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Don’t Violate HIPAA Fighting Bad Yelp Reviews

Healthcare providers, beware: You cannot respond to bad online reviews by disclosing your patients’ protected health information (or PHI). As you know, PHI refers to any health information that identifies or could be used to identify a patient. If you’re not sure what counts, do your homework or call your lawyer. But don’t disclose it Read More

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The Lure of Free Cancer Screenings

Last week, the U.S. Justice Department announced a major takedown of telemedicine that it says went too far. It’s among the bigger healthcare-fraud sweeps to date: 35 people charged with over $2.1 billion in false or fraudulent bills. The defendants hail from telemedicine companies and genetic-testing labs and include nine physicians. They reportedly billed Medicare for tens Read More

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HHS Reduces HIPAA’s Maximum Fines

Last month, the U.S. Department of Health and Human Services said it would no longer apply the same maximum fines to all HIPAA violations regardless of fault or blameworthiness. Before, the agency used the same maximum annual penalty, $1.5 million, for all violations regardless of whether or not you knew you violated HIPAA; whether or not you Read More

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Two Billion-Dollar Healthcare Prosecutions in One Month

Last month, the U.S. Justice Department reported two healthcare prosecutions for billion-dollar frauds. In the first, federal prosecutors in Florida won what they’ve called the biggest healthcare-fraud conviction ever. The target was the owner of a chain of nursing homes who allegedly billed over a billion dollars in fraudulent claims to Medicare and Medicaid over eighteen years. Read More

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California Hospitals Must Report Disciplinary Actions to the State

Remember the hospital from last week? It suffered a $4 million judgment because it revoked a doctor’s staff privileges without notice or an administrative hearing. It may also have violated another law that applies when a hospital (or clinic or like facility) revokes someone’s privileges (or takes similar action) for a medical disciplinary reason. It Read More

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You Can’t Revoke a Doctor’s Hospital Privileges Without Due Process

This ain’t your grandfather’s medical practice anymore, is it? The modern doctor must deal with a dizzying array of rules and regulations like the one we covered last week. At the same time, California law affords you certain protections that can’t be bargained around or contracted away, as a hospital found out when it tried Read More

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California Doctors Must Check Patient Database Before Prescribing Most Drugs

Speaking of new rules, we’ve written about this before, and if you work in healthcare then you already know. As of October 2, doctors and other healthcare providers must check a statewide database before prescribing any Schedule II-IV drug. It’s called CURES: the Controlled Substance Utilization Review and Evaluation System. It’s a prescription-drug monitoring program to curb Read More

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‘Tis the Season for Healthcare Enforcement

Speaking of health care, the federal government brought the heat again this summer. As it has for several years, it announced major, coordinated raids and arrests of healthcare providers and professionals around the country. We covered the government’s raids in 2015 and 2017, and they’re getting bigger and badder each year. This year’s takedown set new records Read More

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Feds Raise Healthcare Penalties Again

If you’re a healthcare provider who takes Medicare or another federal program, take note. We didn’t get a government shutdown, but the budget law from last week more than doubled the civil and criminal penalties you face when the government accuses you of fraud, waste, or abuse. To see for yourself, click the link and scroll all Read More

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When the Doctor Is Not In

Last week, it was the California Medical Board, but Medicare ain’t playing around either, doc. It will revoke your billing privileges if you submit inaccurate claims, and it will test the accuracy of those claims by mining data about you and your travels. Recently, for example, the government revoked a clinic’s privileges because it determined the doctor who supposedly rendered Read More

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