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This month, fraud in the medical industry has been making headlines fairly frequently. In one case, the dentist himself was involved, practicing on a revoked license. We also covered two Medicaid fraud schemes , one resulting in billions of dollars in billing for medical supplies that were never received.
Board Certified by the Florida Bar in Health Law and Shelby Root The largest criminal health care fraud takedown in the history of the US Justice Department, in terms of both loss amount and arrests, took place June 18, 2015. Indest III, J.D.,
On June 7, 2022, Theresa Pickering of Norcross, Georgia was indicted by a federal grand jury on federal charges of health care fraud, aggravated identity theft, and distribution of controlled substances. In addition to these allegations of fraud, waste, and abuse, Pickering had a history of fraud. According to the U.S.
Rendon, said of a Westlake, Ohio cardiologist sentenced to 20 years in prison on Friday, December 18, 2015, "This defendant used his medical license as a license to steal."
Many cited examples beginning with a 2015 case in which an agent allegedly signed up hundreds of people from North Carolina homeless shelters for plans in which the federal government paid the entire premium, often referred to as “zero-premium plans,” by using questionable estimates of their annual income.
The stolen information included names, addresses, email addresses, dates of birth, Social Security numbers, government identification ID numbers, driver’s license numbers, payment/financial institution information, health insurance providers, medical treatment information, medical diagnoses, medications, medical images, and lab test results.
That’s more than any other year to date apart from 2015 when Anthem Inc reported its 78.8 The databases contained extensive patient information, such as contact information, health insurance information, medical record numbers, Social Security numbers, driver’s license numbers, and medical information. million records. Million Records.
Licensing and credentialing were introduced to regulate healthcare professionals and ensure minimum standards of care. Compliance in healthcare began to encompass billing, fraud, and abuse prevention. Compliance evolved to include performance reporting and quality metrics.
Primary source verification must be done to confirm a provider’s education, professional license and certifications, medical training, work history, references, and more. Provider information should be continuously monitored for any changes to exclusion or license status. However, verifying a provider’s credentials is essential.
Primary source verification must be done to confirm a provider’s education, professional license and certifications, medical training, work history, references, and more. Provider information should be continuously monitored for any changes to exclusion or license status. ISO 9001:2015 (quality management).
In January 2015, the OIG settled for $96,259 with a Minnesota Pharmacist, Joseph C. This action was in addition to the 2018 settlement and sought these additional actions alleging that the clinics named in the complaint suffered significant gaps in licensing and supervision of therapists during the relevant time period.
Penn Medicine buys Montgomeryville site for $7.5M of Health Won’t Release Details R.I. physicians group partners with Calif. health tech company Lifespan considering $300M bond issue for construction projects R.I.
Colorado Springs health clinic to pay settlement in fraud lawsuit. Iowa licensing board loses legal fight over subpoenaed patient records. Maryland Doctor Among 18 Indicted In COVID-19 Healthcare Fraud Scheme, Allegedly Overbilled For COVID-19 Tests. Founders of Texas labs plead guilty in $300M fraud scheme. CONNECTICUT.
fraud scheme UConn Health is in financial trouble. health care spending hits $4.5 to address nursing shortage RHODE ISLAND After botched first round, RI again soliciting bids for lucrative Medicaid contract AG and Health Department will review sale of two RI hospitals.
in Medicare fraud settlement 10 behavioral health policy changes taking effect in 2025 An uncertain era for Stark law: 12 updates in 2024 CMS launches campaign to support nursing home staffing rule CMS taps 4 states for behavioral innovation model: 5 things to know Epic files to dismiss antitrust lawsuit Healthcare company to pay $15.2
When he led Turing Pharmaceuticals in 2015, he acquired a license for the drug Daraprim (an anti-malarial therapy also used for HIV/AIDS), raising the drug price from $13.50 Shkreli was ultimately convicted on securities fraud (not related to the Draprim pricing strategy). a pill to $750 a pill.
Nevada, currently the wild west of birthing, is considering licensing midwifery NEW HAMPSHIRE Dartmouth Health opens new 5-story patient pavilion Report: Anthem has yet to process nearly $300 million in N.H. health care fraud scheme SA cancer research company entering Dallas market as it eyes more U.S.,
2023) ( Buckman preemption barred MDL asserting fraud on EPA), cert. Also of interest is Acetaminophen ’s discussion of the FDA’s five reviews of the purported “risk” between 2015 and 2023, all of which ended the same way: that due to “limitations and inconsistent findings,” the science was “unable to support a determination of causality.”
Texas, unlike most states, enforces a strong statutory presumption that prescription medical product warnings complying with FDA requirements imposed by “pre-market approval or licensing of the product” are adequate as a matter of law. 2015 WL 11120857, at *2 (N.D. 23, 2015) (same); Lewis v. manufacturer, . . manufacturer, . .
For qualified IMGs, it issues a certification, which IMGs can then use to apply to residency and other graduate medical education programs and to apply for state medical licenses. The unfortunate truth is that ECFMG was also a victim of this fake doctor’s fraud. 2015 WL 6393869 (S.D. Big Dog Treestands, Inc. 2d 1036, 1050 (N.J.
Here, Plaintiffs fail to supply factual support showing Defendant acted with “oppression, fraud, or malice,” relying instead upon conclusory allegations. Punitive damages are available when the evidence shows that the defendant acted with fraud, malice, or gross negligence. . . . [T]he at *8 (agreeing with Bouncing Angels, Inc.
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