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

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Med-Net Compliance

JUNE 22, 2022

A registered nurse from a veteran’s hospital in Detroit pleaded guilty to charges related to COVID-19 vaccination record cards fraud. Employees and applicants of healthcare facilities must provide truthful information regarding their vaccination status and understand the penalties for engaging in fraud.

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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. million in a case the DOJ described as one of the "largest healthcare fraud schemes in United States history. WHY IT MATTERS. " ON THE RECORD.

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Healthcare Compliance Blog

FEBRUARY 2, 2022

A New York optician has pled guilty to grand larceny for submitting false claims for optician services that he alleged were for specific nursing home residents, but which were never provided. Many of the residents for whom the optician submitted claims were deceased, and he never visited the nursing homes on the dates of the those claims.

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Health Care Performance

FEBRUARY 21, 2023

The scheme 25 people were charged with wire fraud – administrators and employees of three Florida nursing schools as well as recruiters. The recruiters sought out individuals that were willing to pay $10,000 to $15,000 for fake nursing school documents that allowed them to take national nursing licensure examinations.

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The Health Law Firm Blog

MARCH 14, 2024

Board Certified by The Florida Bar in Health Law On August 24, 2022, managed healthcare company, Centene Corporation, agreed to pay $19 million to the State of Washington to settle fraud allegations. Indest III, J.D., Centene owns and operates Sunshine State Health Plan, d/b/a Sunshine Health, in Florida. In addition, [.]

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Provider Trust

MAY 9, 2023

What is a Medicaid Fraud Control Unit (MFCU)? Fraud and abuse are unfortunate realities of the healthcare industry. Hundreds of claims and investigations are carried out yearly to combat the growing number of providers, organizations, and entities contributing to fraud and abuse within state and federal healthcare programs.

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Healthcare Compliance Blog

JANUARY 24, 2022

On January 19, 2022, the Massachusetts Medicaid Fraud Division announced that in calendar year 2021, more than $55 million was recovered from individuals and entities who defrauded the state. The Attorney General’s Medicaid Fraud Division investigates and prosecutes providers who defraud the state Medicaid program, MassHealth.

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Healthicity

NOVEMBER 1, 2022

Medicaid Fraud Control Units.

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The Health Law Firm

MARCH 9, 2023

Board Certified by The Florida Bar in Health Law In late February 2023, multiple states began taking action against licensed practical nurses (LPNs) and registered nurses (RNs) because of the FBI's "Operation Nightingale." This is also being pushed by the National Council of State Boards of Nursing (NCBSN). Indest III, J.D.,

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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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C&M Health Law

SEPTEMBER 11, 2023

Department of Health and Human Services, through the Centers for Medicare & Medicaid Services (“CMS”) issued a much anticipated and contested proposed rule that seeks to establish minimum staffing level requirements for nursing homes. hours of nursing staff per resident per day, or 3.0 HPRD from registered nurses (RNs) and 2.45

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Med-Net Compliance

NOVEMBER 2, 2022

Massachusetts Attorney General Maura Healey announced that her office’s Medicaid Fraud Division recovered more than $71 million during the most recent federal fiscal year, which ended on September 30. The AG’s Medicaid Fraud Division investigates and prosecutes providers who defraud the state’s Medicaid program, MassHealth.

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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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The Health Law Firm Blog

AUGUST 22, 2023

Board Certified by The Florida Bar in Health Law On June 15, 2023, a United States District Judge sentenced a Florida man to 15 years in prison for his role in an HIV prescription drug fraud scheme that amassed more than $230 million in two years. Indest III, J.D.,

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The Health Law Firm Blog

AUGUST 8, 2023

Board Certified by The Florida Bar in Health Law On June 15, 2023, a United States District Judge sentenced a Florida man to 15 years in prison for his role in an HIV prescription drug fraud scheme that amassed more than $230 million in two years. Indest III, J.D.,

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Med-Net Compliance

JULY 11, 2022

The report says that in FY 2021 the DOJ opened 831 new criminal healthcare fraud investigations. Federal prosecutors filed criminal charges in 462 cases involving 741 defendants, and a total of 312 defendants were convicted of healthcare fraud related crimes during the year. 2,947 investigations were pending at the end of FY 2021.

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HIT Consultant

DECEMBER 10, 2021

What You Should Know: – Report from Codoxo that finds 10-15% of telehealth claims fall outside of approved CMS codes and indicates a high potential for rapidly increasing fraud schemes (and provider coding errors) in a new telehealth era. Certified Clinical Nurse Specialist. Nurse Practitioner. Report Background.

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The Health Law Firm Blog

JULY 17, 2023

Board Certified by The Florida Bar in Health Law On June 15, 2023, a United States District Judge sentenced a Florida man to 15 years in prison for his role in an HIV prescription drug fraud scheme that amassed more than $230 million in two years. Indest III, J.D.,

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The Health Law Firm Blog

JUNE 26, 2023

Board Certified by The Florida Bar in Health Law On June 15, 2023, a United States District Judge sentenced a Florida man to 15 years in prison for his role in an HIV prescription drug fraud scheme that amassed more than $230 million in two years. Indest III, J.D.,

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MedTrainer

AUGUST 1, 2022

Here’s a look at one of the OIG’s current medicare investigations to curb fraud, waste, and abuse. Established in 1976, the Office of Inspector General (OIG) was created to fight fraud and abuse in Medicare and Medicaid. The OIG has recently set its sights on one particular group — skilled nursing facilities. A Look at the OIG.

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The Health Law Firm

FEBRUARY 3, 2021

Board Certified by The Florida Bar in Health Law On September 23, 2020, a Tennessee woman who posed as a nurse working at several medical facilities was sentenced to more than four years in prison. In December 2019, she pled guilty to wire fraud, healthcare fraud, identity theft, and practicing nursing without a license.

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Provider Trust

MARCH 13, 2023

Between 2016 and 2021, over 7,600 fake diplomas were sold to nursing students who used the fraudulent degrees to qualify for the National Council Licensure Exam (NCLEX). In addition, an estimated 37 percent of student nurses with fake diplomas passed the NCLEX.

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Healthcare Law Blog

JANUARY 17, 2023

As 2023 begins, the nursing home industry faces unprecedented challenges on multiple fronts. In addition, the government is bringing civil False Claims Act cases, and in some cases filing criminal health care fraud charges, against facilities that provide substandard care.

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Healthcare Compliance Blog

JANUARY 10, 2022

A South Carolina man has been arrested for financial transaction card fraud and exploitation of a vulnerable adult who was a resident of a nursing home. Due to his past criminal record, he also faces enhancement to the financial transaction card fraud charge.

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HIPAA Journal

DECEMBER 15, 2022

A former nurse employed by the Roswell Park Comprehensive Cancer Center in Buffalo, NY, has been sentenced to 37 months in prison for tampering with and stealing controlled medications intended for cancer patients. Mulvey, 30, of Grand Island, NY, worked as a registered nurse at Roswell Park between February 2018 and June 2018.

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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. Discussion Points: Review your policy and procedure for preventing and reporting false claims, kickbacks, or other fraud, waste, and abuse violations.

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Hall Render

FEBRUARY 8, 2023

Department of Health and Human Services Office of Inspector General (“OIG”) recently announced that it coordinated with law enforcement partners in launching a multi-state enforcement action dedicated to uncovering a massive fraudulent nursing diploma scheme. Fraudulent Scheme On January 25, 2023, the U.S.

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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 26, 2022

In connection with the enforcement action, the department seized over $8 million in cash, luxury vehicles, and other fraud proceeds. Issue: Nursing staff should monitor telemedicine appointments held with their residents, review related medical record documentation, and report any concerns with observed practices immediately.

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The Health Law Firm Blog

JANUARY 2, 2024

Board Certified by The Florida Bar in Health Law and Hartley Brooks, Law Clerk, The Health Law Firm On October 18, 2023, an ex-Navy officer was sentenced to 30 months in prison after he pleaded guilty to conspiracy to commit wire fraud for his role in an [.] Indest III, J.D.,

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Provider Trust

JANUARY 18, 2023

In October 2022, the South Carolina Medicaid Fraud Control Unit (SCMFCU) arrested a 37-year-old South Carolina woman named Alyssa Beth Steele for working as a registered nurse despite not having a license. Pursuant to federal regulations, the SCMFCU is authorized to investigate and prosecute any acts of Medicaid provider fraud.

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Med-Net Compliance

NOVEMBER 1, 2022

South Carolina Attorney General Alan Wilson announced that his office’s Medicaid Fraud Control Unit (SCMFCU) arrested a 37-year-old woman for allegedly practicing medicine as a registered nurse without a license at seven nursing and assisted living facilities in Anderson, Greenville, and Pickens counties.

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Healthcare Compliance Blog

MARCH 11, 2022

A Boston registered nurse (RN) has pled guilty to one count of tampering with a consumer product and one count of obtaining a controlled substance by fraud and deception. The RN was working in a nursing home when she tampered with morphine that was prescribed to a resident under her care.

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Healthicity

APRIL 2, 2024

The selected items relate to (1) nursing homes and (2) medications. March was a busy month for new additions to the OIG’s Work Plan. Some of the items fit nicely into two broad categories which we’ve grouped together and summarized below.

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Med-Net Compliance

JUNE 29, 2022

An Oklahoma nurse aide pleaded guilty to abusing a nursing home resident and was placed on a deferred sentence probation for three years under the supervision of the Oklahoma Department of Corrections. toward the cost of the investigation to the Office of the Attorney General Medicaid Fraud Control Unit (MFCU), $300.00

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Fierce Healthcare

APRIL 16, 2024

The National Association of ACOs (NAACOS) hosted a spring conference last week, with sessions on post-acute care, fraud, implementation best practices, health equity and legislative priorities. |

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