Archive
Wade Emmert
OIG Issues Final Rules on Anti-Kickback Statute and the Civil Monetary Penalty
In its final rule, the OIG defined what constitutes “telehealth technologies” more broadly than in its proposed rule, but otherwise chose to track the conditions for…
Fifth Individual Charged in Health Care Kickback Conspiracy
The defendants are alleged to have conspired to pay and receive kickbacks in exchange for physicians’ orders that were used to submit claims for payment to…
Ways your Healthcare Company is Breaking the Law — Without Realizing it
According to the U.S. Department of Health & Human Services’ Breach Portal, sometimes called the “Wall of Shame,” 418 breaches of HIPAA were reported in 2019.…
Stark + AKS Final Rules
The final rules for changes to the Stark Law and Anti-Kickback Statute (healthcare fraud & abuse laws) have been published and go into effect on January…
OIG Fraud Concerns Over Physician Speaker Programs
In a Special Fraud Alert issued on November 16, 2020, the Department of Health and Human Services Office of Inspector General (HHS-OIG) raised significant fraud and…
Houston physician sentenced to prison for $17M billing fraud
Yolanda Hamilton, MD, was found guilty by a federal jury of participating in a Medicare scheme that involved signing false “plans of care” and other medical…
Eleventh Circuit Extends Scope and Time Limits for People Who Sue under the Medicare Secondary Payer Act
Medicare is the Secondary Payor when other insurance is available to pay the claim. However, when the Primary Payor delays payment, Medicare will make a “conditional…
FTC sues to block $350 million sale of 2 Tenet Healthcare-owned hospitals in Memphis area
The Federal Trade Commission is suing to block Farmers Branch-based Tenet Healthcare’s $350 million sale of two hospitals in the Memphis area to another healthcare system.…
California Doctor Pleads Guilty to EKRA Violations
On September 15, 2020, Doctor Akikur R. Mohammad, a California resident and drug treatment facility owner, pled guilty before the U.S. District Court of New Jersey…
San Antonio ER hospital sued for alleged overbilling
A former patient has sued Baptist Emergency Hospital in San Antonio and its owner alleging they fraudulently overcharged for lab work to generate higher reimbursements. This…