Southern California Physician Indicted For Illegally Prescribing Controlled Drugs Including to Out-of-State Residents Without an In-Person Physical Examination

The investigations of physicians for prescribing scheduled drugs to patients including Oxycodone, Xanax, Soma and other medications continue...

California Dermatologist Indicted For Health Care Fraud for Allegedly Billing Microdermabrasions or Chemical Peels Performed by Staff as Acne Surgeries to Private Insurers

The number of prosecutions for health care fraud involving private insurance is on the rise as shown by a recent case.  In years past, the i...

California Oncology Therapy Center Pays $2.8 Million to Resolve Allegations of Providing Radiation Treatments Without Radiation Oncologist Present

The nuances of "incident-to" billing and the alleged lack of physician supervision from 2006 to 2015 at one of its locations is at...

Owner of Holter Labs, Cardiac Monitoring Services Company, Convicted for Health Care Fraud for Billing for Services Not Performed

On May 2, 2017,  Michael Mirando,  an owner of Holter Labs, which provided cardiac monitoring services, was f ound guilty after a week long ...

Los Angeles Dermatologist Pays $2.6 Million to Resolve False Claim Allegations He Billed Medicare for Unnecessary Mohs Skin Cancer Surgeries

On April 10, 2017,   Dr. Norman A. Brooks, M.D.,  t he owner of The Skin Cancer Medical Center in Los Angeles paid the United States  $2,681...

When Is Physician Billing for In Office Prescriptions, Compounded Medications and Urine Toxicology Screening for Workers’ Compensation Patients Illegal? Orange County DA Charges Doctors, Pharmacists and Business Owners Alleging Insurance Fraud and Illegal Referral Fees

For years, there have been companies who approach physicians and offer ways they can add to their revenue stream.   This has been more commo...

Billing for Prescriptions Not Dispensed to Patients Results in 4 Year Sentence for Los Angeles Medical Clinic Manager After Federal Trial

Federal prosecutors used to devote healthcare fraud resources to mainly government programs and allow private insurance carriers to handle t...

Surrendering a Healthcare or Medical License While Disciplinary Charges Pending Will Get You a Medi-Cal Suspension

When a physician, nurse or any licensed healthcare provider has a state disciplinary proceeding pending, one of the issues that arises is wh...

Sales Representative Who Gave Gift Cards and Personal Checks to Medical Referral Sources Sentenced for Obstructing Federal Investigation of Health Care Offenses During Meeting With Investigators

It is becoming more common to charge individuals for "obstructing" a health care fraud investigation. Recently, on February 8, 201...

Forest Laboratories and Pharmaceuticals to Pay $38 million to Resolve Kickback Allegations for Payments to Physicians for Speaking Programs

The government has become far more aggressive in classifying payments to physicians by drug companies as "kickbacks" unless certai...

Neurosurgeon Sentenced for Health Care Fraud Involving Spinal Implant Devices. Admitted Hiding Financial Interest in Implant Company From California Hospitals

Spinal implant billing by hospitals has been an area of intense investigation and scrutiny for the past five years. Physicians who performed...

When Can Patients Be Offered Free or Local Discounted Local Transportation Without Violating the Anti-Kickback Statute? OIG Releases New Rules and Safe Harbor Guidelines for Free and Discounted Transportation to Established Patients.

One persistent and tricky regulatory issue in healthcare is when can patients be offered free or discounted local transportation without it ...

Houston Psychiatrist Sentenced to Long Sentence (144 Months) in Prison for Role in False Claims for Mental Health Treatment and Partial Hospitalization Program

When physicians refer or admit patients to a hospital or outpatient program, if there is deemed to be a lack of medical necessity or fraud, ...

Unlicensed Michigan Physician Who Saw Patients at Home Under Other Doctors' Names for 8 Years Pleads Guilty to Conspiracy to Commit Wire Fraud for Role in Billing Medicare Over $6 Million

Home visits must follow the same rules as billing at a physician's office. In addition, in certain clinics we have seen an increase in o...