A data breach impacted an estimated 20 million patients from three medical testing labs. The breach was connected to the collection agency used by the lab to manage billing. At this time, it appears the breach occurred for eight months before the lab became aware of the issue.
An investigation that spanned many months recently resulted in the arrest of a New York-licensed pharmacist accused of running a “medicine-for-case” scam. The Office of the Insurance Fraud Prosecutor recently announced the charges against this and 18 additional individuals allegedly involved in the scam, which allegedly ran from January through August of 2018.
In 2018, the Department of Justice (DOJ) announced charges against a former state employee for health care fraud violations. The accused waived her right to an indictment and chose to take a plea deal. According to the agreement, the accused confessed to running two social and psychotherapy businesses.
The government recently announced a billion-dollar health care fraud case. The scam allegedly involved sending Medicare recipients shoulder, knee, ankle, wrist and back braces. In most cases, the patients did not need the braces. In others, the patients never received the braces. The companies would then charge Medicare for the cost of the braces, whether patients received them or not. Ultimately, the government states the scheme resulted in a loss of over one billion dollars.
A paramedic alleges his employer terminated his position because he followed a patient’s request instead of adhering to conventional medical practices. The patient was suffering from a serious infection and asked the paramedic not to move forward with an intraosseous infusion (IO). The procedure, which essentially involves using a drill like device to insert an IV into the patient's bone, would be the conventional practice recommended in this instance. The patient declined treatment. Instead of pushing or forcing the issue, the paramedic honored the patient's wishes.
Zone program integrity contract (ZPIC) audits are on the rise. These audits can result in evidence given to the Department of Health and Human Services (HHS) Office of Inspector General (OIG) and potentially result in criminal charges.
New York Attorney General Letitia James has accused a Long Island pharmacist of a complex, multi-million-dollar Medicaid scam. The scam, according to prosecutors, involved pharmacies throughout New York including locations in Manhattan and the Bronx.
Technology has touched every area of our lives. We have devices in our pockets that allow us to be in constant contact with our loved ones and colleagues, our vehicles are beginning to use the technology needed to drive themselves and our refrigerators can tell us when we need to stop at the grocery store.
The government continues to pursue Insys related healthcare fraud investigations. Insys Therapeutics (Insys), a pharmaceutical giant, is known for manufacturing Subsys, a fentanyl-based spray used for management of severe pain suffered by cancer patients.
The government recently accused a professional counselor of taking part in a complex health care fraud scheme. The prosecution accused the counselor of filing false documents to incorporate the counseling business, completing unnecessary tests of patients receiving treatment at the center and using employed doctor’s medical licenses to fraudulently prescribe and move drugs.