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Compliance
Double Trouble: Prosecuted and Sued for the Same Scam
Out of state. Still billing for in-person care.
A physician submitted claims while vacationing in Hawaii—and now faces criminal sentencing and a $500k civil payout.
The Nation’s Largest Health Care Fraud Bust, Plus Bureaucratic Negligence
It’s been said that people read published lists of disciplined fellow professionals out of a sense of schadenfreude, the pleasure derived from another’s misfortune.
Leasing Out Your Medical License? From a Few Bucks to a Felony
As physicians get squeezed by insurers and other payers, including Medicare, and as the costs of operating a medical practice increase, more are looking for ways to supplement their income.
A Ban on PE in Medical Practice and a Gutting of Practice Value
Certainly, Oregon is a small state in terms of medical practice, but what’s happened in Oregon could, and some say will, spread across the country.
Pain Doc Likely in Pain After Settling Allegations That Billed Procedures Weren’t Performed
Was it a scam or an error? A settlement is just that and there’s been no determination of liability.
Neither you nor I can know for sure what went on, but either way, there’s a lesson here about billing compliance.
14 Month Prison Term in “Doctor Chasing” Scam
There’s huge danger in any arrangement in which you put your prescribing imprimatur on any script or order for any item, especially those reimbursed by Medicare.
DOJ to Focus on Criminal Healthcare Fraud and Prosecuting the Individuals Involved
In real life healthcare compliance, there’s no get out of jail free card.
How Medical Group Collaboration Creeps into Fraud—Pass-Through Billing
Hospital-based medical groups, notably anesthesiology and radiology groups, are increasingly turning to creative means to provide coverage and to improve collections.
Did They Sell Their Seoul? The $62+ Million Settlement
There’s a reason why Medicare Advantage is fertile ground for fraud enforcement.