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Case Study: Are Payments to Referral or "Scheduling" Services Legal? Recent Charges Against Riverside Chiropractor Show Some of the Legal Issues That Can Arise.

Posted by Tracy Green | Aug 11, 2018 | 0 Comments

There are many state and federal laws that govern the payments for marketing or referral services for health care patients. Workers' compensation patients in California are also governed by the Labor Code. It is critical to have these type of arrangements reviewed by experienced counsel to ensure...

Prime Healthcare Services and its CEO Agree to Pay $65 Million to Settle Medicare Overbilling Allegations at 14 California Hospitals

Posted by Tracy Green | Aug 06, 2018 | 0 Comments

On August 3, 2018, Prime Healthcare Services, Inc.; Prime Healthcare Foundation, Inc.; Prime Healthcare Management, Inc.; and Prime's Founder and chief executive officer, Dr. Prem Reddy, agreed to pay the United States $65 million to settle allegations that 14 Prime hospitals in California knowin...

What Is A Federal Indictment?

Posted by Tracy Green | Jul 09, 2018 | 0 Comments

What is a federal indictment? An indictment is a formal accusation against one or more defendants, charging them with one or more crimes. In the federal criminal system, the indictment is the principal method by which a prosecutor initiates criminal proceedings. For certain types of crimes, and ...

Why Should I Establish A Compliance Program?

Posted by Tracy Green | Jun 20, 2018 | 0 Comments

Establishing and following a compliance program will help physicians avoid fraudulent activities and ensure that they are submitting true and accurate claims. The following seven components provide a solid basis upon which a physician practice can create a voluntary compliance program:   1. ...

Physician Recruitment Basics

Posted by Tracy Green | Jun 04, 2018 | 0 Comments

Physician Recruitment   A hospital will sometimes provide a physician with a recruitment incentive to induce the physician to relocate to the hospital's geographic area, become a member of its medical staff, and establish a practice that helps serve that community's medical needs. Often, su...

What is the Federal Civil Monetary Penalties Law ?

Posted by Tracy Green | May 27, 2018 | 0 Comments

Civil Monetary Penalties Law [42 U.S.C. § 1320a-7a] OIG may seek civil monetary penalties and sometimes exclusion for a wide variety of conduct and is authorized to seek different amounts of penalties and assessments based on the type of violation at issue. Penalties range from $10,000 to $50,...

What is OIG Exclusion?

Posted by Tracy Green | May 27, 2018 | 0 Comments

Exclusion Statute [42 U.S.C. § 1320a-7] OIG is legally required to exclude from participation in all Federal health care programs individuals and entities convicted of the following types of criminal offenses: (1) Medicare or Medicaid fraud, as well as any other offenses related to the deliver...

What is the Physician Self-Referral Law or Stark Law?

Posted by Tracy Green | May 26, 2018 | 0 Comments

  The Physician Self-Referral Law, [42 U.S.C. § 1395nn] commonly referred to as the Stark law, prohibits physicians from referring patients to receive “designated health services” payable by Medicare or Medicaid from entities with which the physician or an immediate family member has a financ...

What Is The Federal Anti-Kickback Statute?

Posted by Tracy Green | May 21, 2018 | 0 Comments

The five most important Federal fraud and abuse laws that apply to physicians and some other health care providers are the False Claims Act (FCA), the Anti-Kickback Statute (AKS), the Physician Self-Referral Law (Stark law), the Exclusion Authorities, and the Civil Monetary Penalties Law (CMPL)...

Criminal Investigations, Charges And Convictions Have Far Reaching Consequences For Regulated Businesses, Licensed Professionals and Executives

Posted by Tracy Green | May 09, 2018 | 0 Comments

Licensed professionals, corporate executives and those with jobs in law enforcement or the types of job that require security clearances suffer more – almost a type of double jeopardy – when they are charged with or convicted of a crime. In some cases, professionals and executives can suffer coll...

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