As you may recall, back in April, 2018, in my post What’s The Downside Risk for Hospital Executives?, I wrote about the fact that Trevor Fetter, the former CEO of Tenet Healthcare, had no skin in the game: his strategy put the company into a nosedive. It lost hundreds of millions. But upon being pushed…
Be careful not to destroy all of your Medicare claims by turning them into false claims.
Listen to Mark discuss how a coordinated DHS and DOJ healthcare anti-fraud operation collected $2.6 Billion from 2015 to 2017.
When physicians think about allegations of kickbacks in the context of large insurers, it’s generally related to how a carrier’s internal “claims cops” have alleged that some physician or other provider engaged in a kickback…
When my kids were small, we spent many a lazy Sunday afternoon watching monster versus monster movies, you know, like Godzilla versus Mothra. Although today’s post doesn’t feature any Japanese creatures from Monster Island, it does feature a similar, two-monsters-in-one tale, drawing from, and compounding on, violations previously featured on the blog. And, although Tokyo…
There’s an expression in carpentry, “measure twice, cut once.” We should have the same expression in terms of healthcare deals…
In what’s being reported in the popular press as a $60 million healthcare fraud scheme, a Texas physician, Charles R. Leach, M.D., has agreed to plead guilty to one count of conspiracy to commit healthcare fraud. The feds charged 16 people in the overall scheme. Leach is the fourth defendant to plead guilty. The scheme…
When physicians think about allegations of kickbacks in the context of large insurers, it’s generally related to how a carrier’s internal “claims cops” have alleged that some physician or other provider engaged in a kickback scheme, obviating the payor’s need to pay claims, or, even worse, supporting their demand for repayment. In what some physicians…
Today, and tomorrow, as more and more surgical procedures leave the hospital setting for ASCs and other outpatient facilities, query whether hospital administrators will revisit medical directorships with renewed fervor as they seek ties that bind.
Every new, and every existing, financial relationship with anyone or any entity with which physicians and other healthcare providers do business must be vetted or re-vetted in light of today’s enforcement reality.