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Every system, no matter how well-intentioned or structured, has its inherent flaws, and Medicare is no exception. Over the years, the complexities and vulnerabilities within the Medicare system have led to instances of fraud, waste, and abuse, prompting the government...
Whether a celebratory drink with colleagues after a long shift or a glass of wine with dinner when out with family, an evening that ends with the flashing lights of a police car and allegations of drunk driving can lead to a whirlwind of legal troubles, especially for...
The False Claims Act (FCA) serves as a significant mechanism for addressing fraud against the government. However, establishing causation in FCA cases can present considerable challenges. The recent case involving Omni Healthcare and MD Labs underscores the...
Physicians often face the challenge of managing billing and administrative tasks alongside their clinical responsibilities. To alleviate this burden, many seek assistance from third-party services or hire administrative staff. Although this may seem helpful, it is...
Partnerships between medical groups and hospital systems are always evolving. Groups that are looking to expand are wise to take advantage of this environment as securing new contracts can significantly boost the reputation and revenue of small medical practices....
Transitioning into executive roles within the healthcare industry presents unique challenges compared to other sectors. Leaders can bring valuable skillsets from their industry but must also prepare to navigate complex federal regulations, such as the Anti-Kickback...
A federal jury recently found a physician from Queens, New York, guilty of submitting over $24 million in fraudulent claims to Medicare. Allegations included ordering unnecessary laboratory tests and orthotic braces, in exchange for cash kickbacks and bribes. This...
Healthcare leaders throughout the country are implementing various artificial intelligence (AI) systems within their organizations. Use ranges from software to help address scheduling needs to programs that can review tests and flag for additional review. Determining...
Diagnostic laboratories provide essential testing services. These healthcare facilities can face federal scrutiny and allegations of fraud. Such allegations often arise from specific practices within diagnostic labs. Common examples include: Unnecessary Testing: Labs...
Medicare billing is complex but plays an important role within most healthcare facilities. Whether a small private practice or a larger medical group, your organization likely depends on Medicare payments for a portion of its operating costs. Actually getting payment...
