Healthicity Blog

1. Owner of Two New York Medical Clinics Sentenced to 84 Months for Her Role in $55 Million Health Care Fraud Scheme - “The owner of two Brooklyn, New York, medical clinics was sentenced today to 84 months in prison for her role in a $55 million healthcare fraud scheme.

1. CMS and Its Claims Processing Contractors Issued Conflicting Guidance on the Proper Use of the KX Modifier for Part B Immunosuppressive Drug Claims - “Medicare Part B paid for some immunosuppressive drugs billed with the KX modifier that were not eligible for Part B payment.

1. Under ‘Observation,’ Some Hospital Patients Face Big Bills - “In April, Nancy Niemi entered Vidant Medical Center in Greenville, N.C., with cardiac problems. She stayed four nights, at one point receiving a coronary stent.

1. Surgery center says 34,000 patient records potentially breached - “St. Mark’s Surgery Center was hit by a ransomware attack that may have impacted the personal health information of 33,877 patients.

1. Mylan Agrees to Pay $465 Million to Resolve False Claims Act Liability for Underpaying EpiPen Rebates - “Pharmaceutical companies Mylan Inc. and Mylan Specialty L.P. have agreed to pay $465 million to resolve claims

1. Fort Worth Brothers Admit Role in $36 Million Lab Test Kickback Scheme - Two Fort Worth men pleaded guilty Friday afternoon to playing a role in an alleged $36 million fraud scheme involving unnecessary lab tests of saliva and urine that were billed to the U.S. military’s health care system.

1. Pitt County Behavioral Health President Pleads Guilty to Medicaid Fraud Conspiracy and Perjury Charges - “The United States Attorney for the Eastern District of North Carolina John Stuart Bruce Office announced that yesterday in federal court, Shephard Lee Spruill, II, 46, of Winterville, North...

1. Vanderbilt University Medical Center pays $6.5M to resolve Medicare fraud allegations: “Vanderbilt University Medical Center paid $6.5 million to settle a whistleblower suit alleging VUMC committed Medicare fraud between 2003 and 2011, according to a Tennessean report.