Bill of Health

NOVEMBER 7, 2022

The longer the pandemic continues, the more obvious it is how effective the sweeping federal and state laws shielding medical providers from malpractice associated with COVID-19 have been. population experiences multiple COVID-19 infections do not meet any of them. Need for a Governmental Solution.

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Healthcare IT News - Telehealth

MARCH 1, 2021

Department of Health and Human Services' Office of Inspector General recognized telehealth's potential while cautioning that steps must be taken to ensure virtual care will not be compromised by fraud. Grimm in her statement also differentiated between telehealth fraud and "telefraud" schemes. THE LARGER TREND.

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Fraud Telemedicine Department of Veterans Affairs COVID-19 188

Compliance Now

FEBRUARY 7, 2022

On February 4, 2022, additional guidance was issued on the federal mandate requiring health plans to provide over-the-counter (OTC) COVID-19 tests at no cost to participants. Plans are not required to make all brands of OTC COVID-19 tests available through the direct coverage program.

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Healthcare IT News - Telehealth

SEPTEMBER 20, 2021

Department of Justice announced this past week that it was bringing criminal charges against 138 total defendants for their alleged participation in various healthcare fraud schemes, resulting in about $1.4 billion in alleged losses. More than $1.1 billion of that loss involved allegedly fraudulent claims related to telemedicine.

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The Health Law Firm

MARCH 14, 2022

According to the indictment, the former eye doctor was charged with fraudulently obtaining government-guaranteed small business loans under the Paycheck Protection Program (PPP) a COVID-19 relief program.

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Healthcare IT News - Telehealth

FEBRUARY 22, 2021

Department of Justice announced earlier this month that an Indian Rocks Beach, Florida-based woman has pleaded guilty to conspiracy to commit healthcare fraud and filing a false tax return. The DOJ describes the case as involving one of the largest healthcare fraud schemes in U.S. Kelly Wolfe and her company, Regency, Inc.,

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Fraud Telemedicine US Department of Health and Human Services Medicare 184

HIT Consultant

AUGUST 17, 2023

Erin Rutzler, VP of Fraud, Waste, and Abuse at Cotiviti As behavioral health claim volumes continue to increase, there’s a growing need for health plans to be vigilant in spotting fraud, waste and abuse. But not every plan has access to a large SIU to combat fraud, waste and abuse in behavioral health.

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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. Bassett stated, “Vaccination fraud is a serious crime. Train appropriate staff to ensure authenticity of COVID-19 vaccination records.

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Med-Net Compliance

AUGUST 8, 2022

Two Texas men have been charged with conspiracy to commit and committing wire fraud during the COVID-19 pandemic involving medical-grade nitrile gloves. The two men were both charged with conspiracy to commit wire fraud, and defendant 1 also faces an additional five counts of wire fraud.

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HIT Consultant

DECEMBER 10, 2021

What You Should Know: – Report from Codoxo that finds 10-15% of telehealth claims fall outside of approved CMS codes and indicates a high potential for rapidly increasing fraud schemes (and provider coding errors) in a new telehealth era. The new baseline appears non-reactive to the emergence of new COVID-19 cases.

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Fraud COVID-19 Nurses Licensing 98

Verisys

MAY 13, 2024

Here is a round up of bad actors: Doctor sentenced to 10 years in prison for unlawfully dispensing controlled substances ( Full Story ) Doctor Convicted for $5.4M Here is a round up of bad actors: Doctor sentenced to 10 years in prison for unlawfully dispensing controlled substances ( Full Story ) Doctor Convicted for $5.4M

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HIT Consultant

OCTOBER 18, 2021

Capturing and combatting fraud in today’s healthcare landscape requires the convergence of innovation and experience to drive value beyond the margins. Organizations must take a multi-layered approach to identify, address, and prevent fraud. The second type, indirect fraud, involves several bad actors that coordinate their efforts.

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Health Law Checkup

JANUARY 20, 2022

Despite the pandemic, the DOJ is continuing to investigate allegations of health care fraud. A recent settlement from Wheeling Hospital serves as a reminder to hospitals to review their physician compensation arrangements to ensure that they are within fair market value and considered commercially reasonable.

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HIPAA Journal

DECEMBER 7, 2022

The COVID-19 vaccination statuses of approximately 500,000 Department of Veterans Affairs employees have been impermissibly disclosed. The spreadsheet also included details of claimed religious and medical exceptions to COVID-19 vaccination.

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COVID-19 Vaccine COVID-19 Department of Veterans Affairs Licensing 81

HIT Consultant

SEPTEMBER 30, 2021

Given these conditions, it is not surprising that over 40 states in the US have reported increases in opioid-related mortality since the COVID-19 pandemic began. Similarly, a recent JAMA study found a pronounced increase in opioid-involved overdose deaths during initial stay-at-home orders. .

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Healthcare IT News - Telehealth

JANUARY 27, 2021

Department of Justice announced Monday that four people and one company have recently pleaded guilty in a telemedicine pharmacy healthcare-fraud conspiracy that allegedly lasted for years. "Telemarketing fraud is a major threat to the integrity of government and commercial insurance programs," said Derrick L. ON THE RECORD.

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Fraud Telemedicine Ransomware COVID-19 128

Med-Net Compliance

JULY 7, 2022

A federal district judge in Miami sentenced the last of five defendants for his role in a healthcare fraud scheme operated out of a physical therapy clinic. The two clinic owners also used the business to fraudulently obtain COVID-19 relief funds. Staff should be knowledgeable and aware of what may be considered a false claim.

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Fraud COVID-19 Health Insurance Compliance 59

Healthcare IT Today

MAY 5, 2023

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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Fraud Medicare Medicare Overpayments 62

Healthcare IT News - Telehealth

SEPTEMBER 27, 2021

"CMS and state efforts to evaluate and oversee telehealth are critical to meeting Medicaid enrollees' behavioral health needs and to safeguarding the Medicaid program from potential fraud, waste and abuse," wrote OIG officials. In response to COVID-19, patients have regularly turned to telemedicine for behavioral health needs.

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Fraud COVID-19 Medicaid Medicaid 175

Healthcare IT Today

SEPTEMBER 21, 2022

Since the COVID pandemic began, healthcare has never had further reach of accessibility. New types of fraud are continually emerging, and it’s also become harder to uncover with traditional approaches. The telehealth market is growing at a significant rate, and fraud is continuing to grow with it.

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Fraud COVID-19 Medicare Medicare 69

American Medical Compliance

JUNE 11, 2023

The COVID-19 pandemic has brought about unprecedented challenges and disruptions across the globe. Alongside the health crisis, there has been an alarming rise in fraud, waste, and abuse related to COVID-19 relief efforts. Many government agencies around the country respond to the rise in COVID-Related Misconduct.

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Governance COVID-19 Fraud Compliance 52

Healthcare IT Today

OCTOBER 22, 2020

The US Department of Justice has filed charges against 345 defendants, including more than 100 medical professionals, accusing them of engaging in healthcare fraud schemes. The […].

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Fraud COVID-19 Medicaid Medicaid 61

McBrayer Law Blog

SEPTEMBER 28, 2021

Posted In COVID-19 , Health Care Fraud , Healthcare Regulation , Telehealth The shift to telemedicine in the United States predates the pandemic, but COVID-19 has accelerated its widespread use.

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Telemedicine Compliance COVID-19 Fraud 64

The Health Law Firm

MARCH 3, 2021

By George F. Indest III, J.D., Board Certified by The Florida Bar in Health Law On February 23, 2021, a federal court in Orlando, Florida, ruled that Adventist Health System Sunbelt (now known as AdventHealth, and which owns Florida Hospital, among others) could pursue claims it has over a bad $57.5

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Healthcare IT News - Telehealth

DECEMBER 13, 2021

A group of legislators from the House Ways and Means Health Subcommittee have introduced a bill aimed at temporarily extending telehealth flexibilities established during the COVID-19 pandemic. "The COVID-19 pandemic has shifted how rural Americans receive health care in fundamental ways," said Rep.

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Healthcare It News

MARCH 2, 2022

One of the lasting lessons of the COVID-19 pandemic is the insidious and corrosive power of mis- and disinformation to undermine public health efforts. Fraud and the Gates foundation stand to make billions from a forced COVID vaccine!" " "Dr. When we developed the playbook, we were doing two things.

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Public Health COVID-19 Health Outcomes Fraud 239

Med-Net Compliance

JULY 13, 2022

Two California brothers were both sentenced to 36 months of probation and ordered to pay $500 dollars in restitution after pleading guilty to misdemeanor conspiracy to steal or convert government property charges stemming from the theft of Centers for Disease Control (CDC) COVID-19 Vaccination Record Cards.

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COVID-19 Vaccine US Department of Health and Human Services COVID-19 Fraud 59

Compliance Now

JANUARY 11, 2022

On January 10, the Department of Labor issued FAQs establishing new requirements for health plans to pay for over-the-counter (OTC) COVID-19 tests as preventive care. The FAQs specifically require that plans cover OTC COVID-19 tests without imposing any cost-sharing, prior authorization, or other medical management requirements.

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COVID-19 Fraud Public Health Compliance 100

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. Led by acting Inspector General Christi A. A Message from Acting Inspector General Christi A.

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Nursing Homes COVID-19 Fraud Medicaid 52

Healthcare Compliance Blog

FEBRUARY 7, 2022

A Michigan woman has pled guilty to stealing government funds that were designated to aid medical providers in the treatment of patients suffering from COVID-19 and acknowledged using the money for her own personal use. She is scheduled to be sentenced on May 19, and faces a maximum penalty of 10 years in prison.

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COVID-19 Fraud Governance Compliance 59

Healthcare IT News - Telehealth

MARCH 2, 2021

Policymakers and stakeholders emphasized the importance of balancing access to care with addressing concerns around fraud and overutilization. When it comes to fraud – a frequently invoked fear in conversations around telehealth – some experts said the concern was overblown. Doris Matsui, D-Calif. Larry Bucshon, R-Ind.

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Fraud Telemedicine COVID-19 Medicare 190

YouCompli

AUGUST 29, 2023

Fraud, waste, and abuse (FWA) associated with telehealth services existed before COVID-19, but it significantly increased during the pandemic. Situation One: Before the Pandemic   In April 2019, government officials announced Operation Brace Yourself: a fraud takedown related to telemedicine and durable medical equipment (DME).

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Fraud Medicare Medicare COVID-19 52

HIT Consultant

DECEMBER 10, 2021

The report is being released as the COVID-19 pandemic continues to not only spur innovation at health systems, but also impede traditional approaches to care delivery. Fraud Schemes in a Telehealth Era: What Healthcare Payers Should Know. The new baseline appears non-reactive to the emergence of new COVID-19 cases.

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COVID-19 Fraud Nurses Licensing 98

Healthcare IT News - Telehealth

MAY 13, 2022

The owners of a national telehealth company pleaded guilty this week to charges of conspiracy to violate the federal Anti-Kickback Statute and to commit healthcare fraud. Law enforcement agencies have ramped up the pressure on telehealth fraud, particularly amid the COVID-19 pandemic. THE LARGER TREND.

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Doctors Fraud COVID-19 Medicare 146

MedTrainer

JULY 28, 2023

Earlier this year, an in-depth OIG investigation resulted in a six-day trial of a former Louisiana health clinic CEO , who was ultimately convicted of Medicaid fraud and sentenced to 82 months in federal prison. But what exactly is considered fraud, waste, and abuse? These complaints can trigger an audit. Data Analysis and Trends.

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Fraud Compliance Medicaid Medicaid 98

C&M Health Law

NOVEMBER 25, 2020

Earlier this month, OIG issued a Special Fraud Alert on Speaker Programs warning drug and device companies and health care providers that it has significant concerns about payments for “speaker programs.” In light of the COVID-19 pandemic, OIG recognizes that the speaker activity may have slowed. free food and drink).

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Healthcare Law Blog

DECEMBER 12, 2022

The COVID-19 Public Health Emergency (“PHE”) led to a rapid expansion in the utilization of telehealth. Now, almost three years later, governmental entities have focused their attention on telehealth services and the potential for fraud and abuse. Notable Updates. Anticipated Termination of the PHE. Increased DOJ Activity.

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COVID-19 Fraud Telemedicine Public Health 52