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The government recently accused two business owners of working together on an elaborate health care fraud scheme that cost the government millions. According to the prosecution, the two business owners, a married couple, put together a health care business to defraud...
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...
Those who wish to enter the field of nursing must meet many requirements before they are able to begin their profession. One is the completion of the NCLEX exam. The prerequisites to take the exam varies as each Nursing Regulatory Body (NRB) has its own requirements...
Orthopedic practices, like any other medical specialty, can face allegations of health care fraud. The government pursues these allegations aggressively and, if successful, can request penalties that include millions in payment and potential jail time. Additional...
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...
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...
The federal Anti-Kickback Statute (AKS) is a key piece of legislation used by the government to prosecute healthcare businesses and practitioners for fraud. The law is broad, and applies to services billed by physicians, nurses and even diagnostic labs. How did the...
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...
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...
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...
