The health care market accounts for a large chunk of the nation's economy. Individuals in the United States spend trillions of dollars to meet their health care needs. As a result, it makes sense that prosecutors follow through on allegations of health care fraud.
New York Attorney General Letitia James filed suit against opioid manufacturers, distributors and the owners of Purdue Pharma.
High-profile actors and actresses have received media attention recently for their roles in a college entrance scam. Enforcement officers arrested multiple members of the Hollywood elite. Prosecutors charged the actors with crimes connected to their rolls in a scandal that allegedly involved parents cheating the college entrance exam process, often hiring others to take the exam on behalf of their children.
Two physicians have filed a lawsuit against a local New York hospital. The physicians claim the hospital that served as their employer illegally retaliated against them when they reported another physician’s dangerous conduct. One of the physicians served as the director of the hospitalist program at the hospital, the other a neurologist and former director of the hospital’s stroke program.
The New York Court of Appeals has agreed to hear a case that delves into fraudulent incorporation of medical practices in the state.
A New York hospital has accused an insurance plan that covers over 10,000 teachers of failing to follow an agreement put together in 1997. The agreement between the hospital and insurance company addresses the billing processes. It is specific and provides an equation stating the insurance company will pay 92 percent of outpatient costs for those covered by the plan.
Ten months ago, federal prosecutors outlined a case against five New York doctors. The indictment accused the physicians of participating in a bribery and kickback scheme that was designed to increase sales of Subsys, a spray form of the opioid fentanyl.
In past generations, physicians often ran solo practices and house calls were common. Since then, physicians have merged to work together in a private practice or work directly as employees of a hospital or other medical or educational facility.
The United States Attorney’s Office recently accused a New York doctor of importing illegal drugs. The doctor, a faculty member and clinical instructor at the University at Buffalo’s Jacobs School of Medicine and Biomedical Sciences, specialized in treating patients who struggle with substance abuse and addiction. Officers state he imported heroin and cocaine to his private residence. They have not yet stated the believed purpose of these illegal substances.
It is not uncommon for physicians and physician groups to have arrangements with clinical laboratories. These arrangements may take the form of a small business investment or management arrangement and include financial incentives to use certain labs to provide quality care for patients. In the past, these arrangements were generally not scrutinized by the federal government if they did not result in payment from Medicare or other government providers.