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Elements of an Effective Compliance Plan for Healthcare Businesses

In the early beginnings of compliance plans for healthcare businesses, big and small, there was a strong suggestion that all healthcare businesses, practices, hospitals and the like adopt a compliance program but there was no directive as to ensuring that a the plan actually worked or was comprehensive enough to ensure the mitigation of potential …

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In the News: Spine Surgeon Gets 10-Year Prison Sentence For Healthcare Fraud

The owner of Texas Center for Orthopedic and Spinal Disorders in Fort Worth was sentenced Feb. 25 to 10 years in prison for his role in a $10 million healthcare fraud scheme. Mark Kuper, MD, admitted to conspiring with his wife and a physical therapist at his practice to defraud Medicare, Medicaid and Tricare, according to the …

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In the News: Inglewood Women Plead Guilty to Running Half Million-Dollar Scheme that Improperly Billed Medi-Cal for Substance Abuse Counseling

Outstanding job by the FBI, California DOJ and Medi-Cal Fraud teams in uncovering these fraudulent claims for healthcare fraud.  White Collar, llc aids attorneys and government agencies across the United States in the investigation phase, as well as scheme reveal, case assembly and damage determination – while also serving as experts in the field of …

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Fraud and Abuse in Federal and State Healthcare Programs – Much More Than Money

Current estimates place percentages on healthcare fraud and abuse at between 3% and 10% of every claim submitted, which translates to an approximate value of just over $300 Billion annually.   Certainly, this has a crippling economic effect on healthcare programs and delivery systems, obviously affecting operations and opportunities to provide leading-edge care.   These numbers are …

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In the News: Owner of Tennessee Drug Screening Lab Sentenced to Probation, Home Detention, and Community Service on Federal Health Care Fraud Charge

Great job by the FDA, MFCU of Virginia, and US Attorney’s Office in bringing these individuals to justice.  Their actions cheated the government of the United States and Virginia out of much needed healthcare funds.  The compensation to be repaid of over $9M is meaningful and demonstrates the seriousness with which healthcare fraud must be treated.   …

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In the News: Nationwide Review of the Administration and Oversight of Physician-Administered Drugs

States are required to collect rebates on covered outpatient drugs administered by physicians in order to be eligible for Federal matching funds (SSA § 1927(a)). Previous OIG work identified significant concerns with States’ efforts in obtaining rebates for these physician-administered drugs. White Collar, llc has extensive experience with audits and examining CMS’s policies and procedures …

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In the News: Owner of Durable Medical Equipment Companies Admits Role in $16 Million Dollar Kickback Scheme

The owner of a group of related durable medical equipment (DME) companies recently admitted his role in a conspiracy to pay kickbacks in exchange for durable medical equipment in New Jersey.    The improper benefit conferred was over $16 million for the charged conspiracy to violate the federal Anti-Kickback statute.    White Collar, llc has significant expertise …

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The Elements of an Effective Compliance Plans for Healthcare Businesses

In the early beginnings of compliance plans for healthcare businesses, both big and small, there was a strong suggestion that all healthcare businesses, practices, hospitals and the like adopt a compliance program.  The caveat was that there was no directive to ensure that the plan actually worked or was comprehensive enough to ensure the mitigation …

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In the News: OIG Oversight of State Medicaid Fraud Control Units

The 50 State MFCUs, located in 49 States and the District of Columbia, investigate and prosecute Medicaid provider fraud as well as complaints of patient abuse or neglect in Medicaid-funded facilities and board and care facilities. OIG provides oversight for the MFCUs and administers a Federal grant award that provides 75 percent of each MFCU’s …

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Mitigating Compliance Issues in the COVID-19 Environment

In the healthcare arena, compliance issues constantly arise, and especially when a crisis comes along.   COVID-19 is such a crisis, and one that has been enhanced from a compliance perspective by the Coronavirus Aid, Relief and Economic Security (CARES) Act, which released over $2.2 billion into the economy to various businesses, healthcare facilities, providers’ offices, …

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