Healthicity Blog

A Jacksonville, FL area pain clinic, Coastal Spine and Pain, recently settled with the U.S. Department of Justice for $7.4 million

Recently, Raleigh Orthopedic Clinic, a provider group practice that operates clinics and an orthopedic surgery center in Raleigh, North Carolina, settled with OCR for $750,000

We’ve highlighted the significance of this case in previous webinars and blog posts, but now we know that it’s at least $3 million dollars more significant than it was before.

It’s not unusual to read about large, multi-million dollar settlements for alleged healthcare fraud and abuses.

As we discussed in our previous incident management posts, your compliance program doesn’t need to be perfect, but rather, it needs to be “generally effective” in preventing non-compliance.

Tenet Health announced on Aug. 1, 2016 that it believes it has come to an agreement with the U.S. government for a $514 million settlement associated with a lawsuit alleging it paid for maternity patient referrals.

Our job as compliance officers is not to expect perfection, but rather to be “generally effective” in preventing non-compliance.

Most of the time, whistleblowers are employees or someone internal to an organization. In the recent guilty verdict of Dr. Syed Ahmed, a surgeon in New York, it appears from court documents that patient complaints triggered the HHS-OIG and FBI investigations which led to the doctor’s trial.