Call it the enforcement "flavor of the month," but laboratories have been feeling the heat from federal investigators recently, particularly those interested in their relationship with physician practices, which may run afoul of the anti-kickback statute.
Two multi-million dollar cases against two ophthalmologists, including the headline-grabbing Salomon Melgen, have thrown the specialty into the regulatory hot seat. Add Melgen's high-profile case to payment data that lists Medicare payments to ophthalmologists that reach eight figures and an OIG report that identified $171 million in questionable claims, and you've got a recipe for additional federal scrutiny, plus potentially more fraud cases involving ophthalmologists. Read more...
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A prominent New Orleans businesswoman and owner of Abide Home Care Services Inc. pleaded guilty, along with three others, to orchestrating a $30 million Medicare fraud scheme, according to the U.S. Attorney's Office in the Eastern District of Louisiana.
A much-anticipated review of the Delaware's Medicaid program revealed $11 million in potential fraud, waste, and abuse over the last three years, according to the Associated Press.
The federal government spent an estimated $124.7 billion in 2014 inimproper payments across 22 government agencies, most of which came from Medicare and Medicaid programs, according to expert testimony from a senior GAO official.
Last week's Fraud and Compliance Forum, hosted by the American Health Lawyers Association, outlined current and future fraud enforcement trends straight from the mouths of OIG officials.
The government isn't doing enough to prevent improper chiropractic payments, particularly claims involving "maintenance therapy," according to a new OIG report, particularly claims involving "maintenance therapy."
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The United States continues to lead the developed world in per-capita healthcare expenditures while trailing other countries in results, according to a new study by the Commonwealth Fund.
Michael O'Connell, vice president of clinical and support services at the Cleveland Clinic, Marymount Hospital, offered 30 cost-saving ideas to attendees of this year's Medical Group Management Association conference. We list three of them.