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.
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.
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.
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.
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%.
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.
The United States Attorney for the Southern District of New York recently announced the conviction of a medical doctor and physical therapy doctor for health care fraud. The conviction was the result of a six-week jury trial and results in a total of 15 convictions for the state stemming from this same scheme. The New York State Office of the Medicaid Inspector General’s Complex Frauds and Cybercrime Unit is handling the case.
The House Energy and Commerce Committee recently released a proposal that targets “unexpected charges” to patients for care received at hospitals. The lawmakers behind the bill state they are attempting to remove the issue of surprise billing for patients in both emergency and non-emergency situations.
Although due diligence is important in any merger or acquisition transaction, deals that involve purchasing a physician practice offers unique obstacles. Whether a new physician looking to take over another doctor’s practice or a private equity firm looking for an investment, an interested buyer can mitigate the risk that comes with these hurdles by including these questions in the due diligence process:
Building a business is a labor of love. Entrepreneurs spend long hours researching their market and making sure their operations are in compliance with applicable rules and regulations. Although all business owners work hard to get their enterprises up and running, those who start a medical practice are balancing more than just their business' success, they are also balancing the interest of the patient.