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January 2018 Archives

Eye doctor, senator face retrial on Medicare fraud-related charges

A few days ago, New York media was filled with surprise that U.S. Sen. Bob Menendez and his friend, Dr. Salomon Melgen, will be retried on corruption charges. More eyebrows were raised later when a judge granted a request to acquit the pair on several charges they faced in a case that ended in mistrial last year.

Major consideration for valuations of your health care business

After you decide to sell your health care business, you must, of course, have some idea of its value to attract buyers. However, five people could scrutinize your business and come up with five quite different estimates. In part, the estimate depends on the person's relationship to the business. For example, someone such as you who may have invested years and many emotions into the business might come up with a higher price than a more neutral third party would.

Physicians groups and DOJ settle kickback claims

Negative publicity began to swirl around now-shuttered Health Management Associates back in 2012 when news magazine "60 Minutes" aired a segment alleging that the hospital chain pressured emergency room doctors to admit patients whether they needed care or not. The pressure on HMA escalated two years later when the New York Times reported that the company inflated its Medicare and Medicaid payments by pressuring physicians to admit at least half of patients age 65 and above.

Eye doctor awaits sentencing for Medicare fraud conviction

Two very different portraits were painted recently of Dr. Salomon Melgen, the Harvard-trained ophthalmologist. At his sentencing hearing, Melgen was painted by prosecutors as a greedy doctor willing to subject his patients to painful treatments that were medically unnecessary so that he could bill Medicare. Melgen's defense team said that portrait was a false one and insisted that the doctor is devoted to his patients and had helped many to regain sight after other physicians had given up on them.

Court rejects Medicare fraud appeals

"Upon thorough review and with the benefit of oral argument, we affirm on all issues," the U.S. Court of Appeals for the Eleventh Circuit said as it shot down the hopes of a doctor and three therapists. The four had appealed their convictions on conspiracy to commit health care fraud.

Kool Smiles and management company settle False Claims case

The U.S. Department of Justice announced recently that it has achieved a settlement with Kool Smiles dental clinics and their management company, Benevis. The clinics and management company are accused of charging Medicaid programs in 17 states for unnecessary pediatric dental services and for services that were never performed. This allegedly violated the False Claims Act.

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