Compliance News Roundup: East Coast Doctors Caught Breaking Bad

1. U.S. Attorney Announces Arrest Of Ophthalmologist For Healthcare Fraud - Geoffrey S. Berman, the US Attorney for New York, announced that Ameet Goyal, M.D., an ophthalmologist, has been indicted and arrested for healthcare fraud.  Goyal is charged with fraudulently billing patients, Medicare, and private insurance programs for millions of dollars, between 2010 and 2017. They allegations suggest that the billing in question was for complex eye surgeries that had not actually performed. Goyal is also alleged to have falsified patient medical records, pressured other employees in his practice to engage in the scheme, and initiated debt collection proceedings against patients who did not pay the full amounts of his fraudulently billed charges.

Read About Goyal’s Fraudulent Ways Here >>

2. Dr. Pleads Guilty to Accepting Bribes In Exchange for Prescribing Fentanyl - Kenneth Sun, M.D., of Pennsylvania, pleaded guilty to one count of conspiracy to defraud the United States, and receiving healthcare kickbacks. As part of his guilty plea, Sun admitted that from 2012 to 2016, he conspired to solicit and receive more than $140,000 in bribes and kickbacks from Insys Therapeutics, a pharmaceutical company, in exchange for prescribing more than 28 million micrograms of Subsys, a powerful opioid narcotic. Subsys is approximately 50 to 100 times more potent than morphine, and was prescribed by Sun to patients for whom it was medically unnecessary, likely contributing to the national epidemic we find ourselves in today.


Read More About Subsys and the Fraud Bust Here >>

3. Deeper Than the Headlines: In Case You Needed Another Reason to Conduct Your Annual Risk Analysis - The OCR recently entered into a resolution agreement and corrective action plan with the University of Rochester Medical Center, which agreed to pay $3 million to the OCR. The agreement was the result of lost, unencrypted mobile devices. URMC had previously filed breach reports with the OCR in 2013 and 2017, following the discovery of protected health information (PHI) being impermissibly disclosed through the loss of an unencrypted flash drive and theft of an unencrypted laptop.

Go Deeper Than the Headlines Here >>

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