In June of 2011, I reported on this blog about a software program being launched by the federal Department of Health and Human Services to use a technology called predictive…
Continue Reading Fizzle But Not Much Bang: Medicare Fraud Prevention System Early Results Not Great
Federal prosecutors continue to focus their efforts on preventing health care fraud, as evidenced by a recent case arising in Texas. Earlier this year, a Houston doctor (Dr. Christina Clardy) was convicted of three counts of mail fraud, 14 counts of health care fraud and one count of conspiracy to commit health care fraud – all relating to over $45 million in false billings to Medicare and Texas’ Medicaid programs.
Continue Reading Federal Prosecutors Continue Focus On Health Care Fraud
Physicians are feeling the economic burn of the down economy perhaps more than the average American. Not surprisingly, creative physician joint ventures are proliferating in the healthcare industry as a…
Continue Reading Another Proposed Physician Joint Venture Bites the Dust
Kathleen Sebelius, Secretary of the Department of Human Services, recently announced during a press conference that HHS will as of July 1, 2011 be rolling out a $77 million computer
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Continue Reading HHS to Employ “Predictive Modeling” to Identify Fraud and Abuse
Many physicians still lack a basic understanding of the complex legal and regulatory framework within which they practice every day.
Continue Reading Physicians Need to Pay Attention to Fraud and Abuse Risks
The United States Attorney’s Office for the District of Maryland has announced that St. Joseph Medical Center in Towson Maryland will pay $22 million to settle allegations that it violated the federal False Claims Act…
Continue Reading Hospital Pays $22M Settlement for Allegedly Improper Physician Professional Service Agreements
HHS Secretary Kathleen Sebelius addressed the New York Health Care Fraud Prevention Summit on November 5 in Brooklyn and updated attendees on the government’s efforts to rein in health …
Continue Reading HHS Secretary Sebelius Talks Fraud, Payment Reform At Summit
Two recent Advisory Opinions by the Office of Inspector General (OIG) shed some much needed light of the OIG’s view of marketing by health care providers.
Continue Reading OIG Advisory Opinions Shed Light on Marketing Activities
Responding to input from medical school deans and residency program directors in a recent survey, the OIG has published a plain-English compliance summary for new physicians entitled Roadmap for …
Continue Reading OIG Publishes Physician Compliance “Roadmap”
The recently enacted health reform law has ignited a great deal of public interest in rising health care costs and the underlying reasons for them. Not surprisingly, fraud, waste and abuse in…
