Healthcare Compliance Blog

MARCH 10, 2022

Complaints of resident abuse in a Michigan nursing home led to an investigation by the Michigan Office of Attorney General’s Health Care Fraud Division, working with the Michigan Sentinel Project. The investigation determined that a nurse was working at the nursing home while her license was suspended, which is a felony.

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Nursing Homes Nurses Licensing Fraud 59

Med-Net Compliance

JUNE 29, 2022

An Oklahoma nurse aide pleaded guilty to abusing a nursing home resident and was placed on a deferred sentence probation for three years under the supervision of the Oklahoma Department of Corrections. toward the cost of the investigation to the Office of the Attorney General Medicaid Fraud Control Unit (MFCU), $300.00

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Nursing Homes Nurses Fraud Medicaid 59

Healthcare Compliance Blog

APRIL 18, 2022

A certified nurse’s aide (CNA) who was working in an Oklahoma nursing home has pled guilty to stealing money from a resident. Our office will not tolerate the financial exploitation of our beloved nursing home residents, no matter how large or small the amount.”.

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Med-Net Compliance

OCTOBER 13, 2022

The evidence at the trial showed that the CNA performed an improper, one-person lift of a nursing home resident which resulted in severe and painful injuries to the resident. I want to thank the Medicaid Fraud Control Unit for thoroughly investigating this crime and successfully pursuing justice.

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Nursing Homes Nurses Fraud Medicaid 59

Healthcare Compliance Blog

JANUARY 24, 2022

On January 19, 2022, the Massachusetts Medicaid Fraud Division announced that in calendar year 2021, more than $55 million was recovered from individuals and entities who defrauded the state. The Attorney General’s Medicaid Fraud Division investigates and prosecutes providers who defraud the state Medicaid program, MassHealth.

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Hall Render

MARCH 4, 2025

Department of Health and Human Services (HHS) issued new Industry Segment-Specific Compliance Program Guidance For Nursing Facilities (Nursing Facility ICPG) for nursing home members of the health care compliance community. Medical Directors in Nursing Homes 42 CFR 483.70(g)

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Compliance Nursing Homes Nurses Medicare 52

Healthcare Compliance Blog

FEBRUARY 4, 2022

The woman is charged with 259 counts of access device fraud, 16 counts of identity theft, and four counts of contributing to the delinquency of a juvenile. The post Louisiana Woman Arrested for Stealing from Nursing Home Resident appeared first on.

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Nursing Homes Nurses Fraud 59

Med-Net Compliance

JULY 8, 2022

A nursing home health system has agreed to pay the United States $1.75 A nursing home health system has agreed to pay the United States $1.75 The company is a not-for-profit corporation located in Florida that oversees healthcare facilities on its campus, including a nursing home and an assisted living facility.

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Nursing Homes COVID-19 Vaccine Nurses COVID-19 59

HIPAA Journal

AUGUST 30, 2022

The Wilsonville, OR-based home health care service provider and nursing home operator, Avamere Holdings, is facing a class action lawsuit over a major data breach that affected 96 senior living and healthcare facilities and resulted in the exposure of the protected health information of more than 380,000 individuals.

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Nursing Homes Fraud Ransomware HIPAA 124

Healthicity

APRIL 2, 2024

The selected items relate to (1) nursing homes and (2) medications. March was a busy month for new additions to the OIG’s Work Plan. Some of the items fit nicely into two broad categories which we’ve grouped together and summarized below.

Nursing Homes 52

Nursing Homes Nurses Fraud Compliance 52

Healthcare Compliance Blog

JANUARY 10, 2022

A South Carolina man has been arrested for financial transaction card fraud and exploitation of a vulnerable adult who was a resident of a nursing home. Due to his past criminal record, he also faces enhancement to the financial transaction card fraud charge.

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Fraud Nursing Homes Nurses Medicaid 52

Healthcare Compliance Blog

FEBRUARY 8, 2022

The United States has filed a lawsuit against an Alabama psychiatrist for improper prescribing of Nuedexta to nursing home residents. In return, the psychiatrist prescribed Nuedexta to nursing home residents who did not have pseudobulbar affect.

Nursing Homes 52

Nursing Homes Nurses Compliance Medicare 52

Med-Net Compliance

JULY 26, 2022

In connection with the enforcement action, the department seized over $8 million in cash, luxury vehicles, and other fraud proceeds. Issue: Nursing staff should monitor telemedicine appointments held with their residents, review related medical record documentation, and report any concerns with observed practices immediately.

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Fraud Telemedicine Medicare Medicare 59

Hall Render

OCTOBER 20, 2023

Effective October 1, 2023, Connecticut enacted a law that contains several updates to Connecticut’s change of ownership laws for nursing homes and other health care providers. If the owner is a corporation that is incorporated in another state, a certificate of good standing from the state of incorporation.

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Nursing Homes Nurses Licensing Public Health 40

Healthcare Law Blog

DECEMBER 1, 2023

The Department of Health and Human Services (HHS) and the Department of Justice (DOJ) recently released its “Health Care Fraud and Abuse Control Program Annual Report for Fiscal Year 2022 ” (the “Report”), highlighting continued enforcement and recovery actions under the Health Care Fraud and Abuse Control Program (HCFAC).

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COVID-19 Fraud Telemedicine Medicaid 52

AIHC

JUNE 14, 2024

This can be threat of harming a pet or loved one or threaten nursing home placement, etc. The Transnational Elder Fraud Strike Force provides the following list to warn and educate the public about trending elder fraud threats. Call the Elder Fraud Hotline at 1-833-372-8311 (Monday-Friday, 10:00 a.m.-6:00

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Fraud Elder Abuse Governance Compliance 52

Healthcare Compliance Blog

FEBRUARY 3, 2022

A mother and her two daughters have been charged for providing fraudulent COVID-19 vaccination cards to maintain and obtain employment at a New York nursing home. Vaccination is mandatory for nursing home employment in New York. Bassett stated, “Vaccination fraud is a serious crime.

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The Health Law Firm

MARCH 13, 2013

Individuals working in the health care industry, whether for hospitals, nursing homes, medical groups, home health agencies or others, often become aware of questionable activities. In many cases the activity may amount to fraud on the government. Indest III, J.D., Board Certified by The Florida Bar in Health Law.

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The Health Law Firm

MARCH 14, 2013

Individuals working in the health care industry, whether for hospitals, nursing homes, medical groups, home health agencies or others, often become aware of questionable activities. In many cases the activity may amount to fraud on the government. Indest III, J.D., Board Certified by The Florida Bar in Health Law.

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Fraud Governance Nursing Homes Nurses 40

Verisys

JULY 25, 2024

Here is a round up of bad actors: National Health Care Fraud Enforcement Action Results in 193 Defendants Charged and Over $2.75 Million to Settle Allegations Related to Telehealth Services for Nursing Home Residents ( Full Story ) Chronic Disease Management Provider to Pay $14.9M

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Fraud Nursing Homes COVID-19 Licensing 52

Verisys

JULY 25, 2024

Here is a round up of bad actors: National Health Care Fraud Enforcement Action Results in 193 Defendants Charged and Over $2.75 Million to Settle Allegations Related to Telehealth Services for Nursing Home Residents ( Full Story ) Chronic Disease Management Provider to Pay $14.9M

Fraud 52

Fraud Nursing Homes COVID-19 Licensing 52

Verisys

JULY 25, 2024

Here is a round up of bad actors: National Health Care Fraud Enforcement Action Results in 193 Defendants Charged and Over $2.75 Million to Settle Allegations Related to Telehealth Services for Nursing Home Residents ( Full Story ) Chronic Disease Management Provider to Pay $14.9M

Fraud 52

Fraud Nursing Homes COVID-19 Licensing 52

Healthcare Compliance Blog

MARCH 11, 2022

A Boston registered nurse (RN) has pled guilty to one count of tampering with a consumer product and one count of obtaining a controlled substance by fraud and deception. The RN was working in a nursing home when she tampered with morphine that was prescribed to a resident under her care.

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Provider Trust

AUGUST 9, 2023

Grimm, the OIG continues its tireless efforts to uncover instances of fraud, waste, and abuse within HHS programs. OIG continues to work tirelessly to identify instances of fraud, waste, and abuse and prosecute offenders. Through years of oversight, they have discovered various obstacles and weaknesses within nursing home facilities.

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Nursing Homes COVID-19 Fraud Medicaid 52

Verisys

NOVEMBER 20, 2022

If you are looking for something to read prior to turkey or afterwards, here is a round up of bad actors: Pharma Fraud: . Pharma Fraud. Pharma Fraud . Pharma Fraud. Fraud Scheme. Fraud Scheme. Fraud Scheme . Fraud Scheme. Telemedicine Fraud: . Telemedicine fraud. . Fraud Scheme.

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Fraud Medicaid Medicaid Nursing Homes 52

MedTrainer

AUGUST 8, 2024

Fraud, Waste, and Abuse (FWA) Training Fraud, Waste, and Abuse (FWA) training is designed to help healthcare professionals detect, prevent, correct, and report fraudulent, wasteful, and abusive practices within the Medicare system. Attestation: Providers must complete training within 90 days of their hire date and annually thereafter.

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MedTrainer

JANUARY 10, 2024

The OIG is making major investments to systematically detect and prosecute fraud. In this guidance it’s clear the OIG expects healthcare organizations and suppliers to understand their role and responsibilities to fight fraud, waste, and abuse. We all should be a LOT more prepared!

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Provider Trust

JULY 17, 2023

Their guidance aims to improve a number of potential risks within the healthcare space by improving care at nursing homes and strengthening the program integrity in managed care. OIG pointed to the increased instances of patient neglect abuse as well as the need for oversight within nursing homes.

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MedTrainer

AUGUST 1, 2022

Here’s a look at one of the OIG’s current medicare investigations to curb fraud, waste, and abuse. Established in 1976, the Office of Inspector General (OIG) was created to fight fraud and abuse in Medicare and Medicaid. OIG Medicare Fraud at Skilled Nursing Facilities. OIG Plans for Ending Medicare Fraud.

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Pharmacy Law Blog

FEBRUARY 13, 2018

On November 22, 2017, a Florida woman who was accused of a $45 million Medicare fraud, received a six-and-a-half-year prison sentence, following a 2016 U.S. This came after a 2016 guilty plea to a charge of conspiracy to commit health care fraud. By George F. Indest III, J.D., Board Certified by The Florida Bar in Health Law.

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Fraud Medicare Medicare Governance 40

The Health Law Firm

JANUARY 2, 2013

The Office of Inspector General (OIG) of the US Department of Health and Human Services (HHS) is investigating a Tennessee-based nursing care company. The company runs more than 200 skilled nursing homes (SNFs), assisted living facilities (ALFs), retirement living communities, home care services, and Alzheimer's centers across the country.

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US Department of Health and Human Services Nurses Medicare Medicare 40

Healthcare Compliance Blog

MAY 11, 2022

The South Carolina Attorney General announced that his office’s Medicaid Fraud Control Unit (SCMFCU) had arrested a 57-year-old woman on two counts of Exploitation of a Vulnerable Adult and two counts of Breach of Trust with Fraudulent Intent, value of $10,000 or more.

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Fraud Nursing Homes Medicaid Medicaid 59

The Health Law Firm

AUGUST 8, 2017

It is reported that Blanco oversaw inspections by the Florida Agency for Health Care Administration or "AHCA" of Florida nursing homes owned by Phillip Esformes. Bertha Blanco faces a wide range of charges including accepting bribes to tip off individuals when state wide investigations were to begin. The Ring Alleged Ring Leader.

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Healthcare Compliance Blog

MARCH 28, 2022

An Illinois licensed practical nurse (LPN) was convicted and sentenced for failing to administer lifesaving measures to a resident in a nursing home in 2017. The woman, 45, pleaded guilty to an amended charge of Reckless Conduct (Class A Misdemeanor).

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Nurses Nursing Homes Licensing Fraud 59

Med-Net Compliance

OCTOBER 18, 2022

The defendant began working at a nursing home 11 days later. The nursing home subsequently discovered diversions of hydrocodone, and that the defendant had worked shifts at the facility within the days of the diversions. A subsequent diversion occurred in November 2021 at yet another nursing home.

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American Medical Compliance

AUGUST 1, 2022

By analyzing fraud, waste, and abuse occurring in the medical system, the HHS is able to put regulations in place to minimize risks for patients and providers. HHS Concerned About Quality of Nursing Homes. Then, they are able to offer recommendations to improve the infrastructure of the healthcare industry.

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US Department of Health and Human Services COVID-19 Nursing Homes Medicare 52

YouCompli

AUGUST 2, 2022

MorseLife Nursing Home Health System was alleged to have provided vaccines to individuals who were not eligible under this program. It was also alleged the nursing home did not promptly test a symptomatic resident for COVID-19 and did not implement facility-wide infection control and prevention measures.

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