Healthcare Law Blog

DECEMBER 1, 2023

The Department of Health and Human Services (HHS) and the Department of Justice (DOJ) recently released its “Health Care Fraud and Abuse Control Program Annual Report for Fiscal Year 2022 ” (the “Report”), highlighting continued enforcement and recovery actions under the Health Care Fraud and Abuse Control Program (HCFAC).

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Healthcare Compliance Blog

JANUARY 24, 2022

On January 19, 2022, the Massachusetts Medicaid Fraud Division announced that in calendar year 2021, more than $55 million was recovered from individuals and entities who defrauded the state. The Attorney General’s Medicaid Fraud Division investigates and prosecutes providers who defraud the state Medicaid program, MassHealth.

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Healthcare Compliance Blog

FEBRUARY 4, 2022

The woman is charged with 259 counts of access device fraud, 16 counts of identity theft, and four counts of contributing to the delinquency of a juvenile. The post Louisiana Woman Arrested for Stealing from Nursing Home Resident appeared first on.

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Healthcare Compliance Blog

JANUARY 10, 2022

A South Carolina man has been arrested for financial transaction card fraud and exploitation of a vulnerable adult who was a resident of a nursing home. Due to his past criminal record, he also faces enhancement to the financial transaction card fraud charge.

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Healthcare Compliance Blog

FEBRUARY 8, 2022

The United States has filed a lawsuit against an Alabama psychiatrist for improper prescribing of Nuedexta to nursing home residents. In return, the psychiatrist prescribed Nuedexta to nursing home residents who did not have pseudobulbar affect.

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Provider Trust

AUGUST 9, 2023

Grimm, the OIG continues its tireless efforts to uncover instances of fraud, waste, and abuse within HHS programs. OIG continues to work tirelessly to identify instances of fraud, waste, and abuse and prosecute offenders. Through years of oversight, they have discovered various obstacles and weaknesses within nursing home facilities.

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Provider Trust

JULY 17, 2023

Their guidance aims to improve a number of potential risks within the healthcare space by improving care at nursing homes and strengthening the program integrity in managed care. OIG pointed to the increased instances of patient neglect abuse as well as the need for oversight within nursing homes.

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MedTrainer

JANUARY 30, 2024

In this blog, we’ll outline what types of healthcare facilities are required by the government to have a compliance program and why compliance is crucial for both healthcare organizations and the agencies that support them. Nursing Homes: Skilled nursing facilities, long-term care facilities, and other types of nursing homes.

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YouCompli

AUGUST 2, 2022

Wolf, MD provides enforcement action summaries for the YouCompli blog. MorseLife Nursing Home Health System was alleged to have provided vaccines to individuals who were not eligible under this program. Different kinds of fraud and abuse have sprung up in relation to vaccination cards. MorseLife agreed to pay $1.75

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Healthcare Compliance Blog

FEBRUARY 3, 2022

A mother and her two daughters have been charged for providing fraudulent COVID-19 vaccination cards to maintain and obtain employment at a New York nursing home. Vaccination is mandatory for nursing home employment in New York. Bassett stated, “Vaccination fraud is a serious crime.

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Healthcare Compliance Blog

MARCH 11, 2022

A Boston registered nurse (RN) has pled guilty to one count of tampering with a consumer product and one count of obtaining a controlled substance by fraud and deception. The RN was working in a nursing home when she tampered with morphine that was prescribed to a resident under her care.

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MedTrainer

JANUARY 10, 2024

The OIG is making major investments to systematically detect and prosecute fraud. In this guidance it’s clear the OIG expects healthcare organizations and suppliers to understand their role and responsibilities to fight fraud, waste, and abuse. We all should be a LOT more prepared!

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Pharmacy Law Blog

FEBRUARY 13, 2018

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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The Health Law Firm

MARCH 14, 2013

Individuals working in the health care industry, whether for hospitals, nursing homes, medical groups, home health agencies or others, often become aware of questionable activities. In many cases the activity may amount to fraud on the government. Click here to read the first part of this blog.

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Hall Render

FEBRUARY 27, 2023

This has been a growing trend in health care enforcement, and health care fraud remained the leading source of all FCA cases in 2022. Health Care Fraud Actions Medicaid. DOJ filed claims against multiple nursing homes and their management corporation for providing services that the DOJ alleged were grossly below the standard of care.

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The Health Law Firm

MARCH 13, 2013

Individuals working in the health care industry, whether for hospitals, nursing homes, medical groups, home health agencies or others, often become aware of questionable activities. In many cases the activity may amount to fraud on the government. This is the first blog of a two-part series.

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Healthcare Compliance Blog

MAY 11, 2022

The South Carolina Attorney General announced that his office’s Medicaid Fraud Control Unit (SCMFCU) had arrested a 57-year-old woman on two counts of Exploitation of a Vulnerable Adult and two counts of Breach of Trust with Fraudulent Intent, value of $10,000 or more.

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MedTrainer

SEPTEMBER 20, 2023

Examples of covered entities include health plans, clearinghouses, and certain health care providers including but not limited to: doctors, clinics, psychologists, dentists, chiropractors, nursing homes, and pharmacies. There are a number of laws built to fight against Medicare/Medicaid noncompliance and fraud.

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Healthcare Compliance Blog

MARCH 28, 2022

An Illinois licensed practical nurse (LPN) was convicted and sentenced for failing to administer lifesaving measures to a resident in a nursing home in 2017. The woman, 45, pleaded guilty to an amended charge of Reckless Conduct (Class A Misdemeanor).

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Provider Trust

JANUARY 25, 2024

This report helps HHS fulfill its mission to improve the health and well-being of Americans while also providing suggestions for how healthcare organizations can stay ahead of the curve to avoid and combat fraud, waste, and abuse. Unfortunately, Medicare Advantage programs are not exempt from instances of fraud, waste, and abuse.

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MedTrainer

NOVEMBER 6, 2023

While specific compliance requirements vary depending on the type of facility — from large hospitals and surgery centers to clinics and nursing homes — having a well-structured compliance plan is essential for all medical settings. But what exactly is a compliance plan in healthcare, and why is it so crucial?

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MedTrainer

MARCH 8, 2024

Download the Ultimate List of Training Requirements for Long-Term Care to see a full list of federal training requirements for nursing homes and skilled nursing staff broken down by role, with the applicable standard, CMS violation category, and frequency.

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Healthcare Compliance Blog

APRIL 6, 2022

The nurse was sentenced to six months under house arrest and may not seek reinstatement of her license or work in a care facility/home during her five-year supervision period. Issue: Nursing staff should be knowledgeable of standards of care, and the facility’s policies and procedures for implementing them.

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Med Law Blog

MAY 1, 2023

Howell, Constantine Yannelis and Abhinav Gupta positing that their research shows that “PE ownership increases short term mortality of Medicare patients by 10%, in nursing homes”.

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YouCompli

JANUARY 4, 2022

Unger, Chief of Medicaid Fraud Division, Office of the Massachusetts Attorney General; and Patrick Callahan, Healthcare Fraud Unit, US Attorney’s Office. Unger reported that her unit is focused on about 65% Medicare fraud and about 35% abuse and neglect. Millions in dollars in fraud are happening this way,” Callahan said.

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Hall Render

NOVEMBER 10, 2023

Since the release of its first compliance program guidance (“CPG”) for hospitals in 1998, OIG has developed a series of voluntary CPGs directed at various subsets of the health care industry, such as hospitals, nursing homes, third-party billing companies, clinical laboratories, among many others.

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Healthcare Law Blog

JANUARY 17, 2023

As 2023 begins, the nursing home industry faces unprecedented challenges on multiple fronts. In addition, the government is bringing civil False Claims Act cases, and in some cases filing criminal health care fraud charges, against facilities that provide substandard care.

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Hall Render

JULY 12, 2023

Selection Approach In establishing the proposed SFP, CMS examined the Special Focus Facility program for nursing homes and its methodology for facility selection. Hall Render blog posts and articles are intended for informational purposes only. CMS’ goal is to select SFP hospices starting in 2024. Markette, Jr.,

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Verisys

NOVEMBER 20, 2022

If you are looking for something to read prior to turkey or afterwards, here is a round up of bad actors: Pharma Fraud: . Pharma Fraud. Pharma Fraud . Pharma Fraud. Fraud Scheme. Fraud Scheme. Fraud Scheme . Fraud Scheme. Telemedicine Fraud: . Telemedicine fraud. . Fraud Scheme.

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Healthcare Law Blog

NOVEMBER 16, 2023

More broadly, the Final Rule is an important step towards achieving the Biden-Harris Administration’s stated goal of increasing nursing home transparency and accountability. In particular, CMS is interested in evaluating how certain ownership structures impact care and treatment outcomes.

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AIHC

FEBRUARY 16, 2024

The GCPG standardized the seven Elements of a Successful Compliance Program, which differs slightly from the individual compliance guidance documents (CPGs) directed at various segments of the health care industry, such as hospitals, nursing homes, third-party billers, and durable medical equipment suppliers.

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AIHC

FEBRUARY 16, 2024

The GCPG standardized the seven Elements of a Successful Compliance Program, which differs slightly from the individual compliance guidance documents (CPGs) directed at various segments of the health care industry, such as hospitals, nursing homes, third-party billers, and durable medical equipment suppliers.

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Compliance US Department of Health and Human Services COVID-19 Hospitals 52

Hall Render

APRIL 14, 2023

NATIONAL 94% of Organizations Experienced a Cyberattack in 2022 AHA blog: Strengthening crisis management in rural health care Biden signs bill ending Covid-19 national emergency Cancer drug shortages are creating dire circumstances for some patients CMS Releases FY24 IPPS Proposed Rule, Seeks to Boost Rates by 2.8%

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Drug & Device Law

DECEMBER 29, 2023

2023) ( Buckman preemption barred MDL asserting fraud on EPA), cert. This year’s Drug & Device Law Blog top ten decisions of the year reinforced preemption – the most powerful defense we can assert. If any of these are your cases, the Blog congratulates you. Monsanto Co. , 4th 1261 (11th Cir. 4th 851 (6th Cir. 4th 696 (3d.

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Drug & Device Law

JANUARY 17, 2024

O’Lear is a criminal case, in which the defendant was convicted by a jury of healthcare fraud (billing Medicare and Medicaid for fictitious mobile X-rays at nursing homes) and aggravated identity theft. (The Ninth Circuit okayed such exclusions in a couple of unpublished memoranda dispositions.)

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