Compliance News Roundup: Exclusions Advisory Opinion

1. Doctor Sentenced for Healthcare Fraud, Accepting Kickbacks to Prescribe Highly Addictive Version of Fentanyl – “Dr. Jerrold N. Rosenberg, 63 of Warren, the operator of a now-defunct pain management practice in Rhode Island, was sentenced today to 51 months in federal prison for committing healthcare fraud and for conspiring to solicit and receive kickbacks in return for prescribing the drug Subsys, a fast-acting, powerful, and highly-addictive version of the opioid drug Fentanyl.” Get the full scoop >>

2. Florida Dermatologist Agrees to Pay $2.5 Million to Resolve Allegations of Billing Fraud – “Tim Ioannides, M.D., a dermatologist and owner of Treasure Coast Dermatology in Vero Beach and Port St. Lucie, Florida has agreed to pay $2.5 million to resolve allegations that he violated the False Claims Act by billing Medicare and TRICARE for procedures he did not perform, the United States Attorney’s Office announced today. Dr. Ioannides also agreed to operate under an integrity agreement with the Department of Health & Humans Services, Office of Inspector General for 3 years.” Get the full scoop >>

3. Deeper Than the Headlines: Exclusions Advisory Opinion – Let’s talk about exclusions (and I don’t mean leaving people out of a game of pictionary). Exclusions can be a huge risk to your organization, hiring someone on the list can cost you thousands. But, like everything else in healthcare, it’s not that black and white. What do you do when you’re running an exclusion check on an employee or vendor and you receive a positive match? Does a positive match automatically mean that person can’t work for you? The answer: It depends. A recent OIG Advisory Opinion gives an example for someone who’s been excluded to perform certain kinds or work for certain companies working in the healthcare industry. But remember, advisory opinions are limited to specific facts and scenarios presented to the OIG by the requestor and the opinion is issued only to the requestor. The advisory opinion has no application to, and cannot be relied upon by, any other individual or entity. But it is helpful to dissect the OIG’s thought process.” Get the full scoop >>

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