Here’s a selection of recent healthcare frauds from New Jersey. On April 17, John Sher of Margate was sentenced to 37 months in prison and ordered to pay $2.77 million in restitution and $327,987 in forfeiture for defrauding New Jersey state and local health benefits programs and other insurers. Sher and a co-conspirator recruited state…

Transportation fraud isn’t new, but it’s new to Rivkin Rounds. The U.S. Attorney’s Office for the Southern District of New York recently announced that Yonkers resident Julio Alvarado was sentenced to 95 months in prison for leading a scheme that billed Medicaid for fraudulent transportation claims. From 2017 to 2020, KJ Transportation C Services Inc.…

To celebrate the opening of Rivkin Radler’s first Florida office, we’ll cover some recent Florida frauds. The U.S. Department of Justice (DOJ) announced on April 20 that two Miami residents, Dean Zusmer and Lawrence Alexander, were sentenced to prison for their roles in a Medicare fraud scheme. Zusmer, a chiropractor, and Alexander, an orthopedic surgeon…

The U.S. Department of Justice (DOJ) announced on April 20 that it has brought criminal charges against 18 defendants across the U.S. for various fraud schemes related to the COVID-19 pandemic. The DOJ seized more than $16 million in cash and other proceeds from the schemes, which resulted in more than $490 million in false…

On the heels of New York’s Office of the Medicaid Inspector General (OMIG) releasing updated compliance requirements, the U.S. Department of Health and Human Services’ Office of Inspector General (OIG) announced today that it will also be updating and modifying its voluntary compliance guidance documents.

The OIG’s stated purpose for the modifications is to improve…

The New York State Department of Health (DOH) issued Dear Adult Care Facility Administrator Letter (DACF) #23-02 on March 29 announcing that adult homes, enriched housing programs, and assisted living residences will have a new electronic Incident Reporting mechanism—the Drupal Survey. The Drupal Survey will replace the previous incident reporting method via the Health Commerce…

The U.S. Department of Health and Human Services’ Office for Civil Rights (OCR) announced on April 11 that the Notifications of Enforcement Discretion issued under HIPAA and the HITECH Act during the federal COVID-19 public health emergency (PHE) will expire when the PHE ends on May 11.

The four Notifications of Enforcement Discretion that will…

As previously discussed here, New York Governor Kathy Hochul’s proposed budget contained a bill that, if passed, would be transformative for certain healthcare transactions. Gov. Hochul’s proposal was dropped from both one-house budgets proposed by the New York State Senate and Assembly.

While its passage appears unlikely, the final budget is now delayed past…

In the next installment of Rivkin Radler’s Healthcare Compliance Lunch & Learn series, Rivkin Radler’s Bob Hussar will discuss the third and fourth required elements of an Effective Compliance Program:

  • Training
  • Effective lines of communication

Bob is a partner in Rivkin Radler’s Compliance, Investigations & White Collar and Health Services practice groups. The program will…