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
NY Pharmacist in Oxycodone Scheme Pleads Guilty
By Eric Fader on
On February 17, Daniel Russo, a Long Island resident, pleaded guilty in federal court in Brooklyn to multiple charges in connection with illegally distributing oxycodone. Russo faces decades in federal prison when he is sentenced.
Russo owned and operated Russo’s Pharmacy in Far Rockaway, Queens. From 2011 to 2014, he filled thousands of fraudulent prescriptions…
COVID-19 PHE Ending on May 11
By Eric Fader on
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…
Arizona Hospital Pays $1.25 Million in HIPAA Settlement After Cyber Attack
By Ada Janocinska on
The U.S. Department of Health and Human Services’ Office for Civil Rights (OCR) announced on February 2 that Banner Health, a not-for-profit hospital system based in Arizona, has paid $1.25 million in order to settle alleged HIPAA violations in connection with a cyber attack.
The incident occurred in 2016 when a hacker gained access to…
OMIG Update: Compliance, Self-Disclosure, and Managed Care Fraud, Waste and Abuse Guidance Posted
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:
OMIG’s FINALIZED Regulations: What You Need to Do – NOW!
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…
Fraud Week: So Much Fraud, So Little Time
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…
Fraud Week: 25 Charged in Fake Nursing Diploma Scheme
By Eric Fader on
Posted in Fraud and Abuse, Litigation
The U.S. Department of Justice (DOJ) announced on January 25 that 25 defendants have been indicted in Florida for their involvement in the sale of more than 7,600 fraudulent diplomas, and fake transcripts, from three now-closed Florida nursing schools. School officials participated in the scheme, in which aspiring nurses paid $10,000 or more for the…
Fraud Week: Recidivist Psychologist
By Eric Fader on
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…
Fraud Week: J&J Sub in $9.75 Million Settlement of Kickback Claims
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…