Compliance Update

The federal government continues its crackdown on COVID-related fraud with the announcement that 18 defendants in nine federal districts are charged for their alleged participation in various healthcare-related fraud schemes resulting in more than $490 million in false billings and theft from pandemic programs. The charges build on the success of the April 2022 COVID-19 Enforcement Action and...

An Austin, Texas drug testing lab agreed to pay nearly $6 million to settle allegations it violated the Federal False Claims Act by paying volume-based commissions to marketers for six years. The settlement grew out of a whistleblower lawsuit filed by Alex DiGiacomo, the former billing manager of Genotox Laboratories Ltd. According to the settlement agreement, between 2014 and 2020, Genotox drug...

With the uncertainties of personal injury protection benefits (“PIP”) lurking, providers who focus their practice on PIP, are thinking of the next plan to stay in business. It is unclear what will come of HB837 and what parts of the bill will be accepted or denied by Gov. Ron DeSantis. What we do know is tort reform is an inevitable thing, and providers, especially Chiropractors must be ready....

The former CEO of a New Jersey-based company that owned and operated 24 skilled nursing facilities and nine assisted living facilities in Wisconsin and Michigan recently was indicted on charges of healthcare fraud, six counts of wire fraud, three counts of mail fraud, conspiracy to commit tax fraud, and conspiracy to commit money laundering. The crimes were allegedly perpetrated by Kevin Breslin...

“Breach of care” and “duty of care” are related concepts in the field of healthcare, specifically in nursing. While they are closely related, they have distinct meanings and implications. What Is Duty of Care? Duty of care refers to the legal and ethical obligation of a healthcare professional to provide safe and appropriate care to a patient. It is a fundamental principle of healthcare that...

Florida’s governor is taking aim at Pharmacy Benefit Managers (PBM). Earlier this month, Gov. Ron DeSantis announced legislation that he said would protect consumers and help in lowering the price of prescription drugs. A PBM is a third-party administrator of a prescription drug program that processes and pays prescription drug claims. They also are supposed to negotiate the price of...