The federal government recently charged a New York businessman with health care fraud. The entrepreneur ran a non-emergency medical transportation business in the Buffalo area. The business provided services from 2016 through 2020. It was composed of about 15 vehicles...
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Health Care Investigations
3 ways feds are cracking down on pandemic related healthcare fraud
The feds are aggressively pursuing allegations of healthcare fraud related to relaxed regulations and incentives to help address the pandemic. In a recent example, the government charged 14 people with healthcare fraud related to the pandemic. They claim that those...
Feds pursue millions from FCA cases in first quarter of 2021
United States Attorney’s Offices throughout the country continue their aggressive pursuit of physicians and other medical professionals who fail to follow the regulations set out in the False Claims Act (FCA). The feds have found success, reportingly pursuing the...
Anatomy of an HHS audit
The United States Department of Health and Human Services (HHS) recently announced updates to its Phase 2 Health Insurance Portability and Accountability Act (HIPAA) Audit Program. These audits aim to check for an entity’s compliance with certain requirements. The...
Lab owner agrees to pay $2M to settle AKS claim
The United States Department of Justice (DOJ) continues to crackdown on its fight against illegal kickbacks. The feds are clear in their belief that what it considers bribes within the healthcare industry for medical services or equipment taint the ability to provide...
2 lessons about collaborative care and the AKS from recent case
The Department of Justice (DOJ) recently announced success in the prosecution of a case involving allegations of fraud within pharmacies located throughout New York and New Jersey. The government accused the pharmacy owners of paying kickbacks to doctors and...
Is this the dawn of a new value-based care era?
One can argue that value-based care is clearly in the patient’s best interest. Such arrangements allow for the patient to receive care from multiple specialists and reduce the financial burden that may come with visiting more than one physician. However, lawmakers...
How can healthcare execs defeat a whistleblower claim?
The federal government has a system in place that encourages current and former healthcare employees to report wrongdoing. This is achieved through qui tam, or whistleblower cases. The government benefits from this system because workers within healthcare...
3 ways HIPAA could change in 2021
The United States Department of Health and Human Services (HHS) recently recommended the government consider making a number of modifications to the Health Insurance Portability and Accountability Act (HIPAA). HHS states the recommendations are part of the agency’s...
Feds gain momentum with EKRA as doc takes plea deal
A group of medical professionals recently accepted plea deals in connection to a healthcare fraud scheme that operated through the country. The group had operations set up in multiple states, including New Jersey, Maryland, California. According to feds, the group...