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Staten Island healthcare service allegedly bilked Medicaid; pays $1.65M settlement - Dearborn, Sterling Heights foot doctor gets 28 months in prison for Medicare fraud - Germantown pain management doctor gets eight years - And More

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Headlines

Staten Island healthcare service allegedly bilked Medicaid; pays $1.65M settlement

Dearborn, Sterling Heights foot doctor gets 28 months in prison for Medicare fraud

Germantown pain management doctor gets eight years

Pharmacist convicted in fraud scheme

Smart wristband raises health data security, privacy concerns

Six latest healthcare industry lawsuits

Memorial Sloan Kettering CMO failed to disclose conflicts of interest in major research journals

Court revives Pharm Erica kickback case

Regulatory News

CMS Update

From the OIG

From the Federal Register

CMS Transmittals

Acronym Library

Product Features

HCCA HIPAA Training Handbook, Third Edition

Building An Ethical Culture: Why It’s Vital, How It’s Done

Subscribe to Report on Medicare Compliance | Learn more >

 

 

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Staten Island healthcare service allegedly bilked Medicaid; pays $1.65M settlement

On September 12, 2018, silive reported, “A Staten Island healthcare facility has agreed to pay almost $2 million after it was accused of fraudulently billing Medicaid for a couple of years, authorities said.

“Centers Plan for Health Living, located at 75 Vanderbilt in Clifton, settled the civil suit for $1.65 million after allegedly billing Medicaid for services it did not provide to its beneficiaries, according to the Brooklyn U.S. Attorney's office.”

 

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Dearborn, Sterling Heights foot doctor gets 28 months in prison for Medicare fraud

On September 12, 2018, Detroit Free Press reported, “A suburban Detroit podiatrist has been sentenced to 28 months in federal prison after receiving about $340,000 from Medicare in a fraudulent billing scheme.”

 

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Germantown pain management doctor gets eight years

On September 12, 2018, MyMCMedia reported, “A Germantown physician received an eight-year prison sentence Tuesday for 26 counts arising from nearly $1.4 million in kickbacks and fraudulent billing as well as a plan to defraud the United States of more than $2.1 million in taxes, according to a statement from the U.S. Attorney’s Office in Baltimore.”

 

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Pharmacist convicted in fraud scheme

On September 11, 2018, WLRN (FL) reported, “A South Florida pharmacist has been convicted of health-care fraud charges for submitting claims to government health programs for compounded drugs that were not medically necessary or were not provided, according to the U.S. Department of Justice."

Per the government press release, “After a four-day trial, Stephen Chalker, 42, of Wellington, Florida, was convicted of one count of conspiracy to commit health care fraud and two substantive counts of health care fraud. Sentencing has been scheduled for Nov. 15 before U.S. District Judge Donald M. Middlebrooks of the Southern District of Florida, who presided over the trial."

 

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DOJ Press Release

 

 

Smart wristband raises health data security, privacy concerns

On September 11, 2018, HealthIT Security reported, “Rutgers University researchers have created a new smart wristband with a biosensor that can count particles in the user’s blood and transmit that data via Bluetooth to a nearby smartphone. While this technology could have a major impact on personal healthcare, it also could raise health data security and patient privacy concerns.”

 

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Six latest healthcare industry lawsuits

On September 10, 2018, Becker’s Hospital Review reported, “From national healthcare organizations refiling a lawsuit over 340B drug pricing program cuts to a Georgia physician accused of submitting thousands of false claims to Medicare, here are the latest healthcare industry lawsuits making headlines.”

 

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Memorial Sloan Kettering CMO failed to disclose conflicts of interest in major research journals

On September 10, 2018, Becker’s Hospital Review reported, “An analysis by The New York Times and ProPublica revealed José Baselga, MD, PhD, medical oncologist, physician-in-chief and CMO of Memorial Sloan Kettering Cancer Center in New York City, failed to disclose significant financial ties to the drug industry and other healthcare companies in major medical research journals like The New England Journal of Medicine.”

 

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Court revives Pharm Erica kickback case

On September 6, 2018, McKnight’s Long-Term Care News reported, “A case alleging that Pharm Erica paid kickbacks to nursing homes is back on, following the decision of a federal appeals court.”

 

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Corporate Compliance & Ethics Week. Photo Contest September 4-17 | Submit a Photo >

 

CMS Update

 

Provider Compliance - Bill Correctly for Device Replacement Procedures - Reminder

In a September 2017 report, the Office of the Inspector General (OIG) determined that Medicare paid for many device replacement procedures incorrectly. Hospitals are required to use condition codes 49 or 50 on claims for device replacement procedures resulting from a recall or premature failure (whether the device is provided at no cost or with a credit).

Use the following resources to bill correctly and avoid overpayment recoveries:

 

 

New from CMS’s MLN

 

From the OIG

 

Updated Corporate Integrity Agreement List

 

See Details

 

 

Audit Report

National Institute of Transplantation, an Independent Histocompatibility Laboratory, Did Not Fully Comply With Medicare’s Cost-Reporting Requirements

 

See Details

 

 

Office of Evaluation and Inspections Report

FDA Should Further Integrate Its Review of Cybersecurity Into the Premarket Review Process for Medical Devices

 

See Details

 

 

 

From the Federal Register

Current Items

2018 FR Index

 

 

CMS Transmittals

View 2018 Transmittals

 

 

Acronym Library

Find CMS Acronyms

 

Product Features

 

HCCA HIPAA Training Handbook, Third Edition

 

Learn More

 

 

Building An Ethical Culture: Why It’s Vital, How It’s Done

 

Learn More

 

Register for the 4th Annual Healthcare Enforcement Compliance Conference | Nov 4-7 in DC | Learn more >Register for the 4th Annual Healthcare Enforcement Compliance Conference | Nov 4-7 in DC | Learn more >

 

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Questions/Feedback?

Please feel free to contact Margaret Dragon, editor of Compliance Weekly News.

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Health Care Compliance Library
HCCA offers members and registered guests access to an extensive library of articles. Information provided covers topics in corporate compliance and ethics in healthcare organizations. Contributing authors include attorneys, chief compliance officers, providers of auditing, monitoring, coding, billing and technology services, and other members of our compliance community.