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Healthcare Investigations at Warp Speed

We covered one of the U.S. Justice Department’s major healthcare sweeps last month. But we didn’t know the feds had shut things down with such blinding speed. Reportedly, it took them six to eight months from first alert to coordinated raids. The investigation is said to have begun earlier this year when analysts detected a surge in Read More

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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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‘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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Don’t Keep The Change, Doc

Meaning, don’t just pocket the difference when the government overpays you for healthcare goods or services. Recently, a medical group agreed to pay $450,000 to settle allegations that it refused to return $175,000 in overpayments that it received from federal healthcare programs like Medicare and Medicaid. Here’s the government’s press release. The overpayments at issue tend to happen in medical Read More

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Feds Arrest Hundreds in Healthcare Raids

Last week, the federal government conducted nationwide raids of healthcare providers and facilities based on $1.3 billion in allegedly false billings. In one day, the feds arrested 412 people in a coordinated takedown that netted 115 doctors, nurses, and other licensed professionals. The government also brought legal action to exclude 295 providers—including doctors, nurses, and pharmacists—from further participating in Read More

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