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January 2019 Archives

Study links opioid drug-maker gifts to doctors to overdose deaths

Ten months ago, federal prosecutors outlined a case against five New York doctors. The indictment accused the physicians of participating in a bribery and kickback scheme that was designed to increase sales of Subsys, a spray form of the opioid fentanyl.

Defending against a Mallela fraud lawsuit

As a practicing New York physician, you know that when you render medical services to the victim of a motor vehicle crash and receive his or her assignment of benefits, you can make a claim for reimbursement from his or her insurance company. You also likely know that the insurance company must pay or deny your claim within 30 days per New York’s no fault insurance laws. Oftentimes, however, the insurance company stalls, and instead, sues you, alleging that your claim is fraudulent because you illegally incorporated your medical corporation.

Nurse accused of illegally posing as a doctor

Investigators are reviewing allegations a Licensed Practical Nurse (LPN) illegally posed as a physician. The investigation began after a state agency received complaints about the individual. These complaints led to a search warrant and investigation of a medical building where the nurse allegedly ran an illegal medical practice. At this practice, the accused allegedly provided medical treatments to patients that believed he was a medical doctor.

Anti-Kickback Statute violations in 2018: A review

The federal government takes health care fraud very seriously. In 1996, the passage of the Health Insurance Portability and Accountability Act (HIPAA) resulted in the development of a national program focused on the investigation and prosecution of those who commit health care fraud crimes. The program, now in effect for over twenty years, has resulted in billions of dollars of awards.

DOJ collects over $2 billion in health care fraud for ninth year

The Department of Justice (DOJ) recently announced collection of over $2.5 billion dollars in judgments and settlements as a result of health care fraud cases. This is the ninth year in a row the government agency has collected over two billion dollars related to this form of fraud.

Health care industry breaks records for mergers in 2018

In past generations, physicians often ran solo practices and house calls were common. Since then, physicians have merged to work together in a private practice or work directly as employees of a hospital or other medical or educational facility.

NY nurse loses nursing license after accused of stealing meds

Prosecutors recently accused a New York nurse of wrongfully taking pain medications from his employer. The hospital where he works stated he took the medication without proper authorization. The nurse was originally charged with multiple felonies, but through a plea deal the nurse’s defense team reduced the charges to a misdemeanor and entered a treatment program.

Successful strategies for selling your medical practice

As someone interested in selling your medical practice or health care business, you may be weighing your options and trying to determine the best way to move forward. Maybe you are nearing the age of retirement and want to leave your business in someone else’s capable hands, or perhaps you are simply looking to change your lifestyle and want more time with your friends and family.

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