Ohio Cardiologist Convicted at Trial and Sentenced to 20 Years in Federal Prison for Overbilling Medicare and Private Insurance & Allegedly Performing Unnecessary Procedures

Prosecutors are more aggressive in pursing physicians for criminal charges where just a few years ago the charges would be civil cases or a...

Home Health Agency Owners and Director of Nursing Indicted in Medicare Fraud Conspiracy in Houston - Alleged Kickbacks to Physicians and Patients Drive These Cases

Texas, like California, is aggressively pursuing home health care fraud and submission of claims where there are alleged violations of the A...

CALIFORNIA INSURANCE AGENT SENTENCED TO STATE PRISON FOR "ADVANCE COMMISSION FRAUD" IN ORANGE COUNTY SUPERIOR COURT

We are used to insurance fraud cases brought against those who file fraudulent claims. There has been an increased number of cases against t...

Frequently Asked HIPAA Questions by Health Care Providers - Get Ready for HIPAA Compliance and Audits

While we are working with clients on HIPAA compliance and risk assessment issues , including the OCR pilot request list for potential audit...

21st Century Oncology to Pay $19.75 Million to Settle Civil False Claims Lawsuit for Alleged Unnecessary Laboratory FISH Tests Ordered by Four of Its Urologists. No Admission of Liability But Corporate Integrity Agreement Required

On December 18, 2015, 21st Century Oncology LLC, a publicly traded entity which operates in 17 states, agreed to pay $19.75 million to the g...

Two New Orleans Doctors and a Registered Nurse Convicted by Jury for Roles in Home Health Care Billed to Medicare and Sentenced to Federal Prison. Health Care Professionals Face Challenges in Taking These Cases to Trial.

The investigative agency for Medicare is the Office of Inspector General (OIG). OIG has targeted home health services as being prone to frau...

California Janitorial Company Servicing Hotels Has Owners Indicted for Workers Compensation Premium Fraud

In California,  workers' compensation premium fraud  cases are aggressively investigated by the insurance companies and then presented t...

Splint Supplier and Its President to Pay Over $10 Million to Resolve False Claims Act Allegations for Splints Provided to Patients in Skilled Nursing Facilities

Maryland-based splint supplier Dynasplint Systems Inc., and its founder and president, George Hepburn, agreed on December 18, 2015 to pay ap...

Medical & Dental Management Companies - United Dental Group Ordered to Pay $867,000 Settlement and Cease Business Operations in California for Unlicensed Practice Due to Management of Dental Practices

Management companies operating medical and dental practices in California have long struggled with the State's strong laws against the c...

United States Settles Civil False Claims Act Allegations Against Florida Hospice For More Than $3 Million. Case Study - Hospices' Need for Compliance Plans and Audit Issues.

The hospice industry has been under investigation by the Office of Inspector General and the subject of many Medicare health care fraud inve...