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New York Health Care Law Blog

Did a NY hospital violate human trafficking laws?

The New York State Nurses Association recently accused the Albany Medical Center of violating human trafficking laws. The group claims the hospital violated these laws when it recruited almost 600 Filipino nurses to the hospital. The group has provided evidence to show the hospital has used these illegal practices since 2002 in an effort to help address the nursing shortage in the state.

In an attempt to address the issue, New York State's Nurses Association filed a lawsuit against the hospital.

Timeline of a health care fraud case

Health care fraud cases generally follow the following timeline: the government becomes aware of a potential offense, an investigation occurs, and the government pursues criminal charges if the investigation leads to evidence to support the allegations. It may seem like a relatively straightforward process, but the reality can be circuitous and time consuming. A recent case provides an example.

Lab agrees to pay $12 million to settle AKS claim

A diagnostic laboratory recently agreed to pay the government almost $12 million to settle claims that the health care company violated federal Anti-Kickback Statute (AKS) regulations. The government claimed that individuals within the diagnostic lab were illegally bribing health care professionals to use the professional services offered within their lab.

The investigation began after a former employee moved forward with a qui tam lawsuit. If successful, these cases, also known as whistleblower cases, result in financial gain for the individual that begins the case. In this situation, the whistleblower that brought the case forward will likely receive approximately 20% of the settlement.

RN gets more than a year imprisonment for health care fraud

Authorities recently announced the sentencing of a registered nurse (RN) to 18 months imprisonment for her role in a health care fraud scheme. As part of the sentence, the court has also required the nurse to pay $9,500 in restitution.

What was the reason for the charges?

CMS rollbacks and EKRA: A word of caution for diagnostic labs

The United States Centers for Medicare and Medicaid Services (CMS) has rolled back some regulatory provisions in response to the current coronavirus pandemic. Officials reason that these rollbacks will help to better ensure patients can get the testing, diagnosis and treatment needed during these uncertain times.

Data analytics and healthcare fraud in 2020

2020 is a year that has pushed us to embrace technology. The current coronavirus pandemic has led many to transition from working in an office or other location to working from the home.

How have these changes impacted healthcare providers?

In an effort to reduce the risk of exposure to this virus, medical professionals have revamped some of their services to provide telehealth options where available. The United States Centers for Medicare and Medicaid Services (CMS) has embraced these changes by increasing the number and types of covered telehealth services.

3 key pieces of evidence used to support healthcare fraud case

A recent healthcare fraud case out of New York, New Jersey and Pennsylvania involves two physicians and multiple other individuals who allegedly used illegal kickback payments to conduct and bill Medicare for unnecessary genetic testing. The government claims to have multiple pieces of evidence to support the claims, including:

Important lesson from recent arrest of NY doctor

New York state authorities recently attempted to move forward with criminal drug charges against a neurologist out of Brooklyn. The doctor states officers falsely placed him under arrest and wrongly sent him to prison for a week. Although the prosecution could not gather enough evidence to support criminal charges, Dr. Itay Keshet states the experience destroyed his career.

EKRA and COVID-19: What do labs need to know?

The United States Department of Justice (DOJ) and the Office of the Inspector General (OIG) have stated they will aggressively pursue health care fraud claims related to COVID-19. These agencies further clarify that they will continue to focus on prosecution for violations of the Eliminating Kickbacks in Recovery Act (EKRA). The announcement comes at an uncertain time, when diagnostic labs are working to help patients who are waiting for testing while living amidst a global pandemic.

Not just for the mafia: Racketeering in medicine

The Racketeer Influenced and Corrupt Organizations (RICO) Act is a federal law that triggers visions of the mafia and other forms of organized crime. Although this law is likely most popular for those types of cases, it can play a role in health care law. Individuals or the government may use RICO charges against those who use legitimate enterprises to engage in criminal activity.

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