Recently, the State of New Jersey, Office of the Attorney General, Division of Consumer Affairs (“DCA”) has issued a “SCAM ALERT” with the following, warning all licensed professionals that: “Individuals impersonating New Jersey Division... Read More
Articles | Behavioral Health Practitioners | Dental Practices | Dispensing Physician Practices and Dispensing Physicians | Medical Practice Representation | Medical Spas and Cosmetic Services | Palliative Care, Hospice Care and Home Care | Physicians and Medical Practices of all Specialties | Professional Practice Representation | Telehealth and Telemedicine

The Department of Justice ("DOJ") indicted a North Carolina physician assistant last month on criminal charges in a genetic testing scheme that resulted in the submission of more than $10 million in fraudulent claims to Medicare. The indictment... Read More
All types of single and multi-specialty medical practice groups | Articles | Behavioral Health Practitioners | Federal and State Fraud and Abuse Counseling | Healthcare Practice Compliance | Medical Practice Representation | Physicians and Medical Practices of all Specialties | Professional Practice Representation | Telehealth and Telemedicine | Telehealth and Telemedicine | White Collar Criminal Defense & Government Investigations | White Collar Defense and Government Investigation

According to the DOJ’s indictment, Ms. Lavache prescribed DME for Medicare beneficiaries without conducting any consultations with the said beneficiaries. As a result, she allegedly caused the submission of false claims to Medicare totaling... Read More
All types of single and multi-specialty medical practice groups | Articles | Behavioral Health Practitioners | Federal and State Fraud and Abuse Counseling | Healthcare Practice Compliance | Medical Practice Representation | Physicians and Medical Practices of all Specialties | Professional Practice Representation | Provider Relationship | Telehealth and Telemedicine | Telehealth and Telemedicine | White Collar Criminal Defense & Government Investigations | White Collar Defense and Government Investigation

Earlier this week, the U.S. Supreme Court ruled that to secure convictions under the federal Controlled Substances Act (“CSA”) for excessive prescribing of controlled substances, including opioids, prosecutors must prove beyond a reasonable... Read More
All types of single and multi-specialty medical practice groups | Articles | Behavioral Health Practitioners | Dispensing Physician Practices and Dispensing Physicians | Healthcare | Healthcare Law | Healthcare Practice Compliance | Pain Management Compliance | Physician Dispensing | Physicians and Medical Practices of all Specialties | Professional Practice Representation | Provider Relationship | White Collar Defense and Government Investigation

Earlier this month, two telehealth bills intended to expand patient access to virtual healthcare were introduced to the United States Congress.  Each bill seeks to continue building upon the availability of certain telehealth services that existed... Read More
All types of single and multi-specialty medical practice groups | Articles | Behavioral Health Practitioners | Healthcare Practice Compliance | Hospitals and Healthcare Systems | Physicians and Medical Practices of all Specialties | Telehealth and Telemedicine

Providers should be aware of CMS’s recent aggressively restrictive stance on Medicare Advantage (“MA”) risk adjustment coding. In  U.S. ex rel. Teresa Ross v. Independent Health Association, et al. – a False Claims Act (“FCA”) case... Read More
All types of single and multi-specialty medical practice groups | Articles | Behavioral Health Practitioners | Dental Practices | Healthcare | Healthcare Law | Hospitals and Healthcare Systems | Medicare and Insurance Audits | Physicians and Medical Practices of all Specialties

The closely-watched Kaiser Permanente consolidated False Claims Act (“FCA”) action, involving allegations of substantial Medicare Advantage risk adjustment fraud, has highlighted the dangers of a particular coding practice/policy known as... Read More
All types of single and multi-specialty medical practice groups | Articles | Behavioral Health Practitioners | Dental Practices | Federal and State Fraud and Abuse Counseling | Healthcare | Healthcare Law | Healthcare Practice Compliance | Medicare and Insurance Audits | Physicians and Medical Practices of all Specialties | White Collar Defense and Government Investigation

On October 15, 2021, the U.S. Attorneys’ Office for the District of Connecticut announced the sentencing of an unlicensed and unqualified individual posing as an applied behavioral analysis (commonly referred to as “ABA”) provider in... Read More
Articles | Behavioral Health Practitioners | Healthcare | Healthcare Law | Healthcare Practice Compliance | Medical Practice Representation | Physicians and Medical Practices of all Specialties | Professional Practice Representation | Telehealth and Telemedicine

Last month, the Department of Health and Human Services (“HHS”) Office of Inspector General (“OIG”) issued a report that identified deficiencies in the ability of states to root out fraud, waste, and abuse in Medicaid mental health services... Read More
Articles | Behavioral Health Practitioners | Healthcare | Healthcare Law | Healthcare Practice Compliance | Telehealth and Telemedicine

On October 14, 2021, Massachusetts Office of the Attorney General Maura Healey announced the $25 million dollar settlement of claims alleging violations of the Massachusetts False Claims Act by a private equity firm and executives in connection with... Read More
Articles | Behavioral Health Practitioners | Healthcare | Healthcare Law | Healthcare Practice Compliance | Healthcare Private Equity Services | Management Services Organizations (MSO) | Private Equity Investing | White Collar Defense and Government Investigation