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. […]

Feds to increase exclusion and civil monetary penalty enforcement cases

When it comes to exclusion and civil monetary penalty cases, the federal government is preparing to take an even harder line than in the past. During the recent Health Care Compliance Association’s Healthcare Enforcement Compliance Institute, Gregory Demske, chief counsel at the Health and Human Services Office of Inspector General, told an audience his agency […]

OIG opinion: Free transportation doesn’t violate anti-kickback statute

The U.S. Department of Health and Human Services Office of Inspector General recently issued an opinion stating that a large healthcare system’s free van shuttle service for patients does not violate the federal anti-kickback statute. The statute makes it a criminal offense to knowingly and willfully offer, pay, solicit, or receive any remuneration to induce […]

OIG opinion: Free home health visits are not kickbacks

The U.S. Department of Health and Human Services Office of Inspector General recently issued an opinion that a home healthcare provider’s policy to offer free introductory visits to patients who have already chosen it as their provider does not violate the federal anti-kickback statute. In its request for an advisory opinion, the home healthcare provider […]

OIG cracking down on medical director compensation

If you are thinking of taking on medical director responsibilities, or you are a medical director, there are some things you need to know to ensure that you do not run afoul of kickback laws. On June 9, the OIG issued a fraud alert noting that physicians who enter into compensation arrangements, such as medical […]