The U.S. Department of Justice (DOJ) recently announced that Reliance Medical Systems LLC, a Utah-based distributor of spinal implant devices, two of its individual owners, and two of its physician-owned distributorships (PODs) agreed to pay $1 million to resolve a lawsuit brought under the False Claims Act. Reliance allegedly operated the PODs as a vehicle
HHS OIG Issues Telehealth Fraud Alert
On July 20, the U.S. Department of Health and Human Services’ Office of Inspector General (OIG) issued a Special Fraud Alert to caution healthcare practitioners who may wish to enter into arrangements with telehealth companies. The Alert describes several types of fraud schemes that have resulted in federal investigations and civil and/or criminal charges, particularly
HHS Renews COVID-19 Public Health Emergency Again
California Corporate Practice of Medicine Lawsuit Survives Motion to Dismiss
On May 27, the U.S. District Court for the Northern District of California refused to dismiss a lawsuit[1] brought against Envision Healthcare Corp. alleging violations of California’s corporate practice of medicine (CPOM) prohibition, as well as state fee-splitting and kickback prohibitions. The action was brought by the American Academy of Emergency Medicine Physician Group
NY Pharmacy Owner Sentenced for Healthcare Fraud
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
21 Charged in Federal COVID-19 Fraud Sweep
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
HHS Extends COVID-19 Public Health Emergency Again
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 Law Allows Experienced NPs to Practice Independently in NY
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
OCR Announces Four HIPAA Enforcement Actions
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
Malpractice Statute of Limitations Doesn’t Apply to Indemnity Claim by Hospital
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