ASC is responsible for ensuring that they are in compliance with the numerous statutes and regulations that are in place at both the state and federal levels. However, ASC billing practices must be followed to ensure proper reimbursement and regulatory compliance. ASCs must also meet Medicare’s Conditions for Coverage.

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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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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. In February 2016, the psychiatry company and its owner hired the excluded psychiatrist as a clinical director. This conviction led to the psychiatrist being excluded from all federal healthcare programs.

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False Claims Lawsuit Filed Against Alabama Psychiatrist  for Improper Prescribing of Nuedexta to Nursing Home Resident

Healthcare Compliance Blog

The complaint alleges that an Alabama psychiatrist caused the submission to Medicare and Medicaid of false and fraudulent claims for the prescription drug Nuedexta. Routine audits should be conducted, and the results of the audits should be reported at the compliance and ethics committee meetings and in reports to the governing body.