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February 2019 Archives

Six health care startups named on list of 50 'unicorns'

This month, The New York Times teamed up with the research firm CB Insights to select 50 startup businesses that they think will eventually be valued at $1 billion or more. Six of the startups, which they refer to as "unicorns," are part of the health care industry.

New York medical transport company accused of Medicaid fraud

New York State Police recently collaborated with various federal, state and local agencies to conduct an investigation of a transport service accused of defrauding Medicaid. The investigation spanned two years. Upon completion, New York officials arrested thirteen transport drivers. The prosecution has accused the drivers of fraudulently charging the government for their services.

NY hospital accuses insurance company of failure to reimburse

A New York hospital has accused an insurance plan that covers over 10,000 teachers of failing to follow an agreement put together in 1997. The agreement between the hospital and insurance company addresses the billing processes. It is specific and provides an equation stating the insurance company will pay 92 percent of outpatient costs for those covered by the plan.

How will a misdemeanor impact your nursing license?

Those who earn a nursing degree put in serious study and dedication. In addition to the demands directly tied to the license, there is a tangential cost. These individuals may have to take away time from family and friends as well as put in the financial investment that comes with supporting oneself during the years of work required to earn the license.

Health care providers: Fraud developments to watch in 2019

Health care fraud disputes were present throughout 2018. These cases included everything from individual physicians, nurses and other health care professionals fighting boards for their professional licenses to multi-million dollar Anti-Kickback Statute (AKS) violations cases — as discussed in a previous post, available here.

Former health care exec headed to trial

A health care executive known for running nursing and assisted living facilities in Chicago before expanding to Florida will begin trial within the next two weeks. The government has accused the former exec of his role in a scheme that allegedly defrauded Medicare of over $1 billion in false claims. The accused ran approximately 20 facilities and allegedly filed for claims with Medicare for services that were either never provided or unnecessary. The prosecution has also stated the business owner paid illegal kickbacks to physicians to encourage referrals to his facilities.

Poor billing practices cost Walgreens big

Health care fraud is a major issue that continues to contribute to the financial burden of patients everywhere. Not only does it exploit patients when they are weak and at their most vulnerable, it also causes financial challenges for all, especially people who receive Medicaid and Medicare benefits. One issue that contributes to the growing number of health care fraud investigations and criminal charges is poor billing practices. 

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