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Is Your Practice or Company Under Investigation for Providing Amniotic Injections?

Federal authorities are currently targeting healthcare providers and other companies in relation to amniotic injections. While amniotic injections have received approval from the Centers for Medicare and Medicaid Services (CMS) for some purposes, at present they are not approved specifically for pain management. This distinction appears to be causing issues...

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Chronic Care Management (CCM) is Now a DOJ Enforcement Priority

Chronic care management (CCM) is a relatively new concept within the Medicare system. Established in 2015, the Centers for Medicare and Medicaid Services' CCM program is aimed at reducing the cost of care and improving outcomes for patients who have been diagnosed with two or more chronic conditions. While the...

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OIG Investigations, Compliance, and Defense for Labs

Experienced OIG Compliance Defense Team If you are under investigation for ordering or administering fraudulent COVID-19 testing or have been indicted, there is no time to waste in hiring an experienced OIG compliance attorney. The DOJ has wasted no time prosecuting respiratory and clinical labs for fraudulent COVID-19 testing. In...

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Lab Fraud Alert: DOJ, FBI, HHS OIG Targeting Clinical Laboratories for Healthcare Fraud Related to COVID-19 Testing

Federal authorities including the U.S. Department of Justice (DOJ), Federal Bureau of Investigation (FBI), and U.S. Department of Health and Human Services Office of Inspector General (HHS OIG) are targeting clinical laboratories for healthcare fraud related to COVID-19 testing. The DOJ has filed criminal charges in many cases already, and...

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Top 10 Federal Compliance Risks for Hospitals

Hospitals in the United States face numerous compliance risks. Multiple federal agencies oversee hospitals’ compliance efforts, and directors, administrators, and compliance officers must thoroughly assess their facilities’ compliance efforts on an ongoing basis to ensure that this oversight does not lead to recoupments, loss of program eligibility, or other penalties....

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What to Do When Facing a Federal Investigation for COVID Health Care Fraud

The U.S. Department of Justice (DOJ) and multiple other federal agencies are aggressively targeting health care providers and other businesses suspected of taking advantage of the COVID-19 pandemic to defraud patients, consumers, businesses and government entities. These agencies are targeting a wide range of offenses, and federal prosecutors are seeking...

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Tips and Strategies for Defending Against a DOL Audit

The U.S. Department of Labor (DOL) is the federal agency responsible for enforcing the nation's employment laws. It has broad authority over companies' employment practices, with its jurisdiction covering everything from wages to workplace safety, and from employment discrimination to federal benefit programs. Given the breadth of the DOL's authority,...

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Telemedicine and Cardiovascular Genetic Testing: What Do You Need to Know?

While telemedicine is gaining widespread acceptance – due in no small part to the impacts of the COVID-19 pandemic – when it comes to billing for telemedicine services, providers still face many challenges. Telemedicine billings often face enhanced scrutiny, and there are various issues that do not exist when providing...

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Cardiologist Defense: Cardiovascular Genetic Testing Fraud

For cardiologists, the introduction of cardiovascular genetic testing presents both new opportunities and new risks. Already, many cardiologists are facing scrutiny for Medicare billing fraud, and financial relationships with testing laboratories and other entities are leading to federal enforcement actions as well. As a cardiologist, anything you can use to...

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Department of Justice Renews Crack Down Fraudulent Billing and Unlawful Kickbacks

Healthcare professionals must ensure total compliance with Medicare, Medicaid, and other federally-funded government programs to avoid liability. Federal prosecutors are again focusing their efforts on preventing healthcare fraud. However, as prosecutors hone in on reducing fraud, law-abiding healthcare professionals may get caught in the government's wide net. Two of the...

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