Compliance Plan For A Medical Aesthetic Practice
Venue: Medical Board Investigation (2014)
Background: Our client was being investigated for the unlawful practice of medicine due to the process it had in not having patients seen by a physician or advanced care practitioner before services such as laser hair removal and aesthetic medicine (Botox, fillers, etc.)
Resolution: We immediately put together a compliance agreement, helped the client change its practices and demonstrated the client's commitment to following its procedures. The Medical Board closed the case and no disciplinary proceedings were brought against the practice, physicians or nurses.
Compliance Plan For A Durable Medical Company
Venue: Medicare and OIG Investigation (2016)
Background: Our client was being investigated for unlawful referrals and lack of medical necessity.
Resolution: We met with the client, identified the issues and referring physicians who flagged the investigation, prepared and implemented a compliance plan. Medicare lifted the payment restrictions and the Office of Inspector General closed the investigation.
Compliance Plan For A Pharmacy
Venue: Medicare, Medi-Cal, Third Party Insurers and OIG Joint Investigation (2015)
Background: Our client was being investigated for insurance fraud, Medicare fraud, Medi-Cal fraud, violation of state and federal referral laws and other issues.
Resolution: The allegations related to prior years when the pharmacy was under a former owner. We identified the issues, created a compliance fraud plan, trained the staff and demonstrated that none of the past issues were present in the current pharmacy and that the allegations were barred by the statute of limitation. The investigation was closed and the provider's insurance contracts and provider numbers for Medicare and Medi-Cal remained in place.