On November 9, the Pharmaceutical Coalition for Patient Access (PCPA) filed an action against the U.S. Department of Health and Human Services (HHS) after HHS’s Office of Inspector General (OIG) determined that a proposed patient assistance model posed more than a minimal risk of fraud, waste, and abuse under the federal Anti-Kickback Statute (AKS). PCPA
New 2023 Minimum Wages and Minimum Salaries to Take Effect
Minimum hourly wages for many nonexempt employees and minimum salaries for exempt employees in New York, New Jersey and Connecticut are scheduled to increase in 2023. Employers should begin to make plans to ensure that their hourly wages for nonexempt employees, their minimum salaries for exempt employees and their wage hour policies and practices comply…
Avoiding the Pitfalls in Recent Government Enforcement
In the next installment of Rivkin Radler’s Healthcare Compliance Lunch & Learn series, Rivkin Radler’s Ben Malerba and Ben Wisher will discuss Avoiding the Pitfalls in Recent Government Enforcement. The program will cover recent audits, investigations and actions of government agencies including DOJ, MFCU, OMIG, the NY AG, and others. Ben and Ben will also…
Connecticut Doctor Pleads Guilty to Fraud and Kickbacks
The U.S. Attorney’s Office for the District of Connecticut announced on November 3 that Ananthakumar Thillainathan, a physician with offices in Stratford and Milford, pleaded guilty to healthcare fraud and federal kickback violations. The doctor faces up to 20 years in prison and a restitution payment of almost $1.7 million.
Thillainathan, the owner of MDCareNow…
Pharmacy Not Liable for Filling Prescriptions as Ordered
A Suffolk County, New York court held on November 16 that White’s Apothecary in East Hampton was not negligent when it filled a physician’s opioid and benzodiazepine prescriptions as ordered. The plaintiff had claimed that the pharmacy should be liable for filling “excessive and dangerous doses” of oxycodone and Carisoprodol, a muscle relaxant, despite a…
Former Hospital Employees and Kingpin Indicted for HIPAA Violations
The U.S. Department of Justice announced on November 10 that five former employees of Methodist Hospital, based in Memphis, Tennessee, were indicted by a federal grand jury for allegedly selling the names and telephone numbers of hospital patients who were involved in automobile accidents. Roderick Harvey paid them for the information and then sold it…
NY Pharmacy Owners Plead Guilty to Money Laundering During COVID-19
The U.S. Department of Justice (DOJ) announced on November 16 that two pharmacy owners from Forest Hills, New York have pleaded guilty to conspiracy to commit money laundering through submission of fraudulent claims to Medicare during the COVID-19 pandemic. The co-conspirators owned over a dozen pharmacies in the New York area, through which they submitted…
CMS Adds New Billing Code for Dental Surgeries
The American Dental Association (ADA) announced on November 15 that the Centers for Medicare & Medicaid Services (CMS) has agreed to create a new Healthcare Common Procedure Coding System (HCPCS) code G0330 for dental surgeries performed under anesthesia in hospital operating rooms. The new code resulted from an advocacy campaign driven by the ADA, American…
Artificial Intelligence Now Powers Orthodontics
Align Technology, the manufacturer of the Invisalign system of orthodontic braces, recently announced the release of an improved artificial intelligence-assisted smartphone app that can direct an Invisalign wearer when to advance to his or her next set of aligners. The company’s “Virtual Care AI-assisted Remote Monitoring Solution” helps patients take pictures of their teeth, and…
The Triple Threat of Workers’ Compensation Fraud
Rivkin Radler’s Michael Sirignano authored an article for the November 3 issue of the New York Law Journal entitled “The Triple Threat of Workers’ Compensation Fraud.” Although the article wasn’t in time for Rivkin Rounds’ recent Fraud Week, it discussed some recent attempts by healthcare providers to game the workers’ comp system by…
