It is generally illegal to get benefits in exchange for referring patients to health care providers. A registered nurse care coordinator is experiencing just how serious the government is when it comes to allegations of health care fraud.
The Medicare Fraud Strike Force (MFSF) recently concluded an investigation of a New York based ambulatory company. The MFSF is part of a joint initiative between the Department of Justice (DOJ) and the United States Department of Health and Human Services (HHS) tasked with deterring fraud and enforcing applicable laws.
The Department of Justice (DOJ) recently sent federal agents to raid at least four genetic testing labs to gather evidence in connection with allegations of health care fraud.
The federal government continues to crackdown on allegations of health care fraud. In recent weeks, five from the New York area have been arrested and charged with health care fraud crimes.
The United States Centers for Medicare and Medicaid Services (CMS) recently announced a new rule to address health care fraud. The announcement was made in September 2019. The new rule expands the agency’s ability to revoke or deny applications for entry or re-enrollment into the Medicare, Medicaid and CHIP payment programs.
The government requires medical facilities to follow certain rules and regulations. A failure to do so can result in allegations of wrongdoing. One specific area that can cause great harm to a health care facility are allegations of health care fraud. If substantiated, the allegations can come with crippling financial penalties and potentially result in the inability to continue to bill for services through Medicare and Medicaid.
The Centers for Medicare and Medicaid Services (CMS) recently released information about new efforts to reform its repayment structure to better address the growing public health crisis of antimicrobial resistance.
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.
The federal government recently accused a New York doctor of partaking in a health care fraud scheme that spanned throughout the country. The alleged scheme involved prescriptions for a pain cream in exchange for illegal kickbacks from a pharmacy located in Oklahoma.
State inspectors recently conducted an unannounced inspection of a Connecticut hospital. As a result of this investigation, the state has accused the hospital of mixing up patients’ test specimens.