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In New York, the Office of Professional Discipline (OPD) investigates complaints about dentists to determine if there is a violation of professional conduct. Patients, colleagues, and others can file a complaint. The OPD will review the complaint and, if warranted,...
As we enter 2024, federal authorities have intensified their scrutiny of healthcare fraud nationwide, engaging with numerous cases against medical professionals. These cases are pivotal, with more than a dozen currently progressing through legal channels. Common...
The Health Insurance Portability and Accountability Act (HIPAA) is getting attention with use of AI and machine learning in the healthcare industry — and for good reason. Although these tools can provide a more efficient and potentially reliable means to organizing...
Anyone who receives notification of an investigation or allegations of healthcare fraud may wonder where the accusations came from. This is a question that can have a few different roots. Two examples include the following. Option #1: A whistleblower One of the more...
Pharmacies help people in their communities. Those who work in these healthcare facilities try to help provide patients and community members with the medications they need to treat illness or injury. In a recent case, the government claims a pharmaceutical manager...
Healthcare fraud sounds like the kind of crime committed by a physician or nurse who conducts unscrupulous procedures or provides prescriptions in exchange for money. Although these are examples of activities that can result in criminal charges for healthcare fraud,...
The United States Department of Justice (DOJ) recently announced criminal charges against 78 healthcare professionals. Attorney General Merrick Garland noted in the press release about the matter that the feds are intensifying their efforts to prosecute healthcare...
The government takes allegations of healthcare fraud seriously. It will aggressively investigate and look to move forward with prosecution if evidence supports the allegations. When investigating, the government will look for potential violations including billing...
Allegations of healthcare fraud can do more than tarnish your professional reputation — they can lead to serious criminal penalties. In a recent example, the government accused a nurse practitioner and registered nurse of defrauding Medicare of over $10 million. The...
Knowing how healthcare regulations impact operations is important. The government’s use of these regulations is generally guided by two things. First, the language of the law. The provisions, definitions, and information within the actual law give us the initial round...
