We’ll wrap up this edition of Fraud Week with a look at two Connecticut behavioral health providers, one bad and one very, very bad. First, Alicia Thompkins, a social worker from Hartford, pleaded guilty on April 27 to Medicaid fraud, but received only a three-year suspended jail sentence and an order to pay $140,000 in
Fraud Week: Garden State Fraud Roundup; Much Compounding
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…
Fraud Week: NY Transportation Company Owners Jailed, Fined
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.…
Fraud Week: Focus on Florida Fraud
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…
Fraud Week: DOJ Announces COVID-Related Fraud Sweep
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…
OIG to Update Compliance Program Guidance Documents
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…
NYS DOH Launches New Electronic Incident Reporting Form
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…
PHE HIPAA Enforcement Discretion to Expire, Restoring Compliance Obligations
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…
Budget Delay Puts Cloud Over Gov. Hochul’s Healthcare M&A Regulatory Review
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…
Implementing an Effective Compliance Program: A Focus on Elements Three and Four
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…