The health care industry is known for its financial stability. As this industry continues to show growth, buyers are emerging from interesting, and sometimes unexpected, backgrounds. Two recent examples include:
The issue arose on August 12. At that time, a man called the police and claimed a man at a bar had showed him a gun and made threats of violence. The police arrived and spoke with the man in question. The man, a New York plastic surgeon who works in Massachusetts, admitted to having a gun when questioned. The police then arrested the physician. This arrest led to the search of his vehicle.
The Department of Justice (DOJ) recently charged 30 in a "patients for cash" health care fraud scheme. According to the indictment, a home health organization illegally paid doctors, nurses, and at least one social worker along with other medical professionals in violation of the Anti-Kickback Statute (AKS) for referral of patients to a home health organization.
The Office of the Inspector General (OIG) will investigate allegations of illegal physician payment arrangements. Physicians are wise to take proactive action to protect themselves from allegations of wrongdoing.
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.
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.
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.
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.
A federal court in Brooklyn recently arraigned a New York anesthesiologist for health care fraud. The government has accused the physician of failing to provide services for telemedicine as billed.
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.