In CMS
Aug 13th, 2018
According to a Department of Justice (DOJ) U.S. Attorney’s Office Southern District of New York press release, Mustak Y. Vaid is the latest physician sentenced in a big Medicaid fraud ring involving six Brooklyn clinics between 2007 and 2013, who filled “prescriptions and referrals for medically unnecessary and/or non-existent tests and supplies.” He falsely posed ...
In Billing
May 4th, 2018
From Nov. 1, 2007 through Dec. 31, 2016, Banner Health billed Medicare for short-stay, inpatient procedures provided at 12 of its hospitals in Arizona and Colorado that should have been billed on a less costly outpatient basis, and inflated in reports to Medicare the number of hours for which patients received outpatient observation care, according ...
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 ...
In CMS
Feb 28th, 2017
New compliance program guidance has been issued by the Fraud Section of the Department of Justice (DOJ), according to an article published in the AHLA Weekly. Although the “Evaluation of Corporate Compliance Programs” (Guidance) is not specific to the healthcare industry, it does provide a practical set of benchmarks against which the audit & compliance committee, in ...
Jan 20th, 2017
The American Health Lawyers association reported the following in its weekly Fraud and Abuse update: The government won or negotiated more than $2.5 billion in healthcare fraud judgments and settlements in fiscal year (FY) 2016, the Departments of Health and Human Services (HHS) and Justice (DOJ) said in their Health Care Fraud and Abuse Control Program Annual ...