Your prescribed dose of health law news
An article entitled “Avoid Common Mistakes in Malpractice Cases,” which appeared in the March 2023 issue of Healthcare Risk Management magazine, discussed how to handle an allegation of medical malpractice. Rivkin Radler’s Eric Strober was quoted extensively in the article.
Eric pointed out that one of the biggest mistakes would be altering a…
An audit by the New Jersey Office of the State Comptroller (OSC) found that John Gore, a licensed drug and alcohol counselor, improperly billed and received over $1 million in Medicaid payments for services provided between 2016 and 2020. Gore will be required to repay the sum of $1,160,371.
Significantly, Gore billed for clinical level…
Rivkin Radler’s Michael Sirignano authored an article for the March 2 issue of the New York Law Journal entitled “Healthcare Fraud Tops DOJ’s Annual False Claims Act Report – Again!” The article discussed a report issued by the U.S. Department of Justice detailing the settlements and judgments it obtained under the federal False…
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…
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…
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…
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…
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:
