Tag Archives: Physician

Internal Medicine Physician Convicted in Los Angeles Federal Court After Six-Day Trial of Conspiracy to Pay or Receive Kickbacks for Medicare Referrals and Four Counts of Receiving Kickbacks.

Health care fraud and kickback cases can be difficult to defend due to the amount of documentation and when there are numerous cooperating witnesses. A recent case, seemed to have a number of weak, inconsistent witnesses who had already plead … Continue reading

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California Physician Charged in Self-Referral Case With Felony Insurance Fraud and Perjury for Allegedly Referring Workers Comp Patients to a Laboratory and Surgery Center In Which He Allegedly Had Ownership Interest

Referring patients to other business entities that a physician has an ownership interest in can be a violation of the law depending on the type of patient (Medicare, workers' compensation) and it is important to ensure that the rules are … Continue reading

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Physician Billings Are Not Personal Information in Ontario

Canada’s unique health care system, which is publicly funded but largely privately administered, is one of the most important political and public policy issues in our society. Negotiations between physicians and the government in Ontario in past years has been … Continue reading

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CMS Proposes New Rule Change to The Medicare Physician Fee Schedule and Quality Payment Program

July 2018 – On July 12, 2018, the Centers for Medicare & Medicaid Services (“CMS”) proposed rules aimed at fundamentally improving the nation’s healthcare system and restoring the doctor-patient relationship. The proposal is “one of the most significant reductions in … Continue reading

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Untimely Physician Certifications for Medicare Home Care Claims – Arguably a Technicality – Vulnerable to False Claims Act Allegations: Sixth Circuit

On June 11, 2018, the United States Court of Appeals for the Sixth Circuit sustained a complaint against a home health care agency alleging that the agency had violated the False Claims Act (FCA) by submitting numerous claims to the Medicare … Continue reading

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