Any New York business that bills Medicare, Medicaid or another federal provider for services is wise to understand the basics when it comes to allegations of fraud. One way to understand how the feds pursue these allegations is to review a case. In a recent example,...
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Health Care Investigations
DOJ charges PTs and acupuncturists with millions in health care fraud
The United States Department of Justice (DOJ) recently announced it will pursue health care fraud charges against 6 physical therapists (PTs) and 2 acupuncturists who run facilities in New York. The feds claim the professionals developed a multi-million-dollar health...
Healthcare fraud in the NFL? It’s not just for doctors.
Allegations of healthcare fraud are serious. If supported, the government can get substantial financial penalties and additional fines and even, depending on the details of the allegations, push for a prison sentence for those involved in the crime. You may think...
Cardiologist gets 6 years imprisonment for healthcare fraud
The United States Department of Justice (DOJ) announced the conviction of a cardiologist for healthcare fraud back in 2019. According to the feds, beginning in 2008 the medical professional submitted fraudulent claims to government and private insurance programs for...
Feds accuse medical transportation company owner of fraud
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...
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...

