Healthcare IT News - Telehealth

APRIL 21, 2022

Attorney's Office for the Eastern District of New York announced Thursday that an orthopedic surgeon had been arrested and charged with healthcare fraud. According to the indictment, which was unsealed this week, Raffai was paid by telemedicine companies for each consultation with a beneficiary. WHY IT MATTERS. THE LARGER TREND.

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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 of that loss involved allegedly fraudulent claims related to telemedicine. billion in alleged losses. More than $1.1

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Healthcare IT News - Telehealth

APRIL 10, 2019

Hundreds of thousands patients were lured into worldwide criminal healthcare fraud schemes involving telemedicine and durable medical equipment (DME) executives, according to the FBI and Department of Justice. WHY IT MATTERS. billion in losses. ON THE RECORD. WHAT ELSE TO KNOW. billion in claims and were paid over $900 million.

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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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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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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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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.

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Verisys

DECEMBER 13, 2023

Healthcare Fraud Crackdown! The post Healthcare Fraud Crackdown: Telehealth Fraud & Improper Billing Scams | Verisys appeared first on Verisys. Each month we will give a roundup of recent healthcare fraudsters and compliance busters. Secure your success by choosing Verisys.

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Healthcare IT News - Telehealth

DECEMBER 17, 2021

Department of Justice announced this past Friday that it had charged four people, one of whom is a licensed physician, in an international telehealth fraud and kickback scheme. billion in schemes relating to telemedicine. million in a case the DOJ described as one of the "largest healthcare fraud schemes in United States history.

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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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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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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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Verisys

APRIL 2, 2024

Here is a round up of bad actors: Physician Fraud Physician pays $1.8M Million Medicare Fraud Scheme ( Full Story ) New York-Presbyterian/Brooklyn Methodist Hospital Settles Health Care Fraud Claims for $17.3 Here is a round up of bad actors: Physician Fraud Physician pays $1.8M

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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

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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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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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 physician ordered durable medical equipment and genetic tests for 2,184 Medicare beneficiaries between March 2019 and April 2021.

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YouCompli

AUGUST 29, 2023

Fraud, waste, and abuse (FWA) associated with telehealth services existed before COVID-19, but it significantly increased during the pandemic. The audit also identified 1,714 providers whose billing for telehealth services for about a half million beneficiaries during the first year of the pandemic posed a high risk to Medicare.

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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. Mahoney said the restrictions inadvertently create a "donut hole" for Medicare Fee for Service patients, allowing the health system to offer care to everyone but them.

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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 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. According to a statement released by the U.S.

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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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Health Law Advisor

MARCH 7, 2023

The proposed rules are more restrictive than the DEA emergency waivers under which providers conducted telemedicine prescribing for the last three years, but are less restrictive in comparison to the pre-PHE regulations applicable to telemedicine prescribing of controlled substances under the federal Controlled Substances Act (“CSA”).

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YouCompli

JULY 26, 2023

Fraud, waste, and abuse (FWA) associated with telehealth services existed before COVID-19, but it significantly increased during the pandemic. The audit also identified 1,714 providers whose billing for telehealth services during the first year of the pandemic posed a high risk to Medicare. million in Medicare fee-for-service payments.

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YouCompli

JULY 12, 2022

In fact, Medicare beneficiaries used telehealth to receive 12 percent of their services during the first year of the pandemic. An initial report from the OIG also notes that, “over 28 million Medicare beneficiaries used telehealth during the first year of the pandemic. This was more than two in five Medicare beneficiaries.

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Healthcare IT News - Telehealth

APRIL 18, 2022

As outlined in the settlement agreement , PPOA is accused of using telemedicine during the COVID-19 pandemic to allegedly try and compensate for revenue lost from elective services. "Shortly thereafter, PPOA instructed medical providers to begin seeing patients by telemedicine twice a month." WHY IT MATTERS.

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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 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.

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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

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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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.

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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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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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The Health Law Firm

MAY 15, 2020

Board Certified by The Florida Bar in Health Law On February 5, 2020, the owners of two telemedicine companies were charged in New Jersey federal court with defrauding Medicare in an alleged $56 million telehealth scheme involving orthotic braces. Some of the fraud alleged to have occurred was through a Florida location.

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