Recent Blog Posts
Stages of a Federal Healthcare Fraud Prosecution
Prosecution for healthcare fraud can start with something as simple as an accusation by someone at your office who thinks improper billing practices are going on. This can spur an investigation by a federal agency like Health and Human Services’ Office of Inspector General or the FBI, or the Bureau of Medi-Cal Fraud and… Read More »
California Anti-Kickback Statute Rules You’ll Want to Know
The Anti-Kickback Statute and the Stark Law are laws aimed at ensuring that medical decision-making is premised entirely upon what is best for the patient, rather than based on the influence of monetary gain. The laws impose harsh penalties for medical professionals who accept kickbacks, pay for referrals, or otherwise give providers reason for… Read More »
Is Medicare Fraud a Felony?
Medicare fraud is an extremely serious charge. If you or your medical practice is under investigation for or otherwise facing allegations of Medicare fraud, you need to act quickly to protect your rights, your practice, and your freedom. Depending upon the circumstances, you may face serious penalties including fines, license suspension, and even prison… Read More »
How Breaching HIPAA Could Impact Your Professional Practice
The Health Insurance Portability and Accountability Act (HIPAA) is a federal law that governs how private healthcare information must be maintained, including how it can be stored and transferred. HIPAA sets a host of requirements for healthcare practices, including training, data security, and private health information (PHI) disclosure. The requirements are strict, and violating… Read More »
Red Flags That Can Trigger DEA Investigations (Raids) on Your Healthcare Practice
Healthcare practices are subject to a laundry list of regulations at the local, state, and federal levels. Any misstep can lead to oversight and investigations by an alphabet soup of regulatory agencies. Regulatory and legal compliance is key to maintaining best practices and avoiding the unnecessary stress, money, effort, reputational damage, and potential liability… Read More »
Civil Monetary Penalties: What Should Providers Do When DOJ Imposes Monetary Penalties
When the Department of Justice (DOJ) has evidence of unlawful conduct–whether that takes the form of unlawful kickbacks, billing fraud, illegal prescribing, or other fraud and compliance issues–they may pursue an enforcement action. If the DOJ finds that their allegations are justified, they may impose significant civil penalties on healthcare entities and/or individual owners… Read More »
How Regulation Influences Health Policy
Healthcare providers deal with more regulation than professionals in just about any other industry. What are the effects of that regulatory system? Does the heavy-handed approach to medical regulation serve to increase the quality of care to patients, or to expand access to healthcare for people across the country? Below, we review the effects… Read More »
Protecting Your Healthcare Organization from False Claims Act Liability After CARES Act Funding (PRF)
The federal government enacted the Coronavirus Aid, Relief, and Economic Security (CARES) Act to help individuals and businesses adversely impacted by the novel coronavirus pandemic. In April 2020, the Department of Health and Human Services (HHS) announced a plan to distribute $175 billion in relief funds authorized by the CARES Act and subsequent relief… Read More »
False Claims Act (31 US Code § 3729): What Are the Penalties?
The False Claims Act (FCA) prohibits parties from defrauding the government. Medicare and Medicaid fraud fall under the ambit of the FCA, as do other forms of overbilling and fraud that impact government agencies or entities. The penalties for a scheme of violating the FCA can be severe. Read on to learn about civil… Read More »
What Physicians and Healthcare Organizations Should Know About Asset Forfeiture
Pursuant to federal law, the government has the authority to freeze or force parties to forfeit assets in their possession in advance of criminal prosecution or civil litigation. The government can seize accounts, freeze accounts, and take other actions against healthcare providers in connection with healthcare fraud litigation. Asset freezes and forfeiture can have… Read More »