Imagine a pharmacy operation so brazen that it paid doctors millions in kickbacks to prescribe compound creams mixed in the backroom by untrained teenagers—then billed the government as much as $16,000 per tube.
Compliance
An Algorithmic Conspiracy? DOJ Weighs In on MultiPlan Case
As healthcare payers, tech platforms, and pricing vendors increasingly collaborate through sophisticated analytics, this case is a clear reminder: if you’re coordinating decisions that competitors used to make…
The $4 Million Pee Test Scam: How One Lab Owner Flushed His Future
There are dumb crimes, and then there are crimes so dumb they come with a built-in paper trail leading straight to prison.
Aetna Health v. Radiology Partners and the Danger of Pass-Through Billing
There are, depending upon the particular arrangement, potential end runs around contractual pass-through billing prohibitions, but they are highly fact specific and technical.
Lesson from McKinsey – Avoiding Consultants from Hell
Are you sure those consultants are helping to improve your business? Or are they potentially sending you to jail?
Conviction for $70 Million in Fake Medicare Claims Likely Sending Doc to Big House – Medical Group Minute
Although health care fraud doesn’t require the involvement of telemedicine, with advances in telemedicine come “advances” in criminal schemes.
Snoop Doc Takes The Rap For HIPAA Hop – Faces 5 Years in Pen For Illegally Accessing Medical Records – Podcast
You’re signed in to the hospital’s electronic medical record system. What’s the harm in just typing in the name of a friend to see what pops up?
“Loco Tenens” and Agency Pay $700K to Settle Alleged Telemedicine Kickback Scheme – Medical Group Minute
With physician shortages in many specialties opening up lucrative opportunities for locums work, temporary staffing is undergoing a boom.
Snoop Doc Takes The Rap For HIPAA Hop – Faces 5 Years in Pen For Illegally Accessing Medical Records
You’re signed in to the hospital’s electronic medical record system. What’s the harm in just typing in the name of a friend to see what pops up?
Supreme Court Declares Chevron Out of Gas – Better or Worse for You?
You’d think there’d be far and wide celebration over freedom from the yoke of administrative tyranny, but it turns out that more than a few don’t want to be free…