Congress passed the Health Insurance Portability and Accountability Act (HIPAA) to help ensure the protection of patients’ medical records and personal health information. The rule sets boundaries on the use and release of medical records, established safeguards to help protect the information and holds those who violate these protections accountable for wrongdoing through the use of civil and criminal penalties.
A data analytics firm has accused a healthcare provider of False Claims Act violations. The group states the provider illegally received payment for over $188 million in Medicare claims. If the suit is successful, the firm would receive a portion of the winnings.
The Department of Justice (DOJ) continues to crackdown on the illegal prescription of opioids. Attorney General Jeff Sessions has made clear his focus on opioid-related health care fraud and the prosecution of healthcare professionals that allegedly contribute to the problem. Enforcement efforts have led to the arrest and prosecution of medical professionals throughout the country. Although some have misused their role as a medical practitioner to illegally prescribe opioids for their own financial benefit, many faced false accusations of wrongdoing.
The United States Department of Justice (DOJ) has announced another regional Medicare Fraud Strike Force to join the current forces in 10 cities throughout the country. Strike Forces are currently present in Brooklyn, Miami, Los Angeles, Detroit, Houston, Baton Rouge, New Orleans, Tampa, Chicago and Dallas.
The United States Attorney’s Office for the Southern District of New York recently announced the sentencing of a physician convicted for healthcare fraud. The government sentenced the physician to 18 months imprisonment, three years of supervised release and the payment of $103,843 in ill-gotten gains as well as $2,669,231 in restitution.
The Centers for Medicare and Medicaid Services (CMS) recently filed its 2019 Medicare Inpatient Prospective Payment System (IPPS) proposed rule.
The medical field is a noble profession. Those who work in this field know the value of their professional reputation. An attack on a doctor's professional reputation can effectively end his or her career. As such, it is wise physicians that find themselves the subject of such an attack take action to protect their reputation.
There are many government programs to help ensure those who need medical care receive treatment, even if they cannot afford needed care. Medicare and Medicaid are two examples and Veterans Affairs Medical Centers are another. Medical professionals can bill these programs for services rendered to certain qualifying patients. Most physicians use these programs within the bounds of the law, others see it as an opportunity for abuse and still others are wrongly accused of such abuse.
The United States Attorney for the Western District of New York has charged a local psychiatrist with health care fraud. The medical professional operates a private practice, has served with many nursing homes and has also spoken at consulting engagements for pharmaceutical companies.
The United States Department of Justice Medicare Fraud Strike Force is a government group put together with one focus: take down medical professionals and others that are committing health care fraud. As noted in a recent publication by the New York Law Journal, this group is very successful at this task. It is responsible for the conviction of thousands of medical professionals across the nation.