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.
A $500M medical directorship fraud case exposes how physicians can be exploited. Protect your practice from legal and financial fallout.
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.
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.
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.
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.
In real life healthcare compliance, there’s no get out of jail free card.
Hospital-based medical groups, notably anesthesiology and radiology groups, are increasingly turning to creative means to provide coverage and to improve collections.
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.