Perhaps he should have genetically tested himself for the propensity to commit fraud.
Tag: billing
Surprise: The No Surprises Act Is Working, Just Not How Insurers Planned
The No Surprises Act wasn’t about patients. The fine print told a different tale: it was an insurer-protection law.
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.
You Can’t Lipstick That Pig: Why Physicians Must Carefully Vet Deals
Deals involving management services agreements, consulting contracts, or similar structures can appear completely legal at first glance. But dig deeper, and they might turn out to be elaborate covers for kickbacks or bribes.
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.
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.
How to Almost Make Half a Billion Dollars: The Arizona Wound Graft Fraud
If you thought health care fraud required medical knowledge, think again.
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.
More On Overturning the No Surprises Act
It you haven’t yet read it, see my December 16, 2024, post, Now’s The Time to Overturn the No Surprises Act, for part 1 of this thread.
When that post was published on LinkedIn, my friend James Prudden commented, asking me how patients would be protected if the No Surprises Act were repealed. Here’s my response to James.
Now’s The Time to Overturn the No Surprises Act
Re-frame the issue for what it really is: Surprise physician services stealing. Now’s the time for the No Surprises Act, and each state counterpart, to go.