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...
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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...
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...
Tips to reduce liability for telehealth services
The Department of Health and Human Services has relaxed regulations under the Health Insurance Portability and Accountability Act (HIPAA), at least temporarily. This allows medical professionals to conduct communications with patients using technology like Zoom and...
3 things diagnostic labs need to know about regulatory compliance
Laws and regulations are present to better ensure diagnostic labs provide quality care. A failure to abide by these regulations can result in serious penalties. There are many government agencies that oversee these regulations. The United States Department of Health...
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...
NJ healthcare insurance negotiation deal: 3 lessons
New Jersey healthcare company Humana Inc. recently adjusted its insurance offerings to expand in-network access for members. After much negotiations with local healthcare providers, the private insurance provider agreed to expand its terms to include additional...
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...
Why should my diagnostic lab care about compliance?
Gravity Diagnostics, a CLIA diagnostic and testing laboratory licensed to provide services throughout the country, recently announced the addition of an executive. Although the addition of another executive for this large of an organization on its own is not of note,...
Compliance violations and diagnostic labs: Top three violations
Lab owners must balance a multitude of tasks to have a successful business. They need to make sure they have the staff needed to run a safe, accurate and efficient facility. In addition to watching the bottom line, these entrepreneurs also need to have a basic...

