Compliance Update

Moratorium on Behavioral Analysis Providers Lifted

A moratorium on behavioral analysis services in Miami-Dade and Broward counties imposed by the Agency for Healthcare Administration expired as of Nov. 13, 2022. And it appears that AHCA has decided not to extend it for another six months as it has in the past since it was first imposed in 2018. AHCA said the moratorium’s goal was to fight fraud and safeguard taxpayer dollars, while ensuring...

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Avoiding PIP Billing Litigation with Proper AHCA Licensing

It is a well settled presumption in Florida that healthcare providers can own a medical practice without the need for obtaining a Health Care Clinic License (HCCL). However, healthcare providers who bill motor vehicle insurances for personal injury benefits (PIP) need to be aware of the regulatory requirements and how enforcement has developed. Providers may know that each insurance plan has a...

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Feds Use Data Analytics to Detect Fraud

A Jacksonville-based healthcare provider accused of making false or fraudulent claims with the Florida Medicaid program agreed to pay $700,000 to resolve allegations it violated the False Claims Act. The case against Physicians Group Services resolves allegations that PGS submitted claims to Florida’s Medicaid program for quantitative urine drug testing that were medically unnecessary because...

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Pharma-Funded FDA Gets Drugs Out Faster, But Some Work Only ‘Marginally’ and Most Are Pricey

Dr. Steven-Huy Han, a UCLA liver specialist, has prescribed Ocaliva to a handful of patients, although he’s not sure it helps. As advertised, the drug is lowering levels of an enzyme called alkaline phosphatase in their blood, and that should be a sign of healing for their autoimmune disease, called primary biliary cholangitis. But “no one knows for sure,” Han said, whether less enzyme means...

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FDA and Stem Cells: Update

There was a big update in the stem cell industry recently as a California judge issued a favorable order on behalf of a California based stem cell treatment provider. California Stem Cell Treatment Center, Inc., is a California based medical company offering SVF surgical procedures and MSC surgical procedures. A few years ago, the Food and Drug Administration (FDA) sought an injunction against...

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Feds Hot on the Trail of PPP Fraud

On August 19, a Kansas chiropractor was convicted on multiple charges for Paycheck Protection Program (PPP) loan fraud. According to the U.S. Department of Justice, Timothy Dale Warren was charged with four counts of bank fraud, two counts of money laundering, and four counts of false statements. According to court documents, as owner of Titan Medical Center LLC Warren fraudulently obtained PPP...

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