Your prescribed dose of health law news
Kenneth Fishberger, a Long Island internist with nearly 50 years of medical experience, recently pleaded guilty to conspiracy to commit healthcare fraud. Prosecutors revealed that from 2013 to 2019, Fishberger ordered hundreds of medically unnecessary transcranial doppler (TCD) brain scans in exchange for kickbacks.
In this scheme, Fishberger collaborated with a salesperson and a principal…
A November 25 article in Part B News, “Third-party biller fraud may hook your practice, unless you protect yourself,” discussed the federal government’s recent fraud investigation of a medical biller in New York State and healthcare providers’ obligation to ensure the accuracy of their claims billing. Rivkin Radler’s Jeff Kaiser was quoted…
On October 31, Elevance Health filed suit against the U.S. Department of Health and Human Services (HHS) and the Centers for Medicare & Medicaid Services (CMS) to challenge the 2025 Star Ratings system used for Medicare Advantage and Part D plans. CMS published the final Star Ratings to the public on October 10 through the…
One of the nation’s largest urine drug testing laboratories recently settled with the federal government by paying $27 million to resolve alleged violations of the federal False Claims Act (FCA) and state statutes. Precision Toxicology (d/b/a Precision Diagnostics), headquartered in San Diego, allegedly provided medically unnecessary urine drug testing and offered free items to physicians…
On October 9, 2024, the United States Attorney’s office in the Eastern District of New York unsealed an indictment alleging that eight defendants defrauded Medicaid of approximately $68 million.1 The alleged scheme involved two adult day care programs and a home care financial intermediary, all owned and controlled by the same individuals, as well…
Eight individuals associated with two Brooklyn social adult day care centers and a home health care intermediary have been charged in an alleged $68 million Medicaid fraud scheme. The defendants, including owners and staff from Happy Family Social Adult Day Care Inc., Family Social Adult Day Care Inc., and Responsible Care Staffing, Inc., are accused…
The U.S. Attorney’s Office for the Southern District of California announced on October 11 that Dr. Janette Gray and her former medical practice, The Center for Health & Wellbeing in San Diego, resolved False Claims Act (FCA) allegations by agreeing to pay $3.8 million.
Gray and her practice allegedly billed Medicare and TRICARE from 2012…
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…
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…
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…
