The Anti-Kickback Statute: A Continuing Compliance Challenge
In recent months, the spotlight in the healthcare industry has largely been focused on the Congressional debate regarding healthcare reform, including implementation of federal…
EMTALA Compliance High Risk Area
The Emergency Medical Treatment & Labor Act (EMTALA) grew from the 1946 Hill-Burton Free Care Program to provide Federal grants…
GAO Report on the Potential for CDRs to Improve Quality and Efficiency.
The Government Accountability Office (GAO) recently released a report on the potential for qualified Clinical Data Registries (CDRs) to improve…
GAO Releases a Report on States’ Reporting of Overpayments.
In a recent study, the Government Accountability Office (GAO) assessed states’ efforts to recover and report Medicaid overpayments identified by…
Nursing Home Provider Settles for $48 Million for Submitting False Therapy Claims.
On November 19, the Department of Justice (DOJ) announced that The Ensign Group Inc., a skilled nursing provider, settled for…
Can The Entire Sanction-Screening Process Be Outsourced?
This is a question that is frequently asked of me and the answer is yes. Vendors can not only provide…
Clinic Owner Receives 15 Year Prison Sentence for her Role in a $77 Million Medicare Fraud Scheme.
The owner of a clinic in Brooklyn that billed Medicare for more than $77 million for services that were medically…
Former Mental-Health Clinic Therapist Sentenced to 120 Months in Prison for Role in $55 Million Medicare Fraud Scheme.
A former therapist for Biscayne Milieu, a Florida mental-health clinic, was sentenced to prison for 120 months due to his…
Patient Broker Sentenced to 24 Months in Prison for Role in $67 Million Medicare Fraud Scheme.
A patient broker for a psychiatric facility in southern Florida was sentenced to serve 24 months in prison and ordered…
Suzanne Castaldo Contributes to BNA/ACCA Compliance Manual
Suzanne Castaldo, Strategic Management Senior Consultant, is a contributing editor to BNA/ACCA Compliance Manual, Chapter 16, ‘‘Prevention of Liability For…
Federal Agencies Create Initiative to Prevent Potential Fraud in the Health Insurance Marketplace.
On September 18, representatives from the Department of Justice (DOJ), the Department of Health and Human Services, the Federal Trade…
Physician Sentenced to 151 Months in Prison for $77 Million Medicare Fraud Scheme.
A New York physician, Dr. Gustave Drivas, was sentenced to serve 151 months in prison for his role in a…