Healthcare IT News - Telehealth

JULY 22, 2022

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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The Health Law Firm

FEBRUARY 14, 2022

Board Certified by The Florida Bar in Health Law On November 2, 2021, a doctor and his wife who had been indicted for their roles in a $1.3 million Medicare fraud scheme asked a New Jersey court to eliminate a bail condition. The doctor argued that the bail condition impeded his ability to practice medicine. Indest III, J.D.,

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The Health Law Firm Blog

MARCH 16, 2022

Board Certified by The Florida Bar in Health Law On November 2, 2021, a doctor and his wife who had been indicted for their roles in a $1.3 million Medicare fraud scheme asked a New Jersey court to eliminate a bail condition. The doctor argued that the. Indest III, J.D.,

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Verisys

MARCH 8, 2024

Million Medicare and Medicaid Fraud Full Story Pharmacist Fraud Pharmacy Owner and Operations Manager Convicted of $2.3M February 2024 Bad Actor Roundup By Verisys Each month we will give a roundup of recent healthcare fraudsters and compliance busters. Peters Physician Pleads Guilty to False Statements, Resulting in $1.4

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The Health Law Firm

OCTOBER 31, 2019

Board Certified by The Florida Bar in Health Law On October 1, 2019, a Florida doctor was implicated in what federal investigators say is one of the largest health care fraud schemes ever charged. The vast fraud scheme totaled $2.1 billion worth of false Medicare and Medicaid claims between July 2018 and January 2019.

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The Health Law Firm

OCTOBER 3, 2019

Board Certified by The Florida Bar in Health Law On October 1, 2019, a Florida doctor was implicated in what federal investigators say is one of the largest health care fraud schemes ever charged. The vast fraud scheme totaled $2.1 billion worth of false Medicare and Medicaid claims between July 2018 and January 2019.

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Med-Net Compliance

JULY 26, 2022

In connection with the enforcement action, the department seized over $8 million in cash, luxury vehicles, and other fraud proceeds. Additionally, the Centers for Medicare & Medicaid Services (CMS), Center for Program Integrity (CPI), announced that it took administrative actions against 52 providers involved in similar schemes.

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Verisys

FEBRUARY 9, 2024

Here is a round up of bad actors: Physician Fraud Glastonbury Psychologist Admits Defrauding Medicaid of More Than $1.6 Here is a round up of bad actors: Physician Fraud Glastonbury Psychologist Admits Defrauding Medicaid of More Than $1.6 Million Civil Judgment and Drug Treatment Center Enters Settlement to Pay $2.2

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HIPAA Journal

JUNE 9, 2023

Prior to the Supreme Court ruling, there was no distinction between an identity thief stealing an individual’s identity and running up huge debts, a lawyer rounding up bills and only charging full hours, a waitress overcharging customers, and a doctor overbilling Medicaid. The Supreme Court decision related to the latter.

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The Health Law Firm

SEPTEMBER 25, 2018

Board Certified by The Florida Bar in Health Law On August 22, 2018, a doctor received a sentence of one year and a day in prison from a New York federal court for his part in a $30 million scheme to defraud Medicare and the state Medicaid program. Indest III, J.D., Lies and Cover-ups.

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The Health Law Firm Blog

JUNE 1, 2023

Board Certified by The Florida Bar in Health Law On November 18, 2021, a Tallahassee surgeon was sentenced to seven years in federal prison for committing health care fraud, conspiracy to commit health care fraud, and aggravated identity theft. Indest III, J.D., The scheme involved performing hundreds of medically unnecessary, [.]

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Med-Net Compliance

JULY 1, 2022

Fifteen Texas doctors have agreed to pay a total of $2,831,280 to resolve False Claims Act allegations involving illegal kickbacks in violation of the Anti-Kickback Statute and Stark Law, and to cooperate with the Department of Justice’s investigations of and litigation against other parties.

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The Health Law Firm Blog

MARCH 7, 2022

Board Certified by The Florida Bar in Health Law On November 18, 2021, a Tallahassee surgeon was sentenced to seven years in federal prison for committing health care fraud, conspiracy to commit health care fraud, and aggravated identity theft. Indest III, J.D., The scheme involved performing hundreds of medically unnecessary,

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The Health Law Firm Blog

APRIL 20, 2023

Board Certified by The Florida Bar in Health Law On November 18, 2021, a Tallahassee surgeon was sentenced to seven years in federal prison for committing health care fraud, conspiracy to commit health care fraud, and aggravated identity theft. Indest III, J.D., The scheme involved performing hundreds of medically unnecessary, [.]

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The Health Law Firm Blog

JANUARY 24, 2022

Board Certified by The Florida Bar in Health Law On November 18, 2021, a Tallahassee surgeon was sentenced to seven years in federal prison for committing health care fraud, conspiracy to commit health care fraud, and aggravated identity theft. Indest III, J.D., The scheme involved performing hundreds of medically unnecessary,

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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. With Medicaid, the challenges are equally formidable.

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The Health Law Firm

DECEMBER 24, 2016

In June 2016, Banio Koroma, 67, appeared in court in an orange jumpsuit after being jailed for violating his bond when it was discovered that he had again committed fraud by mailing fake checks to strangers. Paying For His Crimes.

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Healthcare IT News - Telehealth

AUGUST 11, 2021

Andrew Vanlandingham, senior counselor for Medicaid Policy and acting health IT lead at OIG, called attention to recent revisions to safe harbors under the Anti-Kickback Statute and Civil Monetary Penalty Rules around coordinated care. " DME fraud has been around since Medicare started reimbursing for it, of course.

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HIPAA Journal

JUNE 28, 2023

Individuals that have suffered identity theft, medical fraud, tax fraud, other forms of fraud, and other actual misuses of their personal information, can submit claims for documented, unreimbursed extraordinary losses that are reasonably traceable to the data breach of up to a maximum of $5,000.

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Compliancy Group

MARCH 22, 2024

Compliance Program A comprehensive way to avoid Medicare exclusion is to develop an organization-wide compliance program, one of the Centers for Medicare and Medicaid Services (CMS) requirements. An example is knowingly billing for services a doctor hasn’t provided. Waste is not always intentional.

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Med-Net Compliance

SEPTEMBER 23, 2022

A physician pleaded guilty in federal court to falsely certifying that products and tests were medically necessary for more than 2,000 Medicare and Medicaid patients in Missouri whom he never met or examined. The orders that he signed for genetic testing for Medicaid beneficiaries caused Medicaid to be billed more than $2.5

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American Medical Compliance

JANUARY 9, 2024

This type of theft is just one example of healthcare fraud. Through Medicare, Medicaid, and the Children’s Health Insurance Program, the federal government and state governments offer health care coverage to nearly 100 million individuals. As a result of their large size, these healthcare systems are easy targets for fraud.

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Kaiser Health News

APRIL 16, 2024

As a result, the lawsuit alleges, consumers lost access to their doctors or medications and faced financial costs, such as owing money toward medical care or having to repay tax credits that were paid toward the unauthorized coverage. Some consumers were switched multiple times or had duplicative policies.

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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 several accrediting organizations that require facilities to meet or exceed Medicaid and Medicare guidelines.

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The Health Law Firm

NOVEMBER 7, 2011

Doctor Pleas Nolo Contendre to Fraud Charge. On December 9, 2010, he entered a plea of nolo contendere in federal court to a charge of conspiracy to commit fraud upon the United States in violation of 18 USC. § § 371.

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Healthcare IT News - Telehealth

DECEMBER 13, 2021

"This forward-looking bill, based on expert, independent recommendations, provides clarity, certainty, and a foundation for building a telemedicine system that expands access, preserves patient choice, and includes basic safeguards against fraud and exploitation," said Doggett. WHY IT MATTERS. Mike Kelly, D-Pennsylvania.

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American Medical Compliance

AUGUST 1, 2022

In Spring 2022’s Semiannual Report to Congress (SAR), the Department of Health and Human Services’ Office of Inspector General (HHS-OIG) reported that nearly $3 billion had been misspent on Medicare and Medicaid services. The report also included civil lawsuits and settlements. HHS Examines Medicare Spending and COVID-19 Tests.

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AIHC

AUGUST 30, 2023

Written by: Nancie Lee Cummins, CFE, CHA, CIFHA, OHCC, CHCM, CHCO, CORCM Due to the high volume of fraud schemes involving telemarketing revealed by the Department of Justice (DOJ) over recent years, it is important that providers heed “buyer beware” when engaging with a telemarketing firm. “If If it is too good to be true it probably isn't.”

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American Medical Compliance

AUGUST 1, 2022

In Spring 2022’s Semiannual Report to Congress (SAR), the Department of Health and Human Services’ Office of Inspector General (HHS-OIG) reported that nearly $3 billion had been misspent on Medicare and Medicaid services. The report also included civil lawsuits and settlements. HHS Examines Medicare Spending and COVID-19 Tests.

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US Department of Health and Human Services COVID-19 Nursing Homes Medicare 52

Hall Render

APRIL 19, 2024

Cedars Leads Latest Round Of Funding In Yolo County, 16,000 Medi-Cal patients lose doctors in Dignity Health dispute with Partnership HealthPlan Kaiser med school names CEO Kaiser Permanente launches food-is-medicine hub Kaiser, Vizient target healthcare greenhouse gas emissions L.A. Can lawmakers do anything about it?

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Healthcare Compliance Blog

MARCH 2, 2022

An indictment was filed on February 25, 2022, against ten persons in Florida for their alleged roles in a $67 million healthcare fraud, wire fraud kickback, and money laundering scheme. The defendants allegedly paid kickbacks and bribes to telemedicine companies in exchange for doctors’ orders for tests and durable medical equipment.

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Kaiser Health News

NOVEMBER 11, 2021

Yet federal officials say complaints are rising from seniors tricked into buying policies — without their consent or lured by questionable information — that may not cover their drugs or include their doctors. She found out when she visited her doctor, who did not accept her new insurance.

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The Health Law Firm

MAY 4, 2012

Over 100 doctors, nurses and other health professionals were arrested on charges relating to Medicare fraud by federal agents on May 2, 2012. By George F. Indest III, J.D., Board Certified by The Florida Bar in Health Law. The arrests were made in seven cities nationwide, but more than half took place in South Florida.

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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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Healthcare IT News - Telehealth

SEPTEMBER 2, 2021

According to the agency , the conspiracy involved paying a telemedicine company to arrange for doctors to authorize medically unnecessary genetic testing. Fraud has been raised as a concern regarding the future of telehealth regulations – and, indeed, a few cases have made splashy headlines over the past year. THE LARGER TREND.

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Pharmacy Law Blog

MARCH 8, 2018

On December 6, 2017, three nurse practitioners and a doctor were arrested following an Alabama federal grand jury indictment accusing them of operating a “pill mill.” They face maximum sentences of 10 years in prison on the health care fraud counts. Doctor, 3 Nurse Practitioners Charged With Running ‘Pill Mill’ ” Law360.

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The Health Law Firm Blog

JULY 8, 2023

By George F. Indest III, J.D., Board Certified by The Florida Bar in Health Law On February 23, 2022, a psychiatric practice and its owner agreed to pay $310,874 to resolve allegations they improperly hired and employed a physician who was excluded from federal healthcare programs. The physician who was hired was on [.]

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