On March 28, the U.S. Departments of Health and Human Services, Labor and the Treasury collectively issued final rules with respect to short-term and limited duration insurance (STLDI) plans in an effort to reduce healthcare costs by protecting consumers from purchasing such “junk” health plans that may provide little to no coverage in many scenarios.
Health Network Pays $345 Million for Compensating Physicians Above FMV
Community Health Network, Inc., based in Indianapolis, Indiana, has paid $345 million to settle alleged violations of the False Claims Act (FCA). The lawsuit was initiated through a whistleblower complaint that was filed in 2014 by the network’s former Chief Financial Officer. The suit alleged that, between 2008 and 2009, the network recruited hundreds of
Neurosurgeon Settles FCA Allegations for $825,000
The U.S. Department of Justice (DOJ) recently announced a settlement with a Missouri neurosurgeon and his fiancée regarding alleged violations of the False Claims Act (FCA) and Anti-Kickback Statute (AKS). The parties agreed to pay $825,000 to settle the case.
The neurosurgeon and his fiancée were accused of receiving impermissible kickbacks from spinal implant companies
Arizona Hospital Pays $1.25 Million in HIPAA Settlement After Cyber Attack
The U.S. Department of Health and Human Services’ Office for Civil Rights (OCR) announced on February 2 that Banner Health, a not-for-profit hospital system based in Arizona, has paid $1.25 million in order to settle alleged HIPAA violations in connection with a cyber attack.
The incident occurred in 2016 when a hacker gained access to
OIG Advisory Opinion Promotes Hospital Use of NPs
The U.S. Department of Health and Human Services’ Office of Inspector General (OIG) recently issued a favorable Advisory Opinion on a hospital arrangement in which the hospital was using its employed nurse practitioners to perform services that were traditionally performed by patients’ attending physicians. Specifically, if the attending physician elected to participate in the hospital’s
NY Pharmacy Owners Plead Guilty to Money Laundering During COVID-19
The U.S. Department of Justice (DOJ) announced on November 16 that two pharmacy owners from Forest Hills, New York have pleaded guilty to conspiracy to commit money laundering through submission of fraudulent claims to Medicare during the COVID-19 pandemic. The co-conspirators owned over a dozen pharmacies in the New York area, through which they submitted
Pharmacy Owners Charged for Fraud and Kickbacks to a Marketing Company
The U.S. Department of Justice recently announced that a federal grand jury has charged two pharmacy owners, a mother-daughter duo from South Florida, with healthcare fraud, wire fraud, and payment of kickbacks in exchange for patient referrals.
According to the indictment, the pharmacy entered into sham contracts with marketing and telemedicine companies that disguised the
OIG Concludes that $25 Patient Gift Card Presents Low Risk of Fraud and Abuse
The U.S. Department of Health and Human Services’ Office of Inspector General (OIG) recently issued an Advisory Opinion on offering gift cards to patients for completing an online patient education program.
In this particular case, the online program was used to educate patients on the risks, benefits and expectations relating to surgeries, and it was
Employer Alert: First Deadline to Claim NYS Healthcare Worker Bonus is September 2
As part of its 2023 state budget, New York State has allocated $1.2 billion for the payment of bonuses to certain frontline healthcare workers. This bonus program is intended to reward healthcare workers for their services during the COVID-19 pandemic and to promote employee retention and recruitment in the healthcare sector. Qualified employers who wish
University Health Center Pays $875,000 in HIPAA Fines after Cyber Hack
Oklahoma State University’s Center for Health Services recently paid $875,000 to settle potential HIPAA violations after a cyberattack resulted in the unauthorized access of its patients’ protected health information. A hacker installed malware on the Center’s web server which contained electronic protected health information. More than 275,000 individuals were affected by the breach, which resulted