Providers Beware: Ensure That Diagnostic Tests are Medically Necessary!

A pen and paper with some diagnostic tests written on it

A fundamental principle of providing healthcare services to Medicare beneficiaries is that the services must be “medically necessary,†which means that they must be “reasonable and necessary for the diagnosis or treatment of illness or injury.†42 U.S.C. § 1395y(a)(1)(A). This requirement also imposes an obligation on healthcare providers to ensure that health services ordered…

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Eleventh Circuit Upholds Convictions for Patient Recruiter in Home Health Kickback Conspiracy

A pile of money with a stethoscope on top.

The Eleventh Circuit Court of Appeals recently upheld convictions for a South Florida patient recruiter for conspiring to defraud the United States and receiving illegal kickbacks for referring patients to a Medicare provider. The case involved Yamilet Diaz who was accused of sending Medicare beneficiaries to a home health agency in exchange for $2,000 per…

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