The Office of Inspector General (“OIG”) of the Department of Health and Human Services, generally, would have concerns about a potential or existing referral source receiving free goods or services,
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Fraud and Abuse
King of Nursing Homes Sentenced to 2 Years in Prison and $786,000 in Repayments and Fines
In March 2016, we covered the conviction of Dr. Venkateswara Kuchipudi for violating the federal anti-kickback statute by referring nursing home patients to Sacred Heart Hospital (in Chicago) in exchange…
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Food for Thought: Is a Free Meal the Way to a Physician’s Heart (and Prescription Pad)?
Long gone are the days when drug reps enticed physicians with extravagant meals at five-star restaurants and box seats to the Phillies’ playoffs (and sadly, gone are the days when…
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OIG Issues Advisory Opinion on Transportation Aid and Lodging Benefits
In a recent Advisory Opinion (No. 16-02), the OIG concluded that it would not seek sanctions against a state-run hospital (the “Hospital”) under the federal anti-kickback statute or the civil…
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Nursing Home Fraud Scam Results in Conviction for “King of Nursing Homes”
Called by some the “King of Nursing Homes” for his many low-income nursing home patients in northeast Illinois, Dr. Venkateswara Kuchipudi was recently convicted for referring patients to Sacred Heart…
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Physician Convicted of Second Degree Murder in Drug Overdose Case
Alexandra L. Sobol writes:
Since as early as the fifth century, physicians have taken an oath to do no harm. But one California internist was sentenced to 30 years to…
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CMS Finally Makes Reasonable Changes to 60-Day Overpayment Rule
The Affordable Care Act (ACA) requires Medicare providers to return overpayments within 60 days of the date they are identified in order to avoid liability under the False Claims Act. …
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Understanding Medicare Overpayments
Under the federal Affordable Care Act, physicians and other providers have only 60 days to refund overpayments to the Medicare program before they face potential liability under the False Claims…
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OIG Issues Favorable Advisory Opinion on Patient Assistance Charitable Foundation
This week the Office of Inspector General (OIG) published Advisory Opinion 15-16 addressing a 501(c)(3) charitable foundation (the “Requestor”) that would seek donations from third parties (including drug manufacturers) and…
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OIG Issues Advisory Opinion Regarding Radiology Transcription Feeds
This week, the Office of Inspector General (OIG) issued OIG Advisory Opinion No. 15-15 regarding a proposed arrangement in which a hospital would bill a radiology group for transcription of…
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