In 2018, Congress enacted the Eliminating Kickbacks in Recover Act (EKRA). This law remains relatively untested. As such, labs can learn valuable lessons by watching court cases that are navigating this law.
What led to the first EKRA conviction?
Spine device manufacturer faces lawsuit for health care fraud
The United States Department of Justice (DOJ) recently announced it was pursuing allegations of health care fraud against a spine device manufacturer along with its executives.
What were the accusations?
Doctor gets arrested for coughing on nurses: 3 things to know
Nurses at an outpatient surgery clinic called the police on a doctor that was allegedly intentionally coughing on and hugging nurses. The nurses state the orthopedic surgeon repeatedly acted out in this manner in front of multiple witnesses. A representative speaking on behalf of the nurses states the physician was acting in complete disregard to “space and safety concerns involving the coronavirus pandemic.” The nurses further allege the physician was acting in a manner to intentionally cause “a substantial amount of alarm.” The doctor is not known to currently have the virus.
One key difference between civil and criminal AKS violations
The government uses the Anti-Kickback Statute (AKS) to help better ensure doctors are not letting financial gain impact decisions about patient care. As a result, the government may make an AKS claim if a doctor is getting payment or has some financial benefit from an arrangement with other health care providers.
Allegations can result in a civil or criminal lawsuit.
3 things to know about continuing education and nursing in NJ
The New Jersey Board of Nursing requires nursing to complete continuing education (CE) to keep an active nursing license in the state. Nurses in the state can use the following information to help better ensure they meet this requirement.
Question #1: How much CE does the Board require?
The Board requires a minimum of 30 contact hours of CE during the two-year period that proceeds renewal. This is true for anyone who wants to keep an active license, whether currently working or not.
Another option for those who want to keep their license current but not put in the CE time is to put their license into an inactive status. Although this removes the CE requirement, it also means the nurse will need to go through a reactivation process before the Board will allow the license to return to active status.
Doctors trained abroad: Getting a NY medical license
Practicing medicine takes more than just countless hours of study, passage of exams and additional preparation. In the United States, it also requires an official medical license from the state the doctor wishes to have their practice.
Can doctors who are trained in other countries practice in the U.S.?
Yes, but the details of the process will vary for each state. Generally, doctors trained abroad who wish to practice will need to complete additional educational courses before a state will grant licensure. It is not uncommon for foreign programs to focus on field work. In the United States, the training program also requires foundational knowledge in physiology, biology, chemistry and the like. As a result, leaders in the field have decided this additional coursework is advantageous before a foreign trained physician can begin their practice in the U.S.
State medical board investigation leads to loss of DEA license
Regulations require physicians have a special license to prescribe controlled substances. The physician who wishes to offer these services to patients must generally receive a Drug Enforcement Administration (DEA) registration. Getting such a license generally involves completing requirements that can vary by state. The process is often connected to the state medical license.
A recent case provides an example of how fragile this license can be.
Why does the CMS’ now require disclosure of certain affiliations?
As noted in a previous post, CMS changes tactics, targets health care provider affiliates, the Centers for Medicare and Medicaid Services (CMS) has a new tool in its fight against health care fraud. The tool allows the agency to go after those who affiliate with certain “bad actors,” or other professionals previously accused of health care fraud violations.
In order to avoid prosecution, the CMS’ new rule requires health care providers disclose their affiliations with such parties.
CDC provides guidance for COVID-19 samples
The United States Centers for Disease Control and Prevention (CDC) recently provided guidelines for health care providers who wish to have samples tested for the new coronavirus. The agency states all labs should preform risk assessments to identify and mitigate any potential risks and encourages caution when handling specimens.
The agency’s guidelines focus on two main areas: the type of specimen and proper shipping technique.
NY pharmacist charged with health care fraud and tax crimes
New York officials recently charged a local pharmacy owner of Anti-Kickback Statute (AKS) violations and tax crimes. Prosecutors claim the man, along with others associated with the pharmacy, began illegally bribing doctors to use their pharmacy for services in 2010. In addition to cash payments, the government claimed the accused offered expensive meals and lavish gifts to entice doctors and doctors' employees in New Jersey and New York to send prescriptions to their facility.
The government claims that as a result of these efforts, the accused earned $33.9 million in additional income.
