The coronavirus pandemic has led officials to make changes to regulations that impact nurse licensure. Some changes impact operations, others impact legislation. The medical community describes some of these changes as long-overdue updates while others were simply a...
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Is my physicians’ group ready for an audit?
Healthcare organizations with delegation agreements with private or government insurance programs are wise to prepare for, at a minimum, audits on an annual basis. Insurance providers use these audits to better ensure the healthcare business complies with the...
New York officials accuse doctor of selling opioids
New York officials recently arrested a local pediatric surgeon. The officials state they caught the medical professional attempting to illegally sell opioids. The physician, who also serves on an opioid task force, faces up to nine years imprisonment for the charges....
Gov’t increases focus on healthcare fraud and telehealth services
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...
HIPAA Right to Access spotlighted in recent NY case
Government enforcement efforts have proven successful with yet another Health Insurance Portability and Accountability Act (HIPAA) case. In this most recent case, the Office for Civil Rights (OCR) settled with a New York spinal group over allegations the group failed...
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...
Age discrimination and medical practice: A case asks tough questions
A 73-year-old surgeon recently filed a case against his former employer. He claims hospital officials discriminated against him based on his age when they had him undergo a neuropsychological and physical exam as well as have a proctor present when he conducted...
NY podiatrist agrees to pay $1.25M to settle FCA claim
Government officials recently accused a local New York City hospital system along with a podiatrist of fraudulent billing practices. The allegations are in connection with a whistleblower lawsuit. The whistleblower brought the claim forward in 2012, stating the...
Anatomy of an OPMC investigation
What happens when a patient, co-worker or other medical professional files a complaint about a physician's work? If the complaint involves allegations of misconduct, the New York Health Department's Office of Professional Medical Conduct (OPMC) and state Board for...

