The former CEO of a New Jersey-based company that owned and operated 24 skilled nursing facilities and nine assisted living facilities in Wisconsin and Michigan recently was indicted on charges of healthcare fraud, six counts of wire fraud, three counts of mail fraud, conspiracy to commit tax fraud, and conspiracy to commit money laundering. The crimes were allegedly perpetrated by Kevin Breslin...
“Breach of care” and “duty of care” are related concepts in the field of healthcare, specifically in nursing. While they are closely related, they have distinct meanings and implications. What Is Duty of Care? Duty of care refers to the legal and ethical obligation of a healthcare professional to provide safe and appropriate care to a patient. It is a fundamental principle of healthcare that...
Florida’s governor is taking aim at Pharmacy Benefit Managers (PBM). Earlier this month, Gov. Ron DeSantis announced legislation that he said would protect consumers and help in lowering the price of prescription drugs. A PBM is a third-party administrator of a prescription drug program that processes and pays prescription drug claims. They also are supposed to negotiate the price of...
Jacksonville, Fla.-based Ocenture LLC and its subsidiary, Carelumina LLC, agreed to pay $3 million to settle allegations that they paid and received kickbacks in connection with genetic testing samples. It was alleged that Ocenture solicited genetic testing samples from Medicare beneficiaries directly and through other marketers. The company then paid physicians to falsely attest that the...
President Biden has promised that the $740 billion Inflation Reduction Act, signed into law this August, will “lower the cost of prescription drugs and health care for families” thanks to provisions that allow the Department of Health and Human Services to negotiate the price of some medications directly with pharmaceutical companies. Critics are decidedly less enthusiastic. They say the IRA’s...
Efforts by the U.S. Department of Health and Human Services Office of the Inspector General (HHS-OIG) could result in the recovery of some $4 billion in misspent Medicare, Medicaid, and other health and human services funds. The work is outlined in the Fall 2022 Semiannual Report to Congress, which provides an overview of the watchdog agency’s activities for the reporting period comprising the...
