A New York woman was sentenced last month to 78 months in prison for defrauding healthcare programs, including obtaining more than $6.5 million from Medicare Part D plans and Medicaid drug plans.
Queens resident Aleah Mohammed owned five pharmacies, four of which operated under variations of the name “Superdrugs.” Between 2015 and 2020, the pharmacies
On April 20, the U.S. Department of Justice (DOJ) announced criminal charges against 21 people across the country for COVID-19-related frauds. The defendants are accused of over $149 million in false billings to federal programs and thefts from federally funded pandemic assistance programs.
Some of the defendants, in California, New York and Maryland, allegedly obtained
On April 12, Department of Health and Human Services (HHS) Secretary Xavier Becerra extended the COVID-19 public health emergency for another 90 days. The PHE had been scheduled to expire on April 16.
The PHE originally went into effect in January 2020, at the onset of the pandemic. It provides important flexibilities for healthcare providers,
New York’s 2023 state budget, signed into law on April 9, included an amendment to the state’s Education Law establishing 3,600 practice hours as a threshold beyond which nurse practitioners no longer require a collaborative agreement or a collaborative relationship with a physician to practice within their educational and clinical practice area. Practitioners such as
On March 28, the U.S. Department of Health and Human Services (HHS) Office for Civil Rights (OCR) announced four new enforcement actions against healthcare providers for HIPAA violations. Two of the actions were part of OCR’s HIPAA Right of Access Initiative which has been ongoing since 2019.
Three of the actions were against dental
This is outside our usual catchment area, but interesting nonetheless. The Indiana Supreme Court ruled on March 8 that the state’s Medical Malpractice Act (MMA) does not apply to claims for indemnification filed by one medical provider against another. The decision allows a contract claim by a hospital system against an outside radiology group to
At the beginning of the COVID-19 pandemic, the Centers for Medicare & Medicaid Services expanded Medicare coverage for telehealth nationwide, as discussed here. The $1.5 trillion omnibus spending bill signed into law by President Biden today extended the current telehealth accommodations for 151 days after the end of the federal public health emergency, which
The U.S. Department of Justice (DOJ) announced on March 3 that Ameet Goyal, M.D., a Westchester-based ophthalmologist, was sentenced to 96 months in prison for falsely billing for millions of dollars of upcoded procedures over seven years, and for fraudulently obtaining two business loans under the CARES Act’s Paycheck Protection Program (PPP) in the early
In a February 23 order, the U.S. District Court for the Eastern District of Texas vacated a controversial rule issued in September that implemented the independent dispute resolution (IDR) procedure under the federal No Surprises Act (NSA). The lawsuit[1] was brought by the Texas Medical Association. Numerous industry participants had complained that the
The U.S. Department of Health and Human Services’ Health Sector Cybersecurity Coordination Center (HC3) recently issued a report entitled “Electronic Medical Records in Healthcare” that discussed security risks applicable to electronic medical records (EMRs) and electronic health records (EHRs). EHRs and EMRs are prime targets for cyber attackers because protected health information (PHI)