The public generally views the health care industry as a stable career path. In addition to job security, U.S. News and World Report also states that those who hold a position within the health care industry have some of the best jobs in the nation.
DOJ charges 30 in "patients for cash" health care fraud scheme
The Department of Justice (DOJ) recently charged 30 in a "patients for cash" health care fraud scheme. According to the indictment, a home health organization illegally paid doctors, nurses, and at least one social worker along with other medical professionals in violation of the Anti-Kickback Statute (AKS) for referral of patients to a home health organization.
CMS announces increased health care fraud enforcement measures
The United States Centers for Medicare and Medicaid Services (CMS) recently announced a new rule to address health care fraud. The announcement was made in September 2019. The new rule expands the agency’s ability to revoke or deny applications for entry or re-enrollment into the Medicare, Medicaid and CHIP payment programs.
On way the rule, titled the Program Integrity Enhancements to the Provider Enrollment Process, achieves this goal is through the use of an "affiliations authority" to identify those most likely to commit fraud, waste or abuse.
Novartis sets aside millions to settle bribery allegations
Novartis Pharmaceuticals Corp. (Novartis) recently announced it will set aside $700 million to settle claims made by the Department of Justice (DOJ). The DOJ recently accused the pharmaceutical giant of illegally bribing physicians and other health care professionals to prescribe their medications.
Tips for an effective voluntary health care compliance program
The government requires medical facilities to follow certain rules and regulations. A failure to do so can result in allegations of wrongdoing. One specific area that can cause great harm to a health care facility are allegations of health care fraud. If substantiated, the allegations can come with crippling financial penalties and potentially result in the inability to continue to bill for services through Medicare and Medicaid.
Facilities can help to better ensure compliance by putting together a voluntary health care compliance program.
Pharmacy owner accused of bribing doctors: 3 lessons
The government continues to crackdown on allegations of health care fraud. One recent example involves a pharmacist accused of various crimes. According to the complaint, the prosecution has charged the pharmacy owner with two crimes. The first is conspiracy to commit health care fraud and the second conspiracy to pay illegal kickbacks to a physician.
If convicted, he faces over $500,000 in financial penalties and up to 15 years of prison time.
Physicians need to know these 3 payment regulations
The Office of the Inspector General (OIG) will investigate allegations of illegal physician payment arrangements. Physicians are wise to take proactive action to protect themselves from allegations of wrongdoing.
One way physicians can mitigate their risk for violating these laws is to be familiar with the basics of these regulations. Three examples that physicians should know include:
Will New York join the Nursing Licensure Compact?
New Jersey finalized an agreement to partner with 33 other states throughout the country in a multi-state nursing licensing compact in July of 2019. This compact allows nurses from other participating states to practice in New Jersey without receiving a New Jersey specific nursing license and vice versa.
Fired nurse fights back, saves license
A nurse is fighting back after hospital executives claim she attempted to help a patient with mental issues escape from the hospital. Based on this claim, the hospital fired the nurse. The nurse states the situation was exaggerated and used to justify her firing. In reality, she states the firing is a wrongful termination in retaliation for her attempts to fight for better nursing coverage within the hospital.
CMS announces changes to better address antibiotic resistance
The Centers for Medicare and Medicaid Services (CMS) recently released information about new efforts to reform its repayment structure to better address the growing public health crisis of antimicrobial resistance.
