Your prescribed dose of health law news
In the next installment of Rivkin Radler’s Healthcare Compliance Lunch & Learn series, Rivkin Radler’s Bob Hussar will discuss the first two required elements of an Effective Compliance Program:
1. Policies and Procedures; and
2. Compliance Officer/Compliance Committee
Bob is a partner in Rivkin Radler’s Compliance, Investigations & White Collar and Health Services practice groups.
A recent article in Part B News, “Be careful about upcoding; DOJ may come after it as a false claim,” discussed how the U.S. Department of Justice frequently prosecutes improper billing of CPT codes for Medicare patients. Rivkin Radler’s Jeff Kaiser was quoted in the article.
“Sometimes, a provider will upcode a…
The U.S. Department of Justice announced on February 27 that the University of Pittsburgh Medical Center (UPMC), James Luketich, its Chair of Cardiothoracic Surgery, and University of Pittsburgh Physicians have agreed to pay $8.5 million to settle a qui tam suit brought by a former UPMC cardiothoracic surgeon. The suit, brought under the False Claims…
As many of our readers are no doubt already aware, the U.S. Department of Health and Human Services announced on February 9 that the COVID-19 public health emergency (PHE) will end on May 11. The announcement gave payers, providers and states 90 days to prepare for policy changes.
As discussed here, most current Medicare…
On the heels of publishing their final regulations, on January 31, the New York Office of the Medicaid Inspector General (OMIG) released a variety of guidance documents addressing compliance programs; self-disclosure; and Medicaid managed care fraud, waste and abuse prevention programs. The guidance documents can be found at:
In the next installment of Rivkin Radler’s Healthcare Compliance Lunch & Learn series, Rivkin Radler’s Bob Hussar, Ashley Algazi and Mary Connolly will present “OMIG’s FINALIZED Regulations: What You Need to Do – NOW!”
On December 28, the Office of Medicaid Inspector General (OMIG) released their final compliance and self-disclosure regulations. The regulations implement 2020…
For those who just can’t get enough fraud, here are some of the “leftovers” from this edition of Fraud Week that your editor thought noteworthy.
Read about a pharmacy biller’s fake copay assistance scheme:
Genetic testing kickback schemes
In TX: https://www.justice.gov/opa/pr/laboratory-owners-and-executives-charged-health-care-kickback-scheme
And here’s a big one in GA: https://www.justice.gov/opa/pr/lab-owner-convicted-463-million-genetic-testing-scheme-defraud-medicare
DME kickback…
The U.S. Attorney for the District of Connecticut recently announced that Michael Lonski, a Greenwich psychologist, pleaded guilty to healthcare fraud. Lonski admitted to billing insurers for services that were not rendered, including for deceased patients, and for dates of service when he was out of the country, or his medical partner was out of…
The U.S. Department of Justice (DOJ) announced on January 20 that DePuy Synthes, a subsidiary of Johnson & Johnson, agreed to pay $9.75 million to resolve allegations that it entered into a kickback scheme with an unnamed Massachusetts orthopedic surgeon. DePuy admitted that from 2013 to 2018, it gave the surgeon instruments and implants worth…
The U.S. Attorney for the Eastern District of New York recently announced that Morris Barnard, a Great Neck gastroenterologist, was sentenced to 30 months in jail for billing Medicare for procedures he never performed. Between 2015 and 2020, Barnard submitted over $3 million in false claims for colonoscopy and gastroenterological procedures for disabled patients living…
