Recent Blog Posts
What is Considered a Kickback in Healthcare
Healthcare professionals are perhaps more regulated than professionals in any other industry. Even minor oversights can lead to significant liability to patients, insurance providers, and the government. Unlawful conduct perpetrated by physicians and other medical professionals is often punishable with serious criminal charges. Even conduct that is perfectly acceptable in other industries is criminal… Read More »
DEA Audits & Investigations: Reasons for Controlled Substances Audits
Healthcare providers that prescribe or dispense medications are required to comply with the tenets of the Federal Controlled Substances Act (CSA) among myriad other federal laws. The U.S. Drug Enforcement Administration (DEA) has the authority to conduct periodic audits and investigations of medical services providers and pharmacies, reviewing medication storage locations, laboratories, and medical… Read More »
What Are the Penalties for Healthcare Fraud (18 USC ยง 1347)
Healthcare fraud is a prevalent issue in the United States. According to U.S. government estimates, Medicare, for example, pays out over $25 billion a year to fraudulent claims. For that reason, healthcare fraud is taken extremely seriously and is punished quite severely. Healthcare providers facing allegations or investigations about possible healthcare fraud must act… Read More »
Reasons to Hire a Medicare Fraud Attorney
If you operate a healthcare practice, you know just how many laws, regulations, governmental and nongovernmental regulatory bodies, and other concerns you have to address on top of the already-Herculean task of running a medical business. The last thing you need is a government investigation concerning fraud allegations. Below, the seasoned healthcare law and… Read More »
Can Medical Malpractice Be a Crime?
Medical malpractice is typically a civil matter. It can be costly–medical malpractice suits can easily lead to verdicts in the hundreds of thousands or millions of dollars–but doctors, nurses, and other medical professionals are not usually subject to criminal prosecution. Are there circumstances, however, where medical malpractice can be punished criminally? Are physicians ever… Read More »
What is the Difference Between Fraud and Abuse in Healthcare?
Healthcare fraud and abuse are often mentioned in the same breath, and they are sometimes used interchangeably. They are, indeed, related concepts, and the effects of each for patients and others may be difficult to distinguish. There are, however, important legal distinctions between the two concepts, including the potential penalties. Continue reading for a… Read More »
Medical False Claims Act Violations That Will Be Prosecuted: Medically Unnecessary Services
False Claims Act (FCA) violations can derail your medical practice. Filing false claims with Medicare or Medicaid can lead to massive civil fines, including up to three times the loss caused to the program on top of $11,000 per false claim filed. Each instance of an item or service being wrongly billed can be… Read More »
How Improper Medical Coding Can Hurt Your Practice
One of the easiest ways for a medical practice to find itself in hot water is through medical coding errors. While some wrong codes are deliberate attempts to squeeze extra money from private or public insurers, many coding errors are simply mistakes that can arise from overworked or under-trained staff members. Even if you… Read More »
Common Medical Coding Mistakes
Proper coding is extremely important in the operation of a medical practice. Improper coding leads to improper billing, which can lead to significant liability and even criminal charges for a healthcare practice. Billing practices need to be clearly established and administrative staff must be properly trained in order to avoid costly mistakes. Not all… Read More »
Ways Healthcare Organizations Can Prevent and Detect Healthcare Fraud
The healthcare industry is subject to myriad laws and regulations and is under the purview of an alphabet soup of regulators. One of the reasons for such heavy regulation is the prevalence of fraud across the industry. Healthcare practices looking to protect their practices and avoid instances of fraud must take affirmative steps to… Read More »