The False Claims Act allows the government to recover losses from private entities that overcharge the government for services. The Obama Administration placed a high priority on fighting healthcare fraud, which has led to numerous investigations and large recoveries against the healthcare industry. In 2015, the administration recovered over 3.5 billion dollars. Qui tam is […]
Instituting a HIPAA compliance program is only the beginning. Staying HIPAA compliant takes time and commitment. It is critical to review the various departments in your practice and make sure that your policies remain up to date. You may be surprised at how quickly technology evolves and leaves your policies outdated. You may also be […]
March 21, 2010 was a historic day in American history, as Congress passed legislation entitled “The Patient Protection and Affordable Care Act.” Two days later, President Barack Obama signed the bill into law, providing healthcare to citizens across the United States. Supporters celebrated this first major victory in a long struggle to gain some form […]
Over the years, many pharmacies and pharmacists have been charged with or convicted of Medicare fraud, or for fraud committed on another government program. The truth is that a pharmacy employee can commit fraud too. You may not permit the illegal practice, but if you do not have effective internal controls and compliance programs, then […]
Medicaid fraud costs the American taxpayers millions of dollars every year in fraudulent claims and overcharges. All states are affected by Medicaid fraud. Culprits include large hospitals, pharmacies, medical equipment providers, physician practice groups, and clinics. It is important for everyone in the healthcare industry to understand Medicaid fraud and how Medicaid fraud control units […]
In the healthcare industry, compliance is something everyone in a hospital should focus on. The U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) publishes a Work Plan every year that outlines new and ongoing healthcare reviews. This Work Plan is a how-to guide on everything the OIG plans to review, […]
The purpose of insurance is to protect insureds against various types of risk, whether known or unknown. By spreading risk across a large group and pooling premiums, insurance companies are positioned to protect individuals from extensive losses that have the potential of being very expensive to manage. Typically, when a loss occurs, the insured files […]
