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Florida woman to pay $20.3M after using telemedicine to shield alleged fraud

Healthcare IT News - Telehealth

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. In reality, the DOJ alleges, the conspirators had bribed doctors to approve the claims. Kelly Wolfe and her company, Regency, Inc., WHY IT MATTERS.

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Two Healthcare Organizations Caught Up in Medicare Fraud Schemes

Compliancy Group

In one incident, a New Jersey pharmacy admitted to conspiracies to defraud benefits providers, including Medicare and Medicaid, of $65 million for medications never provided to patients. In the other fraud scheme, Medicare patients were billed an estimated $2 billion for urinary catheters they never received.

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What Compliance Officers Need to Know About Stark Laws in Healthcare

Compliancy Group

Many compliance violations in healthcare arise from financial conflicts of interest, particularly when providers get kickbacks or achieve financial gain from their referral services. By removing this potential conflict of interest, doctors are more incentivized to act in a patient’s best interest.

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When Will Self-Service Come to Health Care?

Health Populi

At least one in three people who have tried out virtual health care have done so because they use technology in all aspects of life and want to do the same with their healthcare. A common theme at health care meetings these days is how and when health care will meet its Amazon, Apple, or Uber moment? ” .

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Significant Upcoding Risks Emerge with Medicare Advantage

YouCompli

Approximately 65 million Americans are enrolled in Medicare – about 34 million in traditional Medicare and the rest in Medicare Advantage. Traditional Medicare is administered by the federal government, and individuals pay a separate monthly premium for hospital visits, doctors/outpatient, and prescription drugs.

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Hundreds of industry groups call on Congress to advance permanent telehealth reform

Healthcare IT News - Telehealth

"Much of this transformation is dependent on temporary flexibilities extended to health systems and providers that are limited to the duration of the COVID-19 public health emergency declaration," the letter read. WHY IT MATTERS.

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Reactions to the Ascension Healthcare Ransomware Attack and Suggestions for Healthcare Organizations

Healthcare IT Today

Mike Semel, President and Chief Security Officer of Semel Consulting The Ascension health system data breach can’t be easily separated from the United Healthcare Change Health breach that recently caused a huge financial and medical impact across the healthcare sector and may have breached the personal information for a third of Americans.