Four men, seven companies indicted for $1B telemedicine fraud scheme
The indictment alleges that as part of the scheme, which ran from June 2015 to April 2018, the defendants submitted no less than $931 million in fraudulent claims for payment.
The indictment alleges that as part of the scheme, which ran from June 2015 to April 2018, the defendants submitted no less than $931 million in fraudulent claims for payment.
A report from U.S. Health and Human Services' inspector general's office said a third of the health plans it examined had referred fewer than 10 cases each of suspected fraud or abuse to state Medicaid officials in 2015 for further investigation.
Munck Wilson Mandala Partner Greg Howison shared his perspective on some of the legal ramifications around AI, IP, connected devices and the data they generate, in response to emailed questions.
Federal prosecutors from the U.S. attorney’s office in San Francisco have charged Holmes and COO Sunny Balwani with fraud over allegedly lying to investors and misleading doctors and patients about their technology and its accuracy, according to The Wall Street Journal.
The SEC is also pursuing civil fraud charges against Ramesh “Sunny” Balwani, Theranos’s former president and chief operating officer.
Hector Ramos, the ex-head of information technology at North County Health Services, has been charged with stealing nearly $800,000 from the San Marcos, California-based nonprofit clinic. He pleaded not guilty on December 1.
Blockchain-based systems could automate many administrative tasks in healthcare and remove human error from payment processing and claim adjudication, which can improve accuracy and reduce costs.
Theranos still has not been charged with any crimes, as this would be a civil lawsuit.
The investigation into potential fraud could put the brakes on the planned multibillion-dollar acquisition of Alere by Abbott Laboratories.
It's the largest single criminal healthcare fraud case the Justice Department has ever brought against individuals.
Also, a replacement brought in for striking nurses at Allina Health has gone home, opioid use soars and Kentucky's governor outlines his Medicaid rollback plan.
We will highlight Build My Health's revenue practice management tools, which could help physician practices add up to $250,000 to their practices.
Insurers — who can charge higher rates in most states to admitted smokers — are steamed. They say the cheating that smokers do to escape tobacco surcharges on their monthly premiums means higher rates for everyone else.
CMS released a pre-publication version of the rule Thursday. The rule will take effect 30 days after it officially appears in the Federal Register, which is scheduled for Friday.
"While genomic testing is a valuable and relatively recent medical tool, when specialized laboratories pay for referrals they aren't breaking any new ground but rather engaging in the same old kickback schemes," Special Agent Chris Schrankof said in a statement.
Both Pfizer and Allergan have paid some $4.5 billion to settle government healthcare fraud allegations in the U.S. Shouldn't we just expect more at this point?
In an investigation published Sunday, The Austin (Texas) American-Statesman could find no specific case of someone being charged with fraud related to neuromonitoring, but payers and regulators are concerned.