The United States Attorney’s office recently announced a 50-count indictment charging seven people with health care fraud, wire fraud and other crimes. The charges are the result of alleged abuse of specialty medication prescriptions for compounded medications....
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Avoid these common mistakes when charged with health care fraud
A recent case out of New York provides multiple examples of what not to do if accused of health care fraud. The case began when the U.S. Attorney's Office of the Western District of New York investigated a psychiatric physician for health care fraud. According to the...
Three ways CMS has changed healthcare in response to COVID-19
The United States Centers for Medicare and Medicaid Services (CMS) made many changes to its rules in response to the current coronavirus pandemic. Three that directly impact healthcare include: Telehealth. Although CMS has covered telehealth services in the past, it...
AKS violations: A timeline of a typical case
Lawmakers designed the federal Anti-Kickback Statute (AKS) to help better ensure medical professionals focus on the well-being of their patients. Lawmakers intended this piece of regulation to reduce the risk of medical decisions based on financial gain. But what...
Lab owner sues hospital for breach of contract
Running a lab is a rewarding and difficult profession. In some cases, there are business considerations. Contracts may govern these arrangements. In a recent case, a lab owner accused a hospital of failing to fulfill its agreements as listed within the contract. The...
DOJ pursues first fraud charges for use of coronavirus funds
The United States Department of Justice (DOJ) recently announced criminal charges against two New England men. The agency claims the men were attempting to defraud the government’s recently unveiled small-business lending program — a program lawmakers...
FBI accuses youth football coach of health care fraud
A recent case provides an example of how the government moves forward with a case of health care fraud that may involve an unlikely offender and the types of penalties that can apply. According to the Federal Bureau of Investigation (FBI), the accused in this case was...
Ear, nose and throat specialists pay $9 mill to settle FCA claim
An ear, nose and throat (ENT) practice recently agreed to pay the government along with local state authorities over $9 million to settle claims they violated the federal False Claims Act (FCA) and state regulations.The allegations involved an improper financial...
3 ways the DOJ will use the FCA during the pandemic
The government has stated it is prepared to go after those who commit health care fraud to receive funds set aside to help deal with the coronavirus pandemic. True to its word, the Department of Justice (DOJ) has already reported one action against health care fraud...
NY Governor Cuomo announces win against opioid manufacturer
The governor of New York recently announced another legal tool it will use in its fight against the current opioid epidemic. According to Gov. Andrew Cuomo, the state’s Department of Financial Services (DFS) has filed an insurance fraud action against one of the...

