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 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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Health Law Checkup

AUGUST 9, 2022

On July 20, 2022, the OIG released a Fraud Alert encouraging practitioners to exercise caution when entering into arrangements with telemedicine companies, given the various fraud and abuse risks associated with such arrangements, including an increased risk of fraudulent claims to Medicare, Medicaid, and other federal healthcare programs.

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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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American Medical Compliance

MARCH 13, 2023

The United States Department of Justice charged 36 defendants for healthcare fraud that amounted to over $1 Billion. The fraudulent actions included telemedicine, cancer and cardiovascular testing, and fraudulent durable medical equipment. Many of these individuals targeted elderly patients who receive Medicare benefits.

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Med-Net Compliance

JULY 26, 2022

billion in alleged fraudulent telemedicine, cardiovascular and cancer genetic testing, and durable medical equipment (DME) schemes. In connection with the enforcement action, the department seized over $8 million in cash, luxury vehicles, and other fraud proceeds.

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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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Healthcare IT News - Telehealth

SEPTEMBER 27, 2021

The brief, which examined oversight efforts as of January and February 2020, stemmed from a survey of Medicaid directors from 37 states, as well as structured interviews with relevant stakeholders. In response to COVID-19, patients have regularly turned to telemedicine for behavioral health needs. THE LARGER TREND. ON THE RECORD.

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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 durable medical equipment for Medicare beneficiaries caused Medicare to be billed more than $6.2

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Healthcare IT Today

SEPTEMBER 21, 2022

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. For example telehealth utilization increased 63x (in Medicare alone!) Is Telehealth Fraud Getting Harder to Identify?

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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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Healthcare IT News - Telehealth

DECEMBER 13, 2021

The bill, the Telehealth Extension Act , would also end geographic and site restrictions on approved telemedicine services for Medicare beneficiaries. Despite being broadly popular on both sides of the aisle , the geographic- and site-related Medicare provisions the new bill would establish have yet to be enshrined by Congress.

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The Health Law Firm Blog

JULY 20, 2023

Board Certified by The Florida Bar in Health Law On April 6, 2022, Florida's Governor signed into law legislation to remove the state's prior restrictions on telemedicine prescribing of controlled substances. The new law in Florida allows healthcare providers to prescribe many controlled substances via telemedicine. Indest III, J.D.,

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The Health Law Firm Blog

APRIL 24, 2022

Board Certified by The Florida Bar in Health Law On April 6, 2022, Florida's Governor signed into law legislation to remove the state's prior restrictions on telemedicine prescribing of controlled substances. The new law in Florida allows healthcare providers to prescribe many controlled substances via telemedicine. Indest III, J.D.,

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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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Healthcare IT News - Telehealth

SEPTEMBER 2, 2021

Department of Justice announced this week that a Florida laboratory owner had pleaded guilty for his role in a $73 million Medicare kickback scheme. According to the agency , the conspiracy involved paying a telemedicine company to arrange for doctors to authorize medically unnecessary genetic testing. THE LARGER TREND. ON THE RECORD.

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Medisys Compliance

JANUARY 30, 2023

Medicare and Medicaid: Medicare and Medicaid are government-funded healthcare programs that provide coverage to millions of Americans. These can include additional privacy and security requirements, as well as laws related to medical billing and coding , fraud and abuse, and other issues.

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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 Have you thought of Telemedicine or Telehealth

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MedTrainer

JANUARY 12, 2024

The adoption of electronic health records (EHRs), telemedicine , and data analytics has brought about new challenges and opportunities. Medicare and Medicaid (1960s): The introduction of government-funded healthcare programs brought about increased scrutiny and regulation.

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AIHC

SEPTEMBER 5, 2023

Telemedicine is considered to be under the umbrella of telehealth and refers specifically to clinical services. Telehealth and telemedicine cover similar services, including medical education, remote patient monitoring, patient consultation via videoconferencing, wireless health applications, and transmission of imaging and medical reports.

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Health Law Blog

OCTOBER 29, 2018

IT Donation to Facilitate Telemedicine Consultations – Low Risk of Fraud says OIG. The OIG’s analysis and conclusion of the Proposed Arrangement provides new insight into the government’s position on these type of donations that facilitate telemedicine encounters. The Office of Inspector General (“OIG”) of the U.S.

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Healthcare Law Blog

DECEMBER 12, 2022

Now, almost three years later, governmental entities have focused their attention on telehealth services and the potential for fraud and abuse. The Centers for Medicare & Medicaid Services (“CMS”) temporarily approved certain telehealth flexibilities during the PHE. in healthcare fraud for fraudulent telemedicine schemes.

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MedTrainer

OCTOBER 4, 2023

These regulations and laws help maintain patient confidentiality, ensure quality care, and prevent fraud and abuse within the healthcare industry. These requirements are designed to protect patient rights, privacy, and safety, as well as to prevent fraud, abuse, and other improper practices within healthcare organizations.

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Medisys Compliance

OCTOBER 20, 2023

Insurance Reimbursement: Emergency medical services are typically covered by various insurance plans, including public programs like Medicare and Medicaid, as well as private insurance. Reimbursement is based on contract agreements and fee schedules.

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Florida Health Care Law Firm

FEBRUARY 22, 2022

In yet another take-down of an illicit scheme to defraud the Medicare Program and ChampVA, as well as other insurers, Patsy Truglia has been sentenced to 15 years in federal prison. He has also had assets forfeited since these assets were acquired with money from his ill-gotten fraud scheme. million being paid to Truglia and company.

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Verisys

JANUARY 25, 2023

In short, an entity will lose the ability to service patients or members with Medicare or Medicaid insurance. Employing an individual will jeopardize a healthcare provider’s ability to continue federal programs. A heavy fine follows based on the length and engagement.

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Hall Render

MAY 10, 2024

Million CALIFORNIA California hospital dismisses CEO California physician pleads guilty to $2.5M million expansion ‘Very, very unusual.’ Million CALIFORNIA California hospital dismisses CEO California physician pleads guilty to $2.5M million expansion ‘Very, very unusual.’ million expansion ‘Very, very unusual.’

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Verisys

FEBRUARY 23, 2022

The Social Security Act establishes rules for reimbursement from Medicare, Medicaid, and CHIP. The False Claims Act prevents fraud and abuse by making it illegal to file false medical claims. HCO Best Practices Ensure Patient Safety. Healthcare compliance officers are responsible to safeguard patient privacy and safety.

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Health Care Law Brief

JUNE 2, 2022

Similarly, with respect to Medicare, Congress extended certain Medicare telehealth flexibilities for 151 days following the conclusion of the PHE, as part of the Fiscal Year 2022 Omnibus appropriations bill. Does the state apply different standards, for example, to Medicaid encounters? Provider Licenses.

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Healthcare Law Blog

FEBRUARY 1, 2023

Congress’s expansion of access to telehealth takes steps to ensure continuity of care for Medicare beneficiaries and provides regulators with additional time to determine which flexibilities will become permanent, indicating a success for the telehealth industry as well as a reminder that there is more legislation to come.

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Hall Render

JULY 28, 2023

million for rural hospital expansion Hospices in Arizona & other states receive scrutiny over concerns of fraud, waste & abuse Phoenix Children’s Building New 44,000-Square Foot Level IV Neonatal Intensive Care Unit Firefighters oppose Banner’s planned $400M hospital There’s a growing nurse shortage in Arizona.

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Healthcare IT News - Telehealth

NOVEMBER 22, 2021

A survey put forward by the national healthcare, life science and workforce management law firm Epstein Becker Green found that telemental health services have increased in quantity this year – as have fraud-related enforcement actions at the state and federal levels. For instance, it cited efforts this year from the U.S.

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Hall Render

JANUARY 11, 2023

For example, reimbursement under Medicare and Medicaid for certain telemedicine services was significantly increased due to the COVID-19 pandemic. State law – App developers should also be mindful of the numerous state laws that may apply to the provision of health services through their apps.

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Health Law RX

AUGUST 1, 2022

While this new flexibility increased access to care, it also increased opportunities for fraud. Department of Health and Human Services (HHS) Office of Inspector General (OIG) issued a Special Fraud Alert cautioning Practitioners about potential fraudulent telemedicine contracts ( Fraud Alert ). On July 20, 2022, the U.S.

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Hall Render

SEPTEMBER 16, 2022

Full 4th Circuit to tackle Medicaid fraud standard under False Claims Act. House passes reform to Medicare Advantage prior authorizations. Massachusetts nurse pleads guilty in $100M fraud scheme. Louis County Couple Sentenced for Defrauding Medicaid. New York improperly billed Medicaid $84.3M, OIG says.

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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. A psychiatrist caught improperly billing over $1.36M to Medicare over the course of seven years. Fraud Scheme. Fraud Scheme.

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Hall Render

NOVEMBER 4, 2022

AMA scrutinizes lack of competition, consumer harms in Medicare Advantage plans. CMS makes big changes to Medicare Shared Savings Program. 2 orthopedic hospitals facing Medicare readmission penalties. Governor Hutchinson Announces Expansion To Rural Health Services With ARHOME Medicaid Program. percent in final rule.

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