Hall Render

NOVEMBER 1, 2024

Health care fraud remains a significant focus for federal and state enforcement agencies, with particular attention placed on the integrity of Medicaid and Medicare billing. The doctor received only slightly more than $500,000 in excess payments, which appears minimal compared to other cases that have resulted in prison time.

Fraud 40

Fraud Compliance Medicaid Medicaid 40

HIT Consultant

JULY 19, 2024

Phrases to Watch Out For: Be wary of language like “secret cure,” “doctors are hiding the truth,” or guaranteed results in a short timeframe. Protecting Yourself from Supplement Scams Consult Your Doctor: Always seek medical advice from a licensed physician before using any supplements or medications.

Doctors 104

Doctors Fraud Licensing Public Health 104

Verisys

DECEMBER 8, 2022

A professional career can take a provider across state lines, and through an evolution of various license types. In order to see the full picture of an individual, the comprehensive whole of each state licensing board across all license types must be searched. Take the process back another step.

Licensing 52

Licensing Medicaid Medicaid Fraud 52

The Health Law Firm

NOVEMBER 7, 2011

State of Florida Department of Health , Dr. Mendelsohn's license to practice medicine was suspended under an Emergency Suspension Order (ESO). According to the ESO, Dr. Mendelsohn is licensed to practice medicine in Florida pursuant to the provisions of chapter 458, Florida Statutes. Doctor Pleas Nolo Contendre to Fraud Charge.

Fraud 40

Fraud Medicaid Medicaid Licensing 40

The Health Law Firm

JUNE 22, 2015

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.,

Fraud 40

Fraud Medicare Medicare Licensing 40

Verisys

MAY 13, 2024

Here is a round up of bad actors: Doctor sentenced to 10 years in prison for unlawfully dispensing controlled substances ( Full Story ) Doctor Convicted for $5.4M Here is a round up of bad actors: Doctor sentenced to 10 years in prison for unlawfully dispensing controlled substances ( Full Story ) Doctor Convicted for $5.4M

Fraud 52

Fraud COVID-19 Doctors Licensing 52

HIPAA Journal

JUNE 28, 2023

Individuals that have suffered identity theft, medical fraud, tax fraud, other forms of fraud, and other actual misuses of their personal information, can submit claims for documented, unreimbursed extraordinary losses that are reasonably traceable to the data breach of up to a maximum of $5,000.

Hospitals 87

Hospitals Fraud Licensing HIPAA 87

Healthcare IT Today

DECEMBER 20, 2022

Five former employees of Methodist Hospital in Memphis, TN, including a recently-licensed Registered Nurse, were indicted by a federal grand jury for allegedly selling medical information about car accident victims to personal injury attorneys and chiropractors. The doctor that was jailed for snooping in patient records. “Dr.

HIPAA 111

HIPAA Nurses Licensing Compliance 111

Verisys

AUGUST 13, 2024

Million ( Full Announcement ) Doctor Convicted for Illegally Distributing Over 1.8M Million ( Full Announcement ) Doctor Convicted for Illegally Distributing Over 1.8M Million ( Full Announcement ) Doctor Convicted for Illegally Distributing Over 1.8M The post July 2024 Bad Actors Roundup appeared first on Verisys.

Fraud 52

Fraud Doctors Licensing Medicare 52

Verisys

AUGUST 13, 2024

Million ( Full Announcement ) Doctor Convicted for Illegally Distributing Over 1.8M Million ( Full Announcement ) Doctor Convicted for Illegally Distributing Over 1.8M Million ( Full Announcement ) Doctor Convicted for Illegally Distributing Over 1.8M The post July 2024 Bad Actors Roundup appeared first on Verisys.

Fraud 52

Fraud Doctors Licensing Medicare 52

Verisys

JANUARY 2, 2024

With Verisys, you can instantly validate identities, licenses, and ensure there are no sanctions, exclusions, or debarments associated with anyone in your business network. Each month we will give a roundup of recent healthcare fraudsters and compliance busters. Secure your success by choosing Verisys.

Fraud 52

Fraud Licensing Doctors Medicare 52

Verisys

APRIL 2, 2024

Here is a round up of bad actors: Physician Fraud Physician pays $1.8M Million Medicare Fraud Scheme ( Full Story ) New York-Presbyterian/Brooklyn Methodist Hospital Settles Health Care Fraud Claims for $17.3 Here is a round up of bad actors: Physician Fraud Physician pays $1.8M Secure your success by choosing Verisys.

Fraud 52

Fraud Telemedicine Licensing Doctors 52

Verisys

JUNE 17, 2024

Verisys is a trusted partner that ensures the safety of your business from potential risks and guarantees the validation of identities, licenses, and absence of sanctions, exclusions, or debarments within your business network, enabling you to secure your path to success. Attorney Announces $2.5 Attorney Announces $2.5

Fraud 52

Fraud Doctors Licensing Compliance 52

Verisys

FEBRUARY 9, 2024

Here is a round up of bad actors: Physician Fraud Glastonbury Psychologist Admits Defrauding Medicaid of More Than $1.6 Here is a round up of bad actors: Physician Fraud Glastonbury Psychologist Admits Defrauding Medicaid of More Than $1.6 Million Civil Judgment and Drug Treatment Center Enters Settlement to Pay $2.2

Fraud 52

Fraud Medicaid Medicaid Medicare 52

The Health Law Firm Blog

JANUARY 2, 2024

Board Certified by The Florida Bar in Health Law and Hartley Brooks, Law Clerk, The Health Law Firm On October 18, 2023, an ex-Navy officer was sentenced to 30 months in prison after he pleaded guilty to conspiracy to commit wire fraud for his role in an [.] Indest III, J.D.,

Fraud 52

Fraud Nurses Licensing Doctors 52

Pharmacy Law Blog

MARCH 8, 2018

On December 6, 2017, three nurse practitioners and a doctor were arrested following an Alabama federal grand jury indictment accusing them of operating a “pill mill.” They face maximum sentences of 10 years in prison on the health care fraud counts. Alabama doctor, 3 nurse practitioners federally indicted in pill mill case.”

Nurses 40

Nurses Doctors Licensing Medical Personnel 40

Provider Trust

JULY 26, 2022

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. Further, Ms.

Licensing 52

Licensing Fraud Compliance Nurses 52

HIPAA Journal

MARCH 8, 2023

Asante, an Oregon-based health system with three hospitals and more than 30 primary care facilities, has started notifying certain patients that their medical records have been accessed by a local doctor who had no treatment relationship with the patients.

Electronic Medical Records 77

Electronic Medical Records Doctors Fraud HIPAA 77

Health Law Blog

MAY 22, 2018

Substance Abuse Treatment Center Fraud Scheme Results in Guilty Plea. The Department of Justice recently announced the guilty plea of two individual alcohol and substance abuse treatment center owners for their participation in what DOJ labeled a “multi-million dollar health care fraud and money laundering scheme.”

Fraud 52

Fraud Overpayments Overpayment Licensing 52

AIHC

SEPTEMBER 25, 2024

The American Institute of Healthcare Compliance (AIHC), a Licensing/Certification partner with CMS, provides periodic news blasts highlighting noteworthy cases of fraud, waste, abuse and other violations. Government agencies expect your organization to stay informed. These are free ways to stay informed of lessons learned.

Fraud 52

Fraud Compliance Compliance Officers Licensing 52

Verisys

FEBRUARY 24, 2023

At the emergency room, the doctors begin a series of tests to discover what’s wrong with her knee. It will take months for her to recover, and as she does, Sue will visit multiple clinics and doctors. Estimates range from 3% – 10% of the entire federal healthcare funding lost to fraud, waste, and abuse.

Fraud 52

Fraud Doctors Governance Licensing 52

Verisys

FEBRUARY 24, 2023

At the emergency room, the doctors begin a series of tests to discover what’s wrong with her knee. It will take months for her to recover, and as she does, Sue will visit multiple clinics and doctors. Estimates range from 3% – 10% of the entire federal healthcare funding lost to fraud, waste, and abuse.

Fraud 52

Fraud Doctors Governance Licensing 52

Healthcare IT Today

JUNE 3, 2024

Why would doctors go along with this? Most of the reasoning behind that is that the doctors think they need a special program for their specialty and legacy insurance companies mandate doctors speak International Classification of Diseases (ICD, currently in version 10 or ICD10) and Current Procedural Terminology (CPT).

Health Insurance 80

Health Insurance ACA Doctors Fraud 80

MedTrainer

FEBRUARY 12, 2024

Non-compliance can lead to significant fines, legal battles, and the loss of license or accreditation. For example, healthcare fraud or intentional non-compliance with regulations can lead to criminal charges. These actions can include fines, sanctions, or even revocation of licenses or certifications.

Compliance 52

Compliance Licensing Governance Fraud 52

YouCompli

AUGUST 29, 2023

Fraud, waste, and abuse (FWA) associated with telehealth services existed before COVID-19, but it significantly increased during the pandemic. Situation One: Before the Pandemic   In April 2019, government officials announced Operation Brace Yourself: a fraud takedown related to telemedicine and durable medical equipment (DME).

Fraud 52

Fraud COVID-19 Medicare Medicare 52

YouCompli

JULY 12, 2022

National fraud takedown: $1.1 Department of Justice (DOJ) announced a national health care fraud enforcement action involving over $1.4 This announcement included nationwide criminal charges against 138 defendants, including 42 doctors, nurses, and other licensed medical professionals. In Fall 2021, the U.S.

COVID-19 52

COVID-19 Medicare Medicare Telemedicine 52

YouCompli

JULY 26, 2023

Fraud, waste, and abuse (FWA) associated with telehealth services existed before COVID-19, but it significantly increased during the pandemic. Situation One: Before the Pandemic   In April 2019, government officials announced Operation Brace Yourself: a fraud takedown related to telemedicine and durable medical equipment (DME).

Fraud 52

Fraud Compliance COVID-19 Medicare 52

Verisys

FEBRUARY 23, 2022

The False Claims Act prevents fraud and abuse by making it illegal to file false medical claims. The Department of Health and Human Services and the Office of the Inspector General maintain lists of healthcare providers who have had actions taken against their licenses for fraud or abuse.

Compliance Officers 52

Compliance Officers Compliance US Department of Health and Human Services Governance 52

Verisys

DECEMBER 5, 2023

State licensing boards verify practitioner license type and status. As compliance requirements change to keep up with ever-evolving, accelerating fraud schemes and high expectations for quality care and outcomes, they place increasing demands on healthcare facilities. The Masterfile obtains records directly from medical schools.

Governance 52

Governance Licensing Malpractice Medicaid 52

Verisys

MARCH 1, 2022

State licensing boards verify practitioner license type and status. As compliance requirements change to keep up with ever-evolving, accelerating fraud schemes and high expectations for quality care and outcomes, they place increasing demands on healthcare facilities. The Masterfile obtains records directly from medical schools.

Governance 52

Governance Licensing Malpractice Medicaid 52

HIPAA Journal

DECEMBER 23, 2022

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. Doctors’ Center Hospital – Ransomware Attack Involving 1.2 Million Records.

HIPAA 92

HIPAA Ransomware Health Insurance Compliance 92

Physician Credentialing Company

JULY 15, 2024

For example, when a doctor claims to have graduated from a certain medical school, the credentialing team contacts that school directly to confirm. This process reduces the risk of fraud and ensures accuracy. This includes verifying licenses, liability insurance, and education history.

Malpractice 52

Malpractice Compliance Licensing Medical Billing 52

MedTrainer

FEBRUARY 27, 2024

They are not licensed to diagnose or treat beyond their certifications and state regulations, but they often observe changes in the patient’s condition that can be life saving. HHAs are supervised by medical practitioners, usually nurses, and may work with therapists and other medical staff.

Compliance 52

Compliance HIPAA Fraud Licensing 52

Healthcare Law Blog

MARCH 8, 2023

First, the Biologics License Application approval letter from the U.S. Similar to previous OIG-approved arrangements, the manufacturer limited the eligible pool of patients to those who lived more than 2 hours way, which, in this context, reduced the risk of overlap between the prescribing doctor and the surgeon performing the implantation.

FDA 52

FDA Doctors Medicaid Medicaid 52

The Health Law Firm Blog

MARCH 16, 2024

By George F. Indest III, J.D., Board Certified by The Florida Bar in Health Law Is the Drug Enforcement Administration (DEA) knocking at your door or, even worse, going through your files inside your office? If so, this is what you need to know right now! YES, you do have the right to [.]

Licensing 52

Licensing Fraud Doctors Medicaid 52

The Health Law Firm Blog

MARCH 2, 2024

By George F. Indest III, J.D., Board Certified by The Florida Bar in Health Law Is the Drug Enforcement Administration (DEA) knocking at your door or, even worse, going through your files inside your office? This is what you need to know right now! YES, you do have the right to call your [.]

Licensing 52

Licensing Fraud Doctors Medicaid 52

Hall Render

MAY 20, 2022

Group home at center of Gilbert murder investigation fights to keep license to operate. California aims to tighten licensing of nursing homes after pandemic exposes deadly lapses. IU Health forced doctors to reduce patient time, lawsuit says. IU Health doctor says he was fired for objecting to visit time limit.

COVID-19 40

COVID-19 Nursing Homes Nurses Hospitals 40