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Health Care Investigations Archives

Paramedic gets fired after following patient's wishes

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.

ZPIC audits on the rise: Tips for pharmaceutical companies

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.

Investigators accuse NY hospital execs of conflict of interest

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.

3 tips to avoid allegations of healthcare fraud

The United States Department of Health and Human Services (HHS) continues to crackdown on allegations of healthcare fraud. The government will strike both before and after the fraudulent activity occurs. Predictive analytics allow federal investigators to flag potential violations before they occur. This tool, paired with federal investigations, allows government agencies multiple tools to gather evidence to build support allegations of fraudulent activity.

Long Island pharmacist accused of health care fraud

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.

NY officials remind pharmacies use of ADMs illegal

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.

Insys prosecution continues: NY doc takes plea deal

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.

Counselor gets 3-years in jail for health care fraud

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.

New York medical transport company accused of Medicaid fraud

New York State Police recently collaborated with various federal, state and local agencies to conduct an investigation of a transport service accused of defrauding Medicaid. The investigation spanned two years. Upon completion, New York officials arrested thirteen transport drivers. The prosecution has accused the drivers of fraudulently charging the government for their services.

Health care providers: Fraud developments to watch in 2019

Health care fraud disputes were present throughout 2018. These cases included everything from individual physicians, nurses and other health care professionals fighting boards for their professional licenses to multi-million dollar Anti-Kickback Statute (AKS) violations cases — as discussed in a previous post, available here.

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