In a recent decision, the U.S. Court of Appeals for the Third Circuit held that a physician acting as custodian of records may not withhold records subpoenaed from his professional association on Fifth Amendment...more
Physicians now appear to be more than ever at a greater risk of investigation for healthcare crimes, largely due to their “gatekeeping” function concerning a patient’s need for medical services and the government’s increased...more
Medicare overpaid the home health industry $2 billion between January 2011 and December 2012, according to a recent report by the U.S. Department of Health and Human Services, Office of Inspector General (OIG). The OIG’s...more
Earlier this month, the Texas Health and Human Services Commission (Commission) released a proposed rule, 1 TAC § 354.1452 that prohibits certain marketing activity by Medicaid and CHIP providers. The proposed rule has been...more
Criminal Prosecutions Expected in 2014 Related to ACA Fraud -
Last month's troubled rollout of HealthCare.gov, the federal marketplace for online health insurance enrollment under the Affordable Care Act (ACA),...more
The Ponemon Institute's recent publication of its fourth annual 2013 Survey on Medical Identity Theft (Survey) confirmed what many in the healthcare industry already knew: identity theft is a serious and often overlooked...more
Last week, the U.S. Department of Health and Human Services (HHS) and the DOJ jointly released a report concluding that, for every dollar spent on healthcare fraud investigations in the last three years, the government...more