Question: We were contacted by a local school today questioning a doctor's note from the provider. We had the school send a copy of the note and learned that the parent of the patient (the patient is a minor) had created a letter that appeared to come from our practice. It looked like it was on letterhead, sort of, and included the practice information and the doctor's name at … [Read more...] about What to do when a student forges a note from the doctor
fraud
Feds crack down on telemedicine and COVID-19 fraud
Telemedicine was a minor but growing blip on the enforcement radar before the public health emergency. But with the dramatic step up in utilization during the COVID-19 pandemic, it was all but inevitable that schemes involving telemedicine fraud would command more of the Department of Justice’s attention. So, the agency’s September announcement of its latest nationwide … [Read more...] about Feds crack down on telemedicine and COVID-19 fraud
Fraud recoveries grow as feds target telemedicine and COVID-19 add-on test scams
Despite the COVID-19 pandemic and continued sequestration of enforcement funds, the federal Health Care Fraud and Abuse Control Program (Program) reversed recent trends and recovered more money in FY 2020 than it had the year before. In fact, recoveries for the year reached nearly $3.1 billion, the highest return since 2016. Here’s a briefing for medical office managers on the … [Read more...] about Fraud recoveries grow as feds target telemedicine and COVID-19 add-on test scams
Federal COVID-19 relief fraud crackdown begins
As with so many other businesses, federal COVID-19 relief was (and, in some cases, still is) the only thing that kept some practices afloat during the darkest days of the pandemic. But with the virus in apparent retreat, business is getting back to normal. And that includes the business of enforcing the federal laws. Among the first orders of business for federal investigators … [Read more...] about Federal COVID-19 relief fraud crackdown begins
Feds Take Down $2.1 Billion Medicare Genetic Test Fraud Scheme
You know that a branch of lab testing has gone from fad to mainstream when it becomes the subject of a major federal enforcement takedown. Accordingly, the newly announced breakup of a $2.1 billion genetic billing fraud scam, one of the largest Medicare frauds ever undertaken, signifies that genetic testing has officially arrived. Operation Double Helix Known as Operation … [Read more...] about Feds Take Down $2.1 Billion Medicare Genetic Test Fraud Scheme
Doctors pay $1.1 million to settle genetic test kickback claims
Kickbacks for genetic test referrals has become a focus of recent federal enforcement action. The most recent case involves three doctors and a cardiology practice that allegedly accepted bribes from a now-bankrupt genetic testing company in the Seattle area. The DOJ claims that Natural Molecular Testing Corporation (NMT) paid doctors as much as $10,000 per month in consulting … [Read more...] about Doctors pay $1.1 million to settle genetic test kickback claims
OIG issues genetic testing fraud alert
Have your patients got themselves involved with a genetic testing scam? The Office of Inspector General has issued a fraud alert warning of a genetic testing fraud scheme. According to the OIG, scammers are using telemarketing calls, booths at health fairs and public events and door-to-door visits offering Medicare beneficiaries cheek swabs for genetic testing. The objective … [Read more...] about OIG issues genetic testing fraud alert
5 ways for healthcare providers to get ready for new Medicare cards
By Dr. Richard E. Wild, M.D., FACEP Chief Medical Officer Centers for Medicare and Medicaid Region IV (AL, Fl, GA, KY, MS, NC, SC, TN) Medicare is taking steps to remove Social Security numbers from Medicare cards. Through this initiative the Centers for Medicare & Medicaid Services (CMS) will prevent fraud, fight identity theft, and protect essential program funding and … [Read more...] about 5 ways for healthcare providers to get ready for new Medicare cards
Pain clinic agrees to pay $1.78 million to settle whistleblower lawsuit
Ross Feller Casey, LLP, recently announced that the Atlantic Spine & Joint Institute and its owners, Robert C. McGrath, Sr., D.O., and Robert C. McGrath, Jr., have agreed to pay $1.78 million to settle a whistleblower lawsuit alleging they billed Medicare for procedures that were not medically necessary or were not actually performed. The father and son also pleaded guilty … [Read more...] about Pain clinic agrees to pay $1.78 million to settle whistleblower lawsuit