Healthcare Compliance Blog

JANUARY 25, 2022

A Missouri woman who had previously pled guilty to Medicare and Medicaid fraud was sentenced in Federal Court to three years imprisonment and ordered to pay $7,620,779 in restitution. The DME companies would then submit the reimbursement claims to Medicare and Medicaid. Update your policies and procedures as needed.

Fraud 59

Fraud Medicaid Medicaid Medicare 59

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.

Fraud 178

Fraud COVID-19 Medicare Medicare 178

The Health Law Firm Blog

MARCH 25, 2024

Board Certified by The Florida Bar in Health Law On February 16, 2024, a Parkland, Florida, man agreed to plead guilty to organizing a Medicare fraud scheme worth $110 million. Indest III, J.D., The federal prosecution is taking place in the U.S. District Court for the District of Massachusetts.

Fraud 52

Fraud Medicare Medicare Telemedicine 52

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.

Telemedicine 64

Telemedicine Compliance COVID-19 Fraud 64

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. Healthcare organizations must take all possible steps to prevent instances of fraud.

Fraud 52

Fraud Medicare Medicare Compliance 52

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.

Fraud 59

Fraud Telemedicine Medicare Medicare 59

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.

Fraud 98

Fraud COVID-19 Public Health Medicare 98

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.

Fraud 181

Fraud COVID-19 Medicaid Medicaid 181

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.

Fraud 59

Fraud Telemedicine Nurses Governance 59

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. The group steered members to bill Medicaid rather than going through the NICA. Fraud Scheme. Fraud Scheme .

Fraud 52

Fraud Medicaid Medicaid Nursing Homes 52

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. This kind of fraud isn’t new, but the explosion in telehealth as a whole has made it much more common.

Fraud 69

Fraud COVID-19 Medicare Medicare 69

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

Fraud 59

Fraud Medicaid Medicaid Telemedicine 59

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.,

Telemedicine 40

Telemedicine Licensing Fraud Nurses 40

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.,

Telemedicine 52

Telemedicine Licensing Fraud Nurses 52

HIT Consultant

DECEMBER 6, 2022

trillion Consolidated Appropriations Act of 2022, which extended Medicare coverage related to telemedicine practices. As within many areas of health care, however, expansion and innovation contributed to a higher risk of fraud and resulted in an increase in enforcement activity. Telemental Health Becomes More Accessible Across States.

Compliance 98

Compliance Medicaid Medicaid COVID-19 98

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 […].

Fraud 61

Fraud COVID-19 Medicaid Medicaid 61

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. Meanwhile, the proposed two-year extension of COVID-19 era telemedicine waivers seems to give elected officials some breathing room with regard to permanent telehealth policy.

COVID-19 137

COVID-19 Telemedicine Medicare Medicare 137

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.

Telemedicine 52

Telemedicine Fraud Medicaid Medicaid 52

Healthcare IT News - Telehealth

JUNE 2, 2020

The moves by the Centers for Medicare and Medicaid Services to relax regulations around telehealth have been lauded by providers and patients around the country. Robin Kelly, D-Illinois, introduced a bill yesterday that would mandate a study on the effects of telehealth changes on Medicare and Medicaid during the COVID-19 crisis.

COVID-19 162

COVID-19 Telemedicine Medicare Medicare 162

Healthcare IT News - Telehealth

JANUARY 26, 2022

Please describe some of the emerging technology models in telemedicine and remote patient monitoring, and how they can help improve access to care for underserved populations. How do things look at the national and state levels for supporting expansion of telemedicine and remote patient monitoring during and following the pandemic?

Fraud 148

Fraud Telemedicine COVID-19 Licensing 148

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. companies operating internationally.

Compliance 52

Compliance Medical Billing Medical Billing Outsourcing HIPAA 52

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.

COVID-19 52

COVID-19 Fraud Telemedicine Public Health 52

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.

COVID-19 59

COVID-19 Telemedicine Compliance Informed Consent 59

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.

Compliance 52

Compliance HIPAA Telemedicine ACA 52

Healthcare Law Blog

MARCH 3, 2023

This surge was facilitated, in part, by certain flexibilities authorized by the Centers for Medicare & Medicaid Services in its response to the public health emergency (“PHE”) declared in March of 2020 and which was repeatedly renewed until now. On January 30, 2023, President Joe Biden announced that the PHE would end on May 11, 2023.

Fraud 52

Fraud Nurses Telemedicine COVID-19 52

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.

Medicare 45

Medicare Medicare Fraud Compliance 45

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

Compliance 52

Compliance Fraud Medicare Medicare 52

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.

COVID-19 125

COVID-19 Medicare Medicare Public Health 125

Provider Trust

FEBRUARY 3, 2023

This includes a number of provisions related to Medicaid and the Children’s Health Insurance Program (CHIP), but certain flexibilities were also extended to Telehealth until the end of 2024. In July 2022, the OIG issued a Special Fraud Alert urging providers to exercise caution before entering into arrangements with telemedicine companies.

Compliance 52

Compliance Fraud Nurses Telemedicine 52

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. Telemedicine Billing: The rise of telemedicine has led to the development of new billing procedures and codes to accommodate remote patient consultations.

Medical Billing 59

Medical Billing Medical Billing Outsourcing Medical Billing Services Compliance 59

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.

Compliance 52

Compliance Fraud HIPAA Governance 52

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.

Compliance 52

Compliance Fraud Telemedicine Licensing 52

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.

Compliance Officers 52

Compliance Officers Compliance US Department of Health and Human Services Governance 52

Florida Health Care Law Firm

FEBRUARY 22, 2022

He has also had assets forfeited since these assets were acquired with money from his ill-gotten fraud scheme. million from Medicare, ChampVA, and insurance using a scheme of telemarketing, telemedicine, and multiple DME providers or “store fronts.”. In total, Mr. Truglia and his co-conspirators collected approximately $18.5

Medicare 52

Medicare Medicare Telemedicine Fraud 52

Hall Render

DECEMBER 22, 2023

fraud scheme UConn Health is in financial trouble. fraud scheme UConn Health is in financial trouble. health care spending hits $4.5

Nursing Homes 40

Nursing Homes Nurses Hospitals COVID-19 40

Hall Render

SEPTEMBER 29, 2023

million into USF Health’s new nursing simulation lab UF Health to open ER in former Lake County CVS Nurse Practitioner Convicted of $200M Health Care Fraud Scheme Florida joins 3 other states in adopting new, paid maternity leave for state workers GEORGIA Albany nonprofit addresses medical debt with D.C. officials, helps South Ga.

US Department of Health and Human Services 40

US Department of Health and Human Services Nursing Homes Nurses Hospitals 40

Health Care Law Brief

JUNE 2, 2022

For example, the Department of Justice has aggressively pursued health care fraud claims against individuals and entities involved in non-compliant telehealth models. Does the state apply different standards, for example, to Medicaid encounters? If so, how will patient fees be structured to comport with these restrictions?

Public Health 52

Public Health Compliance COVID-19 Licensing 52