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Compliance Update
OIG reveals fraud risk indicator Print E-mail
Written by Vitale Health Law   
Monday, 15 October 2018 00:00
 
The Health and Human Services Office of Inspector General has launched a new initiative designed to draw attention to those healthcare providers it considers to be high risk for committing healthcare fraud after having been charged under the False Claims Act. The OIG posted this Fraud Risk Indicator on its website after Gregory Demske, the OIG's chief counsel announced the initiative during the American Health Lawyers Association's Fraud and Compliance Forum late last month. Soon providers will be listed with their risk ranking. The OIG evaluates healthcare fraud cases on a continuum with Highest Risk being those who have been excluded from participating in federal healthcare programs (i.e. Medicare and Medicaid) to Lowest Risk, being those who self-disclosed potential fraud and abuse to the OIG.
 

Last Updated on Tuesday, 16 October 2018 17:14
 
How an Innocent Social Media Post Can Turn Into a HIPAA Violation Print E-mail
Written by Vitale Health Law   
Monday, 24 September 2018 00:00
 
A Texas nurse recently learned that you don't have to identify a patient by name to violate Health Insurance Portability and Accountability Act (HIPAA) rules. According to a number of published reports, the unidentified woman,  who worked as an ICU/ER nurse, was fired from her job with Texas Children's Hospital in Houston after posting about a boy who was being treated for a suspected case of the measles. The nurse, an anti-vaccine proponent, posted about her experience treating the child, whom she identified only as between the age of 1 and 3 years old, on a Facebook site called "Proud Parents of Unvaccinated Children - Texas." The hospital became aware of her post when another Facebook user notified them.
 

Last Updated on Tuesday, 25 September 2018 16:58
 
Anti-Kickback Statute and Healthcare Marketing: 3 Legal Considerations Print E-mail
Written by Matt Fischer | Florida Healthcare Law Firm   
Tuesday, 11 September 2018 16:58
 
Healthcare marketing arrangements that violate the Anti-Kickback Statute (AKS) can lead to serious financial and criminal consequences. Understanding the types of marketing arrangements that courts have found to be in violation of the statute and the potential implications are critical for marketers to know in order to operate in the healthcare industry.
 
Under the AKS, it is a criminal offense to knowingly and willfully offer, pay, solicit, or receive any remuneration to induce referrals of items or services reimbursable by the Federal health care programs. Where remuneration is paid purposefully to induce referrals of items or services paid for by a Federal health care program, the AKS is violated. By its terms, the AKS ascribes criminal liability to parties on both sides of an impermissible transaction. An example of a highly scrutinized arrangement involves percentage compensation. For regulators, percentage compensation arrangements provide financial incentives that may encourage overutilization and increase program costs.
 
Here are 3 important things to know...
 
Read More

Last Updated on Tuesday, 11 September 2018 17:10
 
OIG Takes Notice as Compound Drug Use Skyrockets Print E-mail
Written by Vitale Health Law   
Tuesday, 04 September 2018 16:54
 
The cost of compounded topical drugs to the country's Medicare program has  skyrocketed over the past several years, and that's gotten the attention of a government watchdog agency. In a recently released report, the U.S. Department of Health and Human Services Office of Inspector General (OIG) found that Medicare Part D spending for these drugs was 24 times higher in 2016 than in 2010.
 

Last Updated on Tuesday, 02 October 2018 12:14
 
Common Healthcare Fraud Schemes Print E-mail
Written by Vitale Health Law   
Monday, 16 July 2018 00:00
 
Last month's indictment of more than 600 people nationwide, in what the feds dubbed "the largest healthcare fraud takedown in history," should serve as a warning that the government is serious about cracking down on those who abuse the system.
 
As we wrote about in June, of the 601 defendants charged, 165 were medical professionals and the alleged crimes run the gamut - from accepting kickbacks  to writing illegal prescriptions to billing for services that were not provided. In total, the government estimates that the individuals were responsible for more than $2 billion in fraudulent billing. In the Southern District of Florida, 124 defendants were charged with offenses relating to their participation in various fraud schemes involving more than $337 million in false billings. Although healthcare fraud schemes come with their own set of circumstances, many are taken from the same playbook.
 
Here's a quick rundown of some of those tactics being used and some tips on how you can spot such illegal misconduct...
 
Last Updated on Tuesday, 17 July 2018 11:42
 
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