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…
Few doubt that things need fixing in healthcare. But many, from DIYer docs to industry leaders, suffer from being inside an echo chamber.
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.
Some laws derive from morality and others are purely the result of politicking and protectionism.
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.
Medical groups don’t usually collapse because their revenue dropped 3% last quarter.
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.
In healthcare deals, one bad partner—or one bad flip—can end the game.
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.
Is your medical group’s bank just holding your money—or helping you grow?
Strategic banking relationships can unlock leverage, improve deal flow, and strengthen your group’s financial position.