Are Your Employees And Contractors Properly Licensed To Provide Services?
Posted by donna@healthlawcenterplc.com in Jan, 2020
Twenty felony charges for Medicaid Fraud have been filed against a social worker who owns the EDM Treatment Center in Saginaw. The felony counts arose out of a prior employee at the treatment center who was not licensed to provide counseling services to clients in the clinic. The criminal complaint alleged that the social worker […]
Category: Medicaid, Mental Health, News & Updates
Post Tagged with Donna Craig, Fraud & Abuse, Licensure, Professional Counselor, The Health Law Center In Separate Cases Physician And Home Health Care Owner Charged With Medicaid Fraud
Posted by donna@healthlawcenterplc.com in Sep, 2019
In just a week’s time, the Michigan Attorney General, in totally separate cases, has charged a Farmington physician and a home health care owner of Medicaid Fraud. In the first case, Dr. Ban Mechael was charged with Medicaid Fraud and falsifying medical records based on allegations, that between 2016 and 2017 she submitted claims for […]
Category: Medicaid, News & Updates
Psychologist Sentenced for Criminal Sexual Conduct, Delivery of Controlled Substance and Health Care Fraud
Posted by donna@healthlawcenterplc.com in Jul, 2019
An Upper Peninsula psychologist was sentenced last week to 54 months to 15 years in prison on three felony counts of second degree criminal sexual conduct and 282 days each on seven other felony charges. The psychologist will also be required to pay $427,558 in restitution for Medicaid and health care fraud. The psychologist’s limited […]
Category: Medicaid, News & Updates, Opioid Epidemic
Are You Defrauding Medicare By Either Upcoding Or Downcoding Submitted Claims?
Posted by donna@healthlawcenterplc.com in Aug, 2018
Both upcoding and downcoding are significant because these actions have been interpreted as a basis for abusing and defrauding the federal government and its programs. According to CMS, “abuse describes practices that, either directly or indirectly, result in unnecessary costs to the Medicare Program.” Abusive coding practices include: Upcoding – a code with a […]
Could A Sweetheart Contract Or Lease Turn Sour?
Posted by donna@healthlawcenterplc.com in Aug, 2018
Last week the United States Department of Justice announced a settlement agreement with William Beaumont Hospital, located in the Detroit area, based on allegations Beaumont made false claims to the Medicare, Medicaid, and TRICARE programs. The allegations are based on improper relationships with eight referring physicians. Under the settlement agreement, Beaumont is required to pay […]
Post Tagged with Donna Craig, False Claims Act, Fraud & Abuse, Medicare, Physician, Stark Law, The Health Law Center Texas Supreme Court Finds Xerox, Not Dentists, Responsible For Fraudulent Medicaid Dental Payments
Posted by donna@healthlawcenterplc.com in Jul, 2018
The Texas Supreme Court recently upheld a Texas Court of Appeals ruling that Xerox was responsible for the $1 billion in fraudulent Medicaid dental payments. The state found that Texas Medicaid and Healthcare Partnership, a subsidiary of Xerox, allowed workers with limited expertise to approve dental claims for the state’s Medicaid program. Xerox, which was […]
Category: Anti-Kickback Statute, Medicaid, News & Updates
Physician And Two Nurses Found Guilty of $13 Million Home Care Fraud Scam
Posted by donna@healthlawcenterplc.com in Jun, 2018
Dr. Kelly Robinett a semi-retired emergency room doctor with more than 30 years of experience was convicted of fraud for his role in a $13 million home health care scam. After a weeklong trial before U.S. District Judge Reed O’Connor in Dallas, the jury issued its verdict after several hours of deliberations. Along with […]
Category: Anti-Kickback Statute, Medicare, News & Updates
Pfizer to Pay $23.85 Million for Alleged Violations of the Anti-Kickback Statute
Posted by donna@healthlawcenterplc.com in Jun, 2018
Pfizer was alleged to have used a tax exempt, non-profit foundation as a conduit to pay drug co-pays for Medicare patients who were either prescribed two Pfizer drugs for the treatment of renal cell cancer (Sutent and Inlyta) or another Pfizer drug for the treatment of atrial fibrillation or atrial flutter (Tikosyn). The Anti-Kickback […]
Category: Anti-Kickback Statute, Medicare, News & Updates
Post Tagged with Centers for Medicare & Medicaid Services, Fraud & Abuse, Medicare, Physician, The Health Law Center Physicians to Pay $700,000 to Settle False Claims Action
Posted by donna@healthlawcenterplc.com in May, 2018
Three physicians located in Pennsylvania, Florida and Indiana agreed to settle allegations that they each received improper payments for referrals from Universal Oral Fluid Laboratories (UOFL), a Greensburg, Pennsylvania, drug testing lab. By accepting payments from UOFL, the three physicians caused false claims to be submitted to Medicare for drug testing services. According to […]
Category: Medicare
Post Tagged with Centers for Medicare & Medicaid Services, False Claims Act, Fraud & Abuse, Stark Law Is Your Current Physician-Clinical Laboratory Arrangement Against The Law?
Posted by Donna Craig in Jul, 2014
On June 25, 2014, the U.S. Department of Health & Human Services issued a Special Fraud Alert citing the Office of Inspector General’s (“OIG”) concerns that certain laboratory practices with physicians may violate the federal Anti-Kickback Statute. OIG is particularly suspicious of certain arrangements in which a clinical laboratory contracts with a physician to collect, […]
Category: News & Updates
