A recently issued federal court opinion confirmed that certain pre-COVID era prescribing restrictions are back in place. In July 2023, a nonprofit advocacy group, Community Oncology Alliance, filed suit against the U.S. Department of Health and Human Services (HHS) regarding provisions of the Stark Law. Stark prohibits physicians from referring Medicare and Medicaid patients to
Litigation
OCR Imposes $240,000 Penalty in HIPAA Ransomware Investigation
The U.S. Department of Health and Human Services’ Office for Civil Rights (OCR) imposed a $240,000 civil monetary penalty against Providence Medical Institute in connection with a ransomware attack that revealed vulnerabilities in the Institute’s systems and potential HIPAA violations.
The Institute was the victim of a series of ransomware attacks in 2018 that compromised…
Lab Owner Pleads Guilty to COVID-19 Testing Fraud Scheme
On October 1, the U.S. Attorney’s Office for the Northern District of Illinois announced that Zishan Alvi, the owner of a Chicago laboratory, pleaded guilty to one count of wire fraud for his role in a COVID-19 testing fraud scheme.
Alvi pleaded guilty to causing claims to be submitted to the U.S. Department of Health…
HRSA to J&J: Cease Implementation of New 340B Rebate Model
As previously discussed here, Johnson & Johnson (J&J) recently announced its intention to change its 340B Drug Pricing Program discount available to disproportionate share hospital (DSH) Covered Entities on purchases of STELARA and XARELTO. However, the Health Resources and Services Administration (HRSA) notified J&J that its rebate model was contrary to the 340B statute…
Connecticut Dentists Settle Kickback Claims
Three Connecticut dental practices, together with their owners, have agreed with the U.S. Attorney’s Office for the District of Connecticut to pay $1.7 million to settle allegations that the practices violated federal and Connecticut False Claims Acts and the federal Anti-Kickback Statute. This and other recent settlements seem to be suggesting that a crackdown on…
Radiology Practice to Pay $8.9M to Resolve FCA/AKS Claims
The U.S. Attorney’s Office for the Southern District of Texas announced on August 20 that National Interventional Radiology Partners PLLC (NIRP) and its founder and CEO will pay $8,884,091 to the United States to resolve alleged violations of the federal False Claims Act (FCA) and Anti-Kickback Statute. NIRP and Dr. Andrew Gomes allegedly illegally paid…
CA Dental Offices Pay $6.3M to Resolve FCA Claims
West Coast Dental Administrative Services LLC, which operates more than 40 dental and specialist locations in Southern California, and its affiliates have paid $6.3 million to resolve alleged violations of the False Claims Act (FCA). The alleged violations were in connection with loans received by the affiliated offices pursuant to the Paycheck Protection Program (PPP).…
Biotech Company Pays $4.5 Million for Data Breach
The Office of the New York State Attorney General announced on August 13 that Letitia James, along with the Attorneys General of Connecticut and New Jersey, fined Enzo Biochem, Inc. $4.5 million for failing to adequately safeguard its patients’ health data.
Enzo conducts drug research and development, and provides diagnostic services. In 2023, hackers accessed…
Medical Provider to Pay $115,200 Penalty for HIPAA Right of Access Violation
The U.S. Department of Health and Human Services’ Office for Civil Rights (OCR) recently announced that it ordered American Medical Response (AMR) to pay a civil monetary penalty of $115,200 for failing to comply with the patient right of access rule under HIPAA.
HIPAA requires that all covered entities provide timely access to a patient’s…
Know When to Bill Facility Fee for Telehealth Services!
The U.S. Attorney’s Office for the District of Connecticut recently announced that Supportive Care Holdings, LLC and its related companies agreed to pay the federal government nearly $4,600,000 to resolve allegations of submitting false claims. The Supportive Care companies provide behavioral health services via telehealth to patients residing in skilled nursing facilities.
Supportive Care’s companies…