Fla. sleep clinic settles fraud allegations | La. clinic owner admits to fraudulently billing Medicare | DME company owner indicted in suspected Medicaid fraud
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September 12, 2014
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Fla. sleep clinic settles fraud allegations
Florida-based Sleep Medicine Center agreed to a settlement with the Justice Department to resolve allegations of performing unnecessary and unprovided tests to defraud Medicare and Tricare. The clinic agreed to pay $200,000 and undergo an eight-year voluntary exclusion from the Medicare and Tricare programs, the DOJ said. George Restea, a doctor accused of submitting false claims in the case, is to pay under $100,000. The Examiner (Washington, D.C.) (9/11)
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Law Enforcement & The Courts
La. clinic owner admits to fraudulently billing Medicare
Sharon Monroe, owner and operator of Shreveport, La.-based Monroe Medical Management, pleaded guilty to one count each of health care fraud and wire fraud. Monroe admitted to submitting false Medicare claims worth about $6 million from 2007 to 2011 using Medicare provider numbers of doctors without their knowledge and collecting $2 million worth of improper reimbursements, evidence shows. Monroe, who faces a maximum of 30 years in prison, is scheduled for sentencing on Jan. 8. KTAL-TV (Shreveport, La./Texarkana, Texas) (9/11)
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DME company owner indicted in suspected Medicaid fraud
Willie Chester Mitchell, owner of Illusion Medical Equipment and Illusion Medical Equipment II in Rio Grande Valley, Texas, was indicted Wednesday on seven counts of health care fraud and one count of aggravated identity theft. Mitchell is accused of fraudulently billing about $2.3 million to the Texas Medicaid program from December 2007 to November 2011 and receiving nearly $2.1 in payments, court documents show. Mitchell faces up to 12 years in prison if convicted of both charges. The Monitor (McAllen, Texas) (9/10)
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Policy & Regulatory News
HHS offers grants to boost ACA enrollment among minorities
HHS and the Office of Minority Health have rolled out $3.2 million in grants to 13 organizations that will help enroll more racial and ethnic minority groups in health insurance plans under the Affordable Care Act. All the recipients are part of the Partnership to Increase Coverage in Communities program. The Hill (9/11)
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Senate approves measure to extend emergency-service programs for children
The Senate on Wednesday approved by unanimous consent a bill that would increase children's access to health services. The Emergency Medical Services for Children Reauthorization Act now awaits House approval. The Hill/Floor Action Blog (9/10)
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Tools & Technology
ONC names leader of Consumer e-Health initiative
The Office of the National Coordinator for Health IT has tapped Lana Moriarty as acting director of the Consumer e-Health program. Before her appointment at the agency, Moriarty worked with the NURSE Corps and National Health Service Corps initiatives at the HHS' Health Resources and Services Administration. Healthcare Informatics online (9/11)
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Diagnostics lab's breach opened patients' data to Internet search engines
A data breach affecting 7,016 individuals nationally was reported after Diatherix Laboratories found that protected health data was stored on a contractor's unsecured server, making it accessible to public Internet searches for three years. The data included names, addresses and billing information. Officials of the clinical diagnostics laboratory have asked Google and other search engines to remove the data from their systems. Healthcare IT News (9/11)
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Health Insurance Industry News
HealthCare.gov will be better but not perfect, CMS official says
The upcoming Affordable Care Act open-enrollment season will see a federal website that features a more streamlined application process and better back-end communications with carriers, CMS Principal Deputy Administrator Andy Slavitt told a House subcommittee. Slavitt said HealthCare.gov will work better than it did for the 2014 enrollment season, but he cautioned lawmakers not to expect perfection. Kaiser Health News (9/10)
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Medical News
238 sickened, 9 dead in West Nile outbreak in Calif.
An outbreak of the West Nile virus in California has infected 238 people, including nine fatalities, as of Tuesday, state officials said. Last year, the infection had affected 117 people by this time, and the year-long death toll was 15. The Wall Street Journal (tiered subscription model) (9/10)
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Emergency visits up, admissions down for hypertension
Hospital admissions for high blood pressure fell 15% from 2006 to 2011 while emergency department visits rose 25%, according to a study that was scheduled for presentation at an American Heart Association meeting. Deaths among hospital patients admitted for high blood pressure declined by 36%. The study was based on 4 million emergency visits detailed in a national database. HealthDay News (9/9)
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The ATC -- big things will happen here
NHCAA's Annual Training Conference offers more than 70 unique workshops spanning eight different educational tracks, providing nearly 1,200 attendees with health care fraud education that is unmatched. Register by September 15 and save.
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Last chance to earn your AFHI® in 2014
Take the next step in your professional development; attend the November AHFI® Prep Course and get a high-level refresher on all things concerning health care fraud. Those who wish to test immediately after the program can apply to test.
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