The False Claims Act is one of the most commonly used laws to prosecute health care fraud in the United States. According to the most recently available figures, the United States Department of Justice recovered more than $2.2 billion through the False Claims Act in 2020. More than 90% of the recovered funds were related…
In recent months, the federal government has shown an increased interest in opening investigations into practices that administer amniotic fluid injections. Many cutting-edge physicians have been prescribing amniotic fluid injections to patients to help them with pain management with great success. However, because amniotic fluid injections are not currently covered under Medicare for this purpose,…
Dentists Nationwide Are Being Targeted in Medicaid Fraud Audits and Investigations. Could Your Practice Be at Risk? If So, You Need Experienced Legal Representation. As a dentist who relies on Medicaid to pay your staff and keep the lights on, one of the greatest risks to your practice is the risk of having your Medicaid…
Mobile radiology providers, and particularly those that serve patients in hospice, nursing home, and home health settings, are increasingly being targeted in Medicaid fraud investigations. Is your company at risk? For most mobile radiology providers, billing Medicare is both an essential source of income and a primary source of administrative and compliance concerns. Unfortunately, while…
EMS Providers Can Face Civil or Criminal Penalties for Billing Medicare When a Ride to the Hospital Isn’t Medically Necessary. Are Your Billing Practices Putting You at Risk for Federal Prosecution? Not all mobile ambulance transportation services are eligible for reimbursement under Medicare’s billing regulations. In fact, mobile ambulance transportation services are not reimbursable unless…
The Anti-Kickback Statute Outlaws Many Types of Referral Relationships among Medicare Providers. However, the Law Establishes a Variety of “Safe Harbors” as Well. The Anti-Kickback Statute is a federal law that applies to all healthcare providers who bill Medicare for services, equipment, and supplies. Under the statute, it is illegal for providers to offer, pay,…
Medicare Audits and Investigations Can Have Severe Consequences for Healthcare Providers. If You Are Facing an Audit or Investigation, these Are the Key Terms You Need to Know. Healthcare providers that participate in Medicare are subject to constant scrutiny by the federal government. Billing mistakes can lead to costly penalties, while intentional billing fraud can…
If Your Business or Practice Is Being Targeted in a Medicare Fraud Investigation, You Need to Hire Experienced Defense Counsel in Order to Avoid Federal Charges. Facing a Medicare fraud investigation is a serious matter. Federal authorities use data analytics software to constantly monitor healthcare providers’ billing practices, and audit contractors working with the Centers…
As a healthcare provider or a company that supplies medical services or equipment to patients or providers, you have the government’s attention. Whether you do everything possible to comply with your legal and ethical obligations as a healthcare provider or you devote less time than you should to your company’s Medicare compliance efforts, various federal…
The penalties for Medicare fraud are severe. If convicted in federal criminal court, physicians and other providers can face hundreds of thousands of dollars in fines and years or decades of imprisonment, depending upon the specific crime (or crimes) alleged. In civil cases, providers can face enormous fines, recoupments, and various other financial penalties. In…
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