Nov 10th, 2017
Lately it seems that the Office of Inspector General’s (OIG) focus is on fraud and abuse of federal healthcare dollars via the False Claims Act; however, a case in Newark, N.J., has proven that the Anti-Kickback Statute also is being enforced in a big way. A Staten Island doctor, Ahmed El Soury, has been sentenced ...
Promote a compliant environment within your organization, before the whistle is blown. The most notable Medicare fraud cases in the last five years have been whistleblower cases in which someone with inside knowledge of a health system or physician practice (usually an employed physician or administrator) files suit against the employer under the federal False ...
Mar 1st, 2016
Medical device manufacturer Olympus agreed to pay a $646 million fine to end criminal and civil probes alleging the company paid bribes and kickbacks to physicians and hospitals. It’s the largest settlement yet for violations of the U.S. Anti-kickback law. According to Kaiser Health News, federal investigators said the company used grants, consulting deals, trips ...
Jan 26th, 2016
Two recent cases from Georgia demonstrate that organizations must not ignore—and certainly shouldn’t fire (as a knee-jerk reaction)—employees who raise compliance concerns and who are protected by the False Claims Act (FCA). In one case, HCA Holdings, Inc., (HCA) the largest operator of healthcare facilities in the United States, entered into an agreement with the ...
Six takeaways illustrate the importance for providers to have a working compliance plan. By Marcia L. Brauchler, MPH, CMPE, CPC, COC, CPC-I, CPHQ Compliance is the hot topic in healthcare right now — and with good reason. Government payers, especially, are aggressively targeting compliance vulnerabilities, including improper coding and billing (intentional or otherwise), HIPAA lapses, ...