The United States Department of Justice (DOJ) recently announced the recovery of over $3 billion in False Claims Act (FCA) violations for health care fraud cases last year. Although this seems like a large number, it is in line with previous years. In fact, this is the tenth year in a row the agency reports recovering more than $2 billion from its work pursuing these cases.
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.
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.
A recent investigation has resulted in evidence that appears to support allegations a group of hospital executives were more concerned about profits then patient care. The study is an extension of a previous report finding top executives and board members of a local, nonprofit cancer center had benefited due to relationships with drug companies and research projects outside of their normal work duties.
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.
New York v. Acosta could change the administration of association health plans throughout the country. This New York case questions a regulation by President Trump's administration. The regulation allegedly makes it easier for smaller groups to buy association health plans that do not meet Affordable Care Act (ACA) standards.
New York State's Attorney General Eric T. Schneiderman recently announced the arrest of a local pharmacy owner. The government has accused the pharmacy owner of defrauding millions from the New York State Medicaid program.
The Department of Justice (DOJ) continues its fight against the opioid crisis in the United States. As part of this fight, Attorney General Jeff Sessions has sent a dozen top federal prosecutors to scour the country for medical professionals that allegedly abuse the system. More specifically, these agents are looking for physicians that subscribe opioid medications in questionable situations.
If you own a home health care agency, hospice or other health care-related business, a time may come when you start to think about selling it. Maybe you have reached the stage of life where you are considering retirement, or maybe you have found that holding on to the practice has become more of a chore than a labor of love.