When Ignorance is Not a Defense

A 79-year-old New Jersey physician who was charged in connection with a healthcare kickback scheme now faces sentencing in June after being convicted of accepting bribes in exchange for blood test referrals. As we previously wrote about, Dr. Bernard Greenspan, 79, was among more than 40 people, many of them physicians, who allegedly accepted payments […]

Compounding pharmacies in the eye of investigative storm

In the last year or so there have been a number of stories in the media about investigations into wrongdoing by compounding pharmacies, marketing companies and physicians. At last count there were nearly 100 federal investigations underway for what the feds believe are questionable financial relationships involving these three entities. In some instances, physicians are […]

Ready or not here ICD-10 comes

With less than three months until the implementation of the long-awaited ICD-10, it appears many providers are still unprepared – particularly in the areas of testing and assessing the impact it will have on revenue. A new report published by AHIMA and the eHealth Initiative finds that while half of the respondents had completed test […]

OIG adds 21 new investigative focus areas

The Office of Inspector General at the U.S. Department of Health and Human Services recently released the midyear update  of its annual work plan, which not only outlined its accomplishments between October 2014 and May 2015 but also added 21 new focus areas for next year. The OIG noted that it will continue to look […]

Feds use data analytics to detect and investigate Medicare fraud

There have been countless stories in the news about how the federal government has gone about combating Medicare fraud. Still, every year the battle rages on. Between 2012 and 2014, the Office of the Inspector General’s investigations have resulted in $14.8 billion in investigative receivables (dollars ordered or agreed to be paid to government programs […]