When you think about fraud at an ASC, you tend to think about fraud on payers, from Medicare to well, Blue Cross. You know, cases that never happened, patients who didn’t suffer from any medical issue, and the like. But what about fraud on physicians at an ASC? Because physicians hardly think about it, it…
In a healthcare billing and payment system that’s so complex, it’s sad to say that criminals can stay a few steps ahead of the Feds. With $10.6 billion in bogus billing, some cutouts got caught, but the masterminds appear to have escaped with close to $1 billion.
The DOJ kicked back when it secured a conviction against compounding pharmacy executive Sam Glover for a six-year drug alteration and misbranding conspiracy involving free flowing prescription forms and, well, racehorses.
Dr. Jorge Zamora-Quezada, a Texas rheumatologist, was sentenced earlier this year to ten years in federal prison for a healthcare fraud so brazen it left even seasoned prosecutors shaking their heads. Read the full DOJ press release.
The Department of Justice just announced more than six million dollars in settlements with a former lab CEO, seven marketers, and two physicians. Their alleged wrong? Turning the concept of the “Management Services Organization” into a pay-to-play operation.
According to 2023 reports, by 2021, nearly 70% of physicians were employed by hospitals or investor-owned corporations.
Ride along with Mark on a tour of bankrupt facilities and broken physician dreams.
Although health care fraud doesn’t require the involvement of telemedicine, with advances in telemedicine come “advances” in criminal schemes.
In an organization we tend to be judged for what we do – not for the decisions that we make not to do something.
Ride along with Mark as he discusses the importance in ensuring verbal assurances are documented.