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Hamil Little
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Vitreo Retinal Consultants of the Palm Beaches, P.A. (VRC) sued the U.S. Department of Health and Human Resources (HHS) to recover payments it made to Medicare, having previously refunded the payments to Medicare based on Medicare’s notice of overpayment. The Eleventh Circuit affirmed the decision of the U.S. District Court, which upheld the administrative decision supporting Medicare’s overpayment notice.  The ophthalmologist/owner of the VRC was indicted and charged with 46 counts of healthcare fraud, according to a Department of Justice press release.
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If #hospitals get drug discounts for their #patients then the government wants the same discounts when prescribed to their #Medicaid beneficiaries. In a final settlement, Pfizer will pay $784.6 million to Medicaid for the #drug discounts it did not receive for acid reflux #medications. The conduct in question was actually committed by drug manufacturer Wyeth but #Pfizer purchased the company in 2009.
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In making a decision to pursue medicine and healthcare as a livelihood, it is likely that most physicians today did not contemplate the extent to which legally binding contracts would govern and impact their professional lives. Few other careers carry the…
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Of the 2.5 million people who die in the U.S. in a year about 75% of those are 65 and older. As such, Medicare is the largest insurer of the cost of medical treatment during the last year of life, according to an article by the Henry J. Kaiser Family…
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In the past two decades, a growing number of physicians in private practice dissatisfied with reimbursement rates, paperwork and other aspects of the federal Medicare program have opted out of the program.   According to an article by William Buczko…
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DOJ Concludes Medicare Billing Investigation and Issues Press Release: Medicare Billing Company Will Pay $500,000 to Settle False Claims Allegations

This week the United States Department of Justice (DOJ), through the United States Attorney for the Southern District of New York, Richard S. Hartunian, announced a settlement with Medical Reimbursement Systems, Inc. (MRI) of DOJ’s allegations that MRI…
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High on the list of trends in the healthcare industry in 2016 is the advancement of technology in the diagnosis and treatment of disease and medical conditions. According to a recent online article in Healthcare Finance, thirty-two percent of consumers in…
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The U.S. Centers for Medicare and Medicaid Services (CMS) issued a Final Rule earlier this week, which created prior authorization rules applicable to particular durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS). The impetus for the…
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#Healthcare is rarely linear but rather involves varying areas of care across multiple specialties to deal with a single patient's #health needs. This fact necessitates a coordinated, collaborative system of healthcare that connects multiple specialists instead of confining them into separate bubbles. Such a system goes against the grain of current #medical culture but is a necessity for improved care.
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Daniel Suarez, 24, was sentenced earlier this month to nine years in prison following his guilty plea to healthcare fraud and abuse charges. According to the Miami Herald, Suarez, a pharmacy technician, was involved in a family ring of Medicare fraud that…
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