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Telemedicine Company Owner, Doctor Plead Guilty in Multimillion-Dollar Fraud

The owner and chief executive of a telemedicine company, along with a New Jersey physician, have pleaded guilty for their roles in one of the largest healthcare schemes ever, that resulted in charges against 24 defendants. On September 6, Lester Stockett pleaded guilty to one count of conspiracy to defraud the U.S. and pay and […]

Watchdog Agency Cracking Down on Improper Billing by HHAs

Last month, the U.S. Department of Health and Human Services Office of the Inspector General issued its latest report on a home health agency that it contends did not comply with Medicare billing requirements. It was one in a series of actions the watchdog agency has taken this year against HHAs, and part of what […]

DOJ Cites Significant Costs and Burdens on Request to Dismiss Qui Tam Case

The Department of Justice has once again exercised its authority under the False Claims Act in seeking the dismissal of a relator’s qui tam lawsuit. Government attorneys, in their motion to dismiss filed on Aug. 20, told the court that further litigation would result in imposing “significant costs and burdens on the government and waste […]

CMS Program to Give Providers Access to Medicare Patient Data

In an effort to accelerate the transformation of the nation’s healthcare system to one that is value-based, the Centers for Medicare & Medicaid Services (CMS), recently launched the Data at the Point of Care (DPC) pilot program. The pilot program, announced by CMS Administrator Seema Verma during a Blue Button Developer Conference, will give healthcare […]

MedPAC: Eliminate “Incident to” Billing for ARNPs and NPs

If Congress adopts the Medicare Payment Advisory Commission’s (MedPAC), most recent recommendations, “incident to” billing could become a thing of the past for Advanced Registered Nurse Practitioners (ARNPs) and Physician Assistants (PAs). The recommendation to eliminate “incident to” billing for these providers was made in MedPAC’s biennial report issued in June. MedPAC is an independent […]

Healthcare Data Breaches Continue to Break Records

There isn’t a day that goes by that some healthcare organization hasn’t fallen victim to a data breach. Thousands of patients from around the country are having their sensitive and personal healthcare information hijacked one way or another. From phishing emails sent to healthcare company employees, to ransomware attacks, to outright failure to secure patients’ […]

DOJ Intervenes in FCA Lawsuit Filed Against Medical Device Maker

The U.S. Department of Justice has intervened in a whistleblower lawsuit filed against medical device maker Life Spine Inc., along with the company’s founder and its VP for Business Development. The lawsuit alleges that the company paid millions of dollars in kickbacks to surgeons in exchange for using its spinal implants, equipment and other devices. […]

Labs Settle With UnitedHealthcare For $56.2 Million

UnitedHealthcare Insurance Co. has agreed to settle a lawsuit it filed in 2016 against five toxicology laboratory companies for $56.2 million. The suit, filed in U.S. District Court for the Southern District of Florida, alleged that medical testing lab executives offered kickbacks in the form of partnership shares to treatment facilities and doctors in exchange […]

Report: Many High-Risk Medicaid Providers Not Undergoing Critical Background Checks

Eighteen states failed to properly screen high-risk providers before allowing them to receive Medicaid payments by the July 2018 deadline and 13 of those states had not yet complied by Jan. 1, 2019. Those are the findings from a recently released report by the U.S. Department of Health and Human Services Office of Inspector General. […]

Growth of Telemedicine Sees Increase in Healthcare Fraud

Earlier this month, a New York anesthesiologist was indicted on charges stemming from her role in an alleged telemedicine conspiracy to submit fraudulent claims to federal and private insurance plans. The indictment alleges that Anna Steiner, also known as Hanna Wasielewska, along with others, ordered and prescribed durable medical equipment (DME) and prescription drugs in […]

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