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 […]

Home healthcare agencies, aides top fraud list

Home healthcare agencies and home healthcare aides topped the list of providers with the largest number of healthcare fraud convictions in 2014, according to a report released last month by the HHS Office of the Inspector General. Of the more than $1.9 billion recovered in total civil judgments and settlements, the federal government recovered $186 […]

What happens if you become the target of a healthcare fraud investigation?

No healthcare provider wants to become the target of a healthcare fraud investigation. But, as we have seen, it happens more often than we would like to think. Not only does a healthcare fraud investigation come with the potential for criminal penalties, but the state also can impose harsh consequences resulting in the loss of […]

Whistleblower lawsuits: How to avoid becoming a target

Earlier this month, three former managers of AIDS Healthcare Foundation Inc. (AHF) filed federal and state Whistleblower Act claims against their former employer. They allege that the nation’s largest supplier of HIV/AIDS medical care participated in patient referral kickbacks to the tune of at least $20 million since 2010. All three plaintiffs held management positions […]

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 […]

CMS cracking down on fraudsters

Federal agencies are stepping up their efforts to go after providers who engage in healthcare fraud and abuse. On Dec. 3, the Centers for Medicare & Medicaid services issued new rules designed to crack down on what the agency refers to as “bad actors,” as part of an effort to increase oversight of Medicare providers, […]

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It is not intended as professional advice and should not be construed as such.