The Department of Health and Human Services (HHS) Office of Inspector General (OIG) has increased its focus on healthcare fraud schemes involving telehealth services. The OIG began this increased focus in 2016. These efforts contributed to a massive takedown in...
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Study finds errors in HRRP leading to faulty penalties
The Centers for Medicare and Medicaid Services (CMS) oversees the Hospital Readmissions Reduction Program (HRRP). Lawmakers developed this program to help better ensure the provision of quality, value-based care. To help achieve this goal, the HRRP reviews...
What does my medical practice need to know about HIPAA violations?
The Health Insurance Portability and Accountability Act (HIPAA) applies to sensitive patient health information. Medical practitioners are wise to understand how this federal law impacts their practice. Three important facts about this law include: #1: Not everyone is...
Whistleblower begins FCA case against dentist
A former employee recently filed a claim against a dentist. In this claim, the worker does not allege that they were personally injured. In fact, the claim does not even directly involve the worker. Instead, the claim states the dentist and oral surgeon fraudulently...
Lessons from record setting HIPAA fine
The United States Department of Health and Human Services (HHS) recently announced a $6.85 million settlement with Premera Blue Cross, a private health insurance provider, to settle claims the company violated the Health Insurance Portability and Accountability Act...
Is my physician group patient-centric?
The term patient-centric is a popular, sometimes overused, catch phrase within the healthcare industry these days. Although overuse is problematic, there is value to reviewing your practice’s business plan to make sure the culture provides a positive patient...
NY healthcare provider settles allegations of HIPAA violation
This past August, the United States Department of Health and Human Services (HHS) Office for Civil Rights (OCR) received a complaint that Housing Works Inc., out of New York, had failed to provide a patient with a copy of his medical records. The patient argued that...
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...
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...
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...