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There’s an App for That: Benefits and Risks of Using Mobile Apps for Healthcare | The Doctors Company

February 2, 2016 Leave a comment

[The Doctors Company is a physician-owned professional liability insurer that, in my experience with my clients, does a very good job.]

 

With over 100,000 mobile health apps now available, physicians now have to handle an increasing amount of constant data and patient information that they did not have in the past. Mobile apps offer many benefits, but the use of these apps does not come without liability risks for doctors.

Source: There’s an App for That: Benefits and Risks of Using Mobile Apps for Healthcare | The Doctors Company

Dos and Donts of Deal Making in Healthcare

March 9, 2014 Leave a comment

Last week, I presented at a webinar sponsored by the American Association of Orthopaedic Executives.  The topic dealt was “2014 Healthcare Compliance.”  You can access the entire PowerPoint presentation at SlideShare.

I spoke about the dos and don’ts of healthcare deal making. The focus was on deals with physicians, but the concepts are applicable to deals involving all types of healthcare providers.  Below I summarize my Rules of Thumb for healthcare deals:

Rules of Thumb for Healthcare Deals

  • RULE #1:  Just because a proposed deal makes sense and would be appropriate in a business other than healthcare, doesn’t mean it’s legal. (Corollary —  Just because everyone is doing it, doesn’t mean it’s legal.)
  • RULE #2:  Determining the legality of a healthcare deal can be complicated, time consuming, expensive, and inconclusive.
  • RULE #3:  The risks of doing an illegal healthcare deal far outweigh the benefits.
  • RULE #4:  Get professional help early in the deal.

In subsequent posts, I will discuss steps in the deal and ways to screw up the deal.

USDOJ – NJ: Former director of diagnostic testing center admits bribing doctors in cash-for-patients scheme

October 20, 2012 Leave a comment

In the following post, note that the dollars involved are relatively modest:

The former executive director of Orange Community MRI LLC, today admitted paying bribes to doctors since April 2008 and agreed to forfeit $89,000 in proceeds from the crime, U.S. Attorney Paul J. Fishman announced.Chirag Patel, 37, of Warren, N.J., pleaded guilty to an Information charging him with one count of soliciting and receiving illegal cash kickbacks for patient referrals in violation of the federal health care anti-kickback statute.

According to documents filed in this case and statements made in court:

On Dec. 8, 2011, Patel was arrested and charged with offering and paying cash kickbacks to a New Jersey health care practitioner in exchange for referrals to Orange Community MRI. On Dec. 13, 2011, 13 New Jersey doctors and one nurse practitioner were arrested and charged in separate Complaints with accepting similar cash kickback payments from Orange MRI. Each of the defendants was recorded taking envelopes of cash in exchange for patient referrals.

Patel is the ninth person charged in the December 2011 takedown to plead guilty. Patel is the second member of Orange Community MRI to plead guilty; Ashokkumar Babaria, the former owner and medical director of Orange Community MRI, pleaded guilty on Sept. 27, 2012.

As part of his plea agreement, Patel agreed to forfeit $89,180 that constitutes criminal proceeds of the crime. As part of his guilty plea, Ashokkumar Babaria agreed to forfeit his revenues traceable to corrupt referrals, which the government has estimated could reach as much as $2 million. The seven health care providers that referred patients to Orange MRI who have plead guilty thus far have collectively agreed to forfeit over $150,000 in illegal kickbacks from Orange MRI.

See on www.justice.gov

For an aggregation of other articles on Hot Topics in Healthcare Law, go to my magazine on Scoop.it – Hot Topics in Healthcare Law and Regulation and my newspaper on Paper.li – Hot Topics in Healthcare Law.

For an aggregation of other articles on improving healthcare, go to my internet magazine Scoop.it! Changing Health for the Better.

USDOJ: Clinic Owners Plead Guilty in Detroit-Area Infusion Therapy Scheme

October 20, 2012 Leave a comment

Two owners and operators of clinics that claimed to specialize in treating HIV and other conditions pleaded guilty today for their roles in an infusion therapy scheme carried out at two Detroit-area clinics that submitted millions of dollars in fraudulent claims to Medicare.

The guilty pleas were announced by Assistant Attorney General Lanny A. Breuer of the Department of Justice’s Criminal Division; U.S. Attorney Barbara L. McQuade of the Eastern District of Michigan; Special Agent in Charge Robert Foley III of the FBI’s Detroit Field Office; and Special Agent in Charge Lamont Pugh III of the HHS Office of Inspector General’s (HHS-OIG) Chicago Regional Office.

Raymond Arias, 40, and his wife, Emelitza Arias, 25, of Troy, Mich., each pleaded guilty, before U.S. District Judge Paul D. Borman of the Eastern District of Michigan, to one count of conspiracy to commit health care fraud. At sentencing, the defendants each face a maximum potential penalty of 10 years in prison and a $250,000 fine. Sentencing is currently scheduled for Feb. 12, 2013.

According to plea documents, Raymond Arias conceived of and oversaw fraud schemes at two clinics for which he was a beneficial owner: Elite Wellness LLC, and Carefirst Occupational & Rehabilitation Center Inc. He admitted to paying physicians to refer Medicare beneficiaries to Elite Wellness, and to purchasing Medicare beneficiary identifications for the purpose of submitting fraudulent claims to Medicare for expensive infusion therapy services that were not rendered as claimed by Carefirst.

According to court documents, Raymond Arias attempted to hide the Elite Wellness scheme from law enforcement by directing a nominee owner to assume control of the claims submitted and the bank account into which Medicare payments were deposited. After the nominee owner became involved, Raymond Arias and his alleged co-conspirators submitted approximately $10 million in claims over a 3-month period beginning in August 2010.

See on www.justice.gov

For an aggregation of other articles on Hot Topics in Healthcare Law, go to my magazine on Scoop.it – Hot Topics in Healthcare Law and Regulation and my newspaper on Paper.li – Hot Topics in Healthcare Law.

For an aggregation of other articles on improving healthcare, go to my internet magazine Scoop.it! Changing Health for the Better.

USDOJ: Owner and Operator of Florida Halfway House Company Sentenced to 51 Months in Prison for Role in Medicare Fraud Scheme

October 20, 2012 Leave a comment

The owner and operator of New Way Recovery Inc., a Florida corporation that operated several halfway houses, was sentenced today to serve 51 months in prison for his role in a $205 million Medicare fraud scheme involving fraudulent claims for purported partial hospitalization program (PHP) services, announced Assistant Attorney General Lanny A. Breuer of the Justice Department’s Criminal Division; U.S. Attorney Wifredo A. Ferrer of the Southern District of Florida; Michael B. Steinbach, Acting Special Agent-in-Charge of the FBI’s Miami Field Office; and Special Agent-in-Charge Christopher B. Dennis of the HHS Office of Inspector General (HHS-OIG), Office of Investigations Miami Office.

Hassan Collins, 41, was sentenced by U.S. District Judge Kevin Michael Moore in the Southern District of Florida. In addition to his prison term, Collins was sentenced to serve three years of supervised release and ordered to pay $2,413,675 in restitution, jointly and severally with co-conspirators.

On June 14, 2012, Collins pleaded guilty to one count of conspiracy to receive and pay health care fraud kickbacks.

According to court documents, from approximately April 2004 through approximately September 2010, Collins, along with co-conspirators, received kickback payments in exchange for referring Medicare beneficiaries, who did not qualify for PHP treatment, for purported PHP services to American Therapeutic Corporation (ATC), a Florida corporation that operated several purported PHPs throughout Florida. Collins and his co-conspirators caused false and fraudulent claims to be submitted to Medicare for PHP services purportedly provided to Medicare beneficiaries at ATC’s locations, when, in fact, the services were never provided.

See on www.justice.gov

For an aggregation of other articles on Hot Topics in Healthcare Law, go to my magazine on Scoop.it – Hot Topics in Healthcare Law and Regulation and my newspaper on Paper.li – Hot Topics in Healthcare Law.

For an aggregation of other articles on improving healthcare, go to my internet magazine Scoop.it! Changing Health for the Better.

HHS: Hospitals ignoring requirements to report errors

July 20, 2012 Leave a comment

Hospitals are ignoring state regulations that require them to report cases in which medical care harmed a patient, making it almost impossible for health care providers to identify and fix preventable problems, a report to be released today by the Department of Health and Human Services inspector general shows.

Researchers say the hospitals’ failure to report problems isn’t a sign of a coverup but rather the staffs’ ignorance of the regulations and what they need to report.

Hope for the future lies in electronic health records, Adler says, because “we may be able to prevent events, we may be able to ameliorate events, and (electronic records) may become your surveillance system.”

Incentives included in the 2010 federal health care law to encourage more hospitals to use electronic records may change how errors are tracked and addressed, say researchers of the inspector general’s study.

The health care system is “right on the cusp” of identifying “safety issues just as they happen,” said David Classen, a University of Utah associate professor of medicine and infectious disease.

See on www.usatoday.com

For an aggregation of other articles on Hot Topics in Healthcare Law, go to my magazine on Scoop.it – Hot Topics in Healthcare Law and Regulation and my newspaper on Paper.li – Hot Topics in Healthcare Law.

For an aggregation of other articles on improving healthcare, go to my internet magazine Scoop.it! Changing Health for the Better.

Hot Topics in Health Care Law — Saturday July 7, 2012

July 7, 2012 Leave a comment

Today’s edition of Hot Topics in Health Care Law is available.  This topic aggregator/newspaper contains articles that I think are on the cutting edge of health law.

 

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