CVS Pharmacy Inc. Pays $5 Million to Settle Alleged Violations of the Controlled Substance Act in Sacramento Federal Case

As is the norm, national chain pharmacies get fines and compliance plans while small businesses get criminally prosecuted. A recent settleme...

Los Angeles Dentist Charged With Fraud for Allegedly Billing Insurance Carriers for Services Not Provided Over 7 Year Period

We have seen an increase in audits of dentists by private insurers. Big data and updated computer systems have made it easier for insurance ...

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...

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...

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...

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 ...

New York Doctor Charged With Taking Kickbacks In Test-Referral Arrangement With Clinical Lab. Huge Case With 27 Doctors Pleading Guilty.

Federal health care fraud cases involving payments for referrals are getting larger, involving more health care providers and get prosecuted...

New Jersey Woman Pleads Guilty to Role In Medicare Fraud by Clinical Laboratory Billing for Genetic DNA Testing on Seniors Where Healthcare Providers Were Paid for Authorizations

Fraud prosecutions in clinical laboratories are on the rise. Marketing is usually at the heart of these cases. A recent case involving DNA t...

California Facilities Owned By Rideout Health to Pay Civil Monetary Penalties and Agree to 3-Year Compliance Plan to Resolve Controlled Substance Act Claims

The  Drug Enforcement Administration (DEA)  is becoming more aggressive about enforcing recordkeeping and other rules for controlled substan...

California Registered Nurse Who Ordered Botox From Canadian Company Via Internet for Medical Spa Pleads Guilty to Federal Charge of Receipt and Delivery of a Misbranded Drug

One important issue for all medical providers is to understand where FDA medications and injectables come from. Ordering on the Internet or ...

Chicago Marketer Convicted of Violating Anti-Kickback Statute for Receiving Money in Exchange for Marketing and Referring Elderly Patients to Home Health Company. Marketing Is Risky Business Unless Done Right.

Marketing for home health businesses and other health care providers is subjected to many federal and state st atutes and regulations. Viola...

Georgia Doctor Pleads Guilty to False Billing to Private Insurers and Medicare for Surgical Monitoring Performed by Medical Assistant

Analysis of billing data is leading to more investigations, audits and prosecutions. Anonymous  complaints to the HHS-OIG Hotline at 800-HHS...