The Justice Department announced Thursday that it has charged 412 people, including nearly 115 clinicians, in health care fraud schemes worth $1.3 billion, the largest Medicare Strike Force crackdown in US history. More than 120 people are accused of illegal prescription and distribution of opioid painkillers and other narcotics, while many others are accused of submitting false claims to Medicaid, Medicare and TRICARE.
Anthem has filed a lawsuit against Insys Therapeutics, accusing the pharmaceutical firm of submitting fraudulent reimbursement claims for its opioid painkiller Subsys, just a few days after two former Insys sales representatives pleaded guilty to paying kickbacks to prescribers. Anthem argues that the drugmaker lied about diagnoses to obtain reimbursement.
Eric Snyder, owner of Delray Beach, Fla.-based drug treatment center Real Life Recovery and sober home Halfway There, was charged with conspiracy to commit health care fraud for submitting about $58 million worth of false claims to several private insurers from January 2011 to September 2015. The complaint alleges that Real Life Recovery and Halfway There improperly billed insurers for medically unnecessary treatments and unprovided services, most of which were duplicate urine tests, and paid kickbacks to recruit patients, among other offenses.
Gregory Garro Jr., a dentist from Omaha, Neb., was charged with 24 counts of health care fraud for submitting false Medicaid claims for unprovided dental services between February 2013 and January 2016, resulting in more than $82,500 worth of improper payments. Garro faces a maximum of 10 years in prison on each fraud count.
Health IT startup Health Fidelity launched HF360 Data Acquisition, an EHR data acquisition tool for health care providers and health plans. The vendor-neutral tool can retrieve patient records from all major EHR systems and can get clinical data in an EHR-agnostic manner.
A Reaction Data study found that 35% of 113 health care professionals surveyed said they are now "significantly more suspicious of other EHR vendors" than they were before the settlement between eClinicalWorks and the Department of Justice. The deal also led 27% of respondents to say they have reduced confidence in their current EHR vendor, according to the study.
Join NHCAA July 18-19 in Baltimore for the inaugural Excellence in SIU Leadership Program. Sponsored by General Dynamics Health Solutions, the Excellence in SIU Leadership Program will be a highly interactive program providing dynamic sessions to enable participates to become rising stars in their special investigations unit. Register today!
Don't miss your opportunity to reach key decision-makers, meet with potential business partners, and to see what others are offering. Plan to become an exhibitor and sponsor at this year's ATC & Anti-Fraud Expo, Nov. 14-16 in Orlando. Visit the Anti-Fraud Expo website to learn more.