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An investigation that spanned many months recently resulted in the arrest of a New York-licensed pharmacist accused of running a “medicine-for-case” scam. The Office of the Insurance Fraud Prosecutor recently announced the charges against this and 18...
In 2018, the Department of Justice (DOJ) announced charges against a former state employee for health care fraud violations. The accused waived her right to an indictment and chose to take a plea deal. According to the agreement, the accused confessed to running two...
The government recently announced a billion-dollar health care fraud case. The scam allegedly involved sending Medicare recipients shoulder, knee, ankle, wrist and back braces. In most cases, the patients did not need the braces. In others, the patients never received...
The Eliminating Kickbacks in Recovery Act of 2018 (EKRA) is a new federal law that applies to diagnostic and clinical labs throughout the country. The law is a part of the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and...
The United States Department of Justice (DOJ) continues to crackdown on opioid prescription violations. Most recently, the government has accused multiple medical professionals of illegally prescribing these medications in exchange for financial gain and sexual...
A paramedic alleges his employer terminated his position because he followed a patient’s request instead of adhering to conventional medical practices. The patient was suffering from a serious infection and asked the paramedic not to move forward with an...
Zone program integrity contract (ZPIC) audits are on the rise. These audits can result in evidence given to the Department of Health and Human Services (HHS) Office of Inspector General (OIG) and potentially result in criminal charges.ZPICs were created by the Centers...
A recent investigation has resulted in evidence that appears to support allegations a group of hospital executives were more concerned about profits then patient care. The study is an extension of a previous report finding top executives and board members of a local,...
The United States Department of Health and Human Services (HHS) continues to crackdown on allegations of healthcare fraud. The government will strike both before and after the fraudulent activity occurs. Predictive analytics allow federal investigators to flag...
New York Attorney General Letitia James has accused a Long Island pharmacist of a complex, multi-million-dollar Medicaid scam. The scam, according to prosecutors, involved pharmacies throughout New York including locations in Manhattan and the Bronx. The state...
