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Physicians and Group Practices Archives

Lessons from government investigation of UNC Hospital

Any number of events can trigger a government investigation of a medical facility. The government may receive an anonymous tip, billing practices may lead to a red flag or, as recently highlighted in a case involving the University of North Carolina's (UNC) Congenital Heart Program, negative publicity can snowball and fuel a closer look by government officials.

NY court sends podiatrist to prison for health care fraud

New York officials recently charged a local podiatrist with health care fraud. The government alleges the illegal actions occurred between January of 2013 through January of 2017. The prosecution accused the podiatrist of fraudulently charging Medicare and private insurance companies for skin grafts and other services.

NY doctor’s office closes amidst allegations of Hep-C exposure

NY officials recently accused a NY physician’s private practice of a connection with a Hepatitis C outbreak in the area. The New York City Department of Health and Mental Hygiene has confirmed it sent a notice to the practice, stating the agency is in the midst of investigating “several acute hep-C cases linked to the private practice.” The agency urged those who received treatment at the facility involving needles or sharp instruments to get tested for hepatitis C, hepatitis B and HIV. The agency sent letters to anyone who went to the facility between 2015 and 2019. Examples of procedures that warrant getting tested included blood glucose testing, injections and infusions.

OIG accuses sleep study providers of false billing practices

The Office of the Inspector General (OIG) recently released a report that the government overpaid for over half of reviewed payment requests to Medicare for polysomnography services. Overall, the agency estimates the government overpaid by $269 million for these sleep study services.

NY medical practice admin pleads guilty to health care fraud

A pain management facility in New York was the subject of a recent federal investigation. The investigation led to two separate indictments. The first involved two chiropractors, a business manager and an administrator. The government charged all four individuals with health care fraud and conspiracy to commit health care fraud. The second indictment included a pain management medical doctor formerly affiliated with the facility.

New finding in opioid crackdown: Doctors are just the beginning

A recent investigation delves more deeply into the details of the opioid crisis. It digs into a new area of concern: the courtroom. The investigation focuses on the role of judges in these cases and how they may have missed an opportunity to address this growing issue over 15 years ago.

NY cardiologist charged with healthcare fraud for ECP treatments

Assistant United States Attorneys recently accused a 53-year-old cardiologist of perpetrating a scheme in states throughout the country to defraud the health care benefit programs in exchange for personal profit.

Cardiologists under fire after NYT piece critiques their stats

The New York Times recently ran a publication that delves into the surgical complications and deaths of a hospital's pediatric heart surgery program. The researchers with the piece state the hospital's mortality rate started going up in 2013. From 2013 to 2017, the facility reported a cardiac surgery mortality rate of 4.7%.

Prosecutors accuse doctor, consultant of transvaginal mesh fraud

According to an indictment from a federal court in Brooklyn, United States prosecutors have accused a doctor and surgical consultant of defrauding women into having transvaginal mesh implants unnecessarily removed. The prosecution alleges the two recommended the procedures so they could receive funds from financial settlements involving transvaginal mesh litigation.

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