Tis the Season: Gifts to Medicare Patients Nice Gesture or a Crime?

As we approach the holidays, now may be an appropriate time to point out the rules relating to gifts that providers can give to Medicare and Medicaid beneficiaries. During this time of the year, some healthcare professionals may want to give gifts to their patients, other physicians or even referral sources. Before you do, consider […]

Advisory Opinion: Clinic Can Provide Free Telemedicine Equipment, Services

A nonprofit, federally qualified health center look-alike (FQHC) can use grant funds to provide telehealth equipment and services for free to facilitate encounters with patients of a county-run clinic that provides testing, treatment and counseling for HIV, based on a recent advisory opinion issued by the Department of Health and Human Services Office of the […]

OIG Opinion: Providing Sample Ostomy Products Does not Violate Anti-Kickback Statute

An ostomy product distributor can give free samples to Medicare patients without worrying about violating the federal Anti-Kickback Statute, according to a recent advisory opinion from the Office of Inspector General for the U.S. Department of Health and Human Services. The Anti-Kickback Statute makes it a criminal offense to knowingly and willfully offer, pay, solicit […]

Ridesharing Agreements Present Anti-Kickback Risks

Earlier this month, Uber announced the unveiling of a new service it has dubbed “Uber Health” which it describes as “a way to partner with healthcare organizations to provide reliable, comfortable transportation for patients.” The dashboard allows healthcare professionals to order rides for patients who either need to get to, or get home from, healthcare […]

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 […]

Case of 79-year-old Doctor Illustrates Need for Caution When Accepting Payments

The federal trial of a 79-year-old New Jersey physician charged in connection with a healthcare kickback scheme serves as yet another example of federal prosecutors’ aggressive stance against healthcare fraud and abuse. Dr. Bernard Greenspan is the latest physician to find himself facing jail time. He was among more than 40 people, many of them […]

OIG’s New Safe Harbors, Civil Monetary Penalty Exceptions Set to Take Effect

On January 6, new safe harbors to the federal anti-kickback statute and amendments to the civil monetary penalty rules will take effect. The expansion of existing safe harbors, along with the addition of new ones, were issued by the Department of Health and Human Services Office of the Inspector General on Dec. 7, and are […]

Feds Step-up Crackdown on Fraudulent Billing for Compounded Meds

The recent indictment of a St. Petersburg physician who was charged with receiving illegal kickbacks for writing prescriptions for compounded medications serves to further highlight the federal government’s increased level of scrutiny over the industry. The facts of the latest case are as follows: Dr. Anthony Baldizzi was charged on June 23 with one count […]

Healthcare Fraud and Abuse Crackdown Not Slowing as Evidenced by Recent Cases

The federal government has been busy since the beginning of the year announcing arrests, convictions and settlements relating to healthcare fraud and abuse. The activities relate to violations of the Stark Law, anti-kickback law and federal False Claims Act, and there appears to be no end in sight. Whether it’s home health, transportation, durable medical […]

TRICARE Billing Scandal Intensifies as Feds Target More Compounding Pharmacies

Allegations of fraudulent billing practices involving compounding pharmacies and specialty creams is rearing its ugly head again. Now, the U.S. Department of Justice is investigating what is suspected to be half a billion dollars in healthcare fraud linked to these creams used to treat pain. TRICARE, the health insurance program for members of the U.S. […]

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