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August 2020 Archives

CMS announces resumption of enforcement efforts

The United States Centers for Medicare and Medicaid Services (CMS) recently announced it will resume enforcement and routine inspection efforts. The agency had suspended the efforts in response to the current coronavirus pandemic in an effort to help reduce the risk of spreading the disease while also allocating resources to help with efforts for infection control and Immediate Jeopardy situations.

Are hospitals on the hook for $1B in government aid?

The current coronavirus pandemic has hit medical institutions in various ways throughout the country. Some are busy, working hard to serve patients and provide needed care. Others have slowed down as many elective procedures are on hold. Both are facing increased expenses as medical professionals and others who come into contact with patients need to wear additional personal protective equipment to reduce the risk of exposure to the virus.

Private practice and rebranding: When is the right time?

Branding is an important part of a business plan - regardless of the business. Retail stores, tech businesses and even medical practices can benefit from a solid brand. In some cases, an initial branding strategy may not achieve the expected results, or the goal of the group may change. At what point is it time to change a branding strategy? The answer will vary for each practice, but now may be a good time to review your practice's goals.

Can FDA observations lead to reprimands of pharmacists?

The United States Food and Drug Administration (FDA) conducts investigations of certain pharmacies to determine whether or not the facility's practices are in line with Food Drug and Cosmetic (FD&C) Act and related laws. The FDA's Offices of Regulatory Affairs inspectors conduct the investigation and make observations about practices within the pharmacy, noted with FDA Form 483. The observations within this form are based on the "investigator's judgment, conditions, or practices observed" that could indicate a potential violation.

Can pharmaceutical companies bounce back from Novartis scandal?

Pharmaceutical giant Novartis recently reached a settlement with the Department of Justice, Securities Exchange Commission and U.S. Attorney for the Southern District of New York regarding various claims of criminal wrongdoing. The allegations include claims the group violated the False Claims Act (FCA) and Anti-Kickback Statute (AKS). Essentially, the government claimed the group gave health care providers various incentives in exchange for using and prescribing their products.

What happens if a patient accuses a NY doctor of misconduct?

Regulating boards hold physicians to high standards. State law requires these medical professionals to provide quality care to their patients while staying abreast of changes within the medical profession. Patients who are unhappy with their care may file a complaint against the physician. In many cases, this involves a filing with New York’s Office of Professional Medical Conduct (OPMC).

27 nurses reprimanded by NY Nursing Board in June

New York State's Office of the Professions, which oversees nurses who practice within the state, recently reprimanded 27 nurses. These reprimands were for the month of June alone and ranged in severity from probation and fines to the surrender of the licensee's nursing license. Offenses that led to official reprimands during this period included:

DOJ adds 3 more NFL players to health care fraud case

The government continues to crackdown on the commission of health care fraud throughout the country. In a recent case, the United States Department of Justice (DOJ) announced that it will expand the number of former National Football League (NFL) players it will take to court in a current health care fraud case.

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.

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.

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