Compliance News Roundup: New OIG Work Plan Items for Aug 2018

1. Post Acute Medical Agrees to Pay More Than $13 Million to Settle Allegations of Kickbacks and Improper Physician Relationships – “Post Acute Medical, LLC, a Pennsylvania-based operator of long‑term care and rehabilitation hospitals across the country, and certain affiliated entities through which the company operates its facilities (collectively, “PAM”), have agreed to pay the United States, Texas, and Louisiana a total of $13,168,000 to resolve claims that they violated the False Claims Act, and the Texas and Louisiana false claims statutes, by knowingly submitting claims to the Medicare and Medicaid programs that resulted from violations of the Anti‑Kickback Statute and the Physician Self‑Referral Law, the Justice Department announced today.” Get the full scoop >>

2. Genesee County Physician and Two Others Charged with Health Care Fraud – “A grand jury indictment was unsealed today charging Patrick Wittbrodt, Dr. April Tyler and Jeffrey Fillmore of Genesee County with health care fraud and Patrick Wittbrodt with money laundering, United States Attorney Matthew Schneider announced...The Indictment charges the defendants with a conspiracy to commit health care fraud and 17 counts of health care fraud.  The Indictment specifically charges that between 2014 and 2017, the defendants would attend meetings of the United Auto Workers (“UAW”) union. At those meetings, the defendants touted unnecessary prescription pain cream, scar cream, pain patches and vitamins to UAW members. The prescriptions were unnecessary because Dr. April Tyler did not establish a valid doctor-patient relationship with any of the UAW members and/or did not determine medical necessity for the prescriptions she wrote for the UAW members.  Many of the compounded pain and scar creams were billed to the insurance company at over $15,000 per prescription.” Get the full scoop >>

3. Deeper Than the Headlines: OIG Work Plan for August 2018 – The OIG has added more items to their work plan in August (2018). Let’s take a quick look at some of the areas they will be scrutinizing such as: CMS oversight of nursing facility staffing levels, physicians billing for critical care evaluation and management services, and much, much more. If your organization provides these types of services, it’s wise to check your compliance as well. Get the full scoop >>

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