Home care industry, government work to stop fraud | N.Y. physician faces fraud charges | Fla. county commissioner, mother investigated over alleged fraud
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December 15, 2014
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Home care industry, government work to stop fraud
The National Association for Home Care and Hospice is supportive of the Department of Justice's efforts to fight fraud partly because the home care industry doesn't want to have a poor reputation, said William Dombi, the group's vice president. The organization supports the temporary suspension of the creation of some new home care agencies and has requested that the government cap the percentage of revenue an agency can receive from Medicare outlier payments. Home care fraud cases often involve accusations of paying kickbacks to patient recruiters and billing for unneeded services, experts say. Modern Healthcare (free registration) (12/11)
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Law Enforcement & The Courts
N.Y. physician faces fraud charges
Sreekrishna Cheruvu, a physician in East Amherst, N.Y., was charged with health care fraud and submitting false statements in a 13-count indictment. Cheruvu is accused of submitting fraudulent claims to three insurers for services he said he provided when he was not in the country and for group counseling sessions he billed as individual counseling, according to an investigation. Cheruvu, who received payments totaling $800,000, faces a maximum 10-year prison term and a fine of $250,000. WIVB-TV (Buffalo, N.Y.) (12/12)
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Fla. county commissioner, mother investigated over alleged fraud
Bill McClure, commissioner of St. Johns County, Fla., and his mother, Paula Stowell, are being investigated over allegations of falsely billing Medicare and Medicaid at their Medi M.D. clinics. Former employees allege that the clinics altered billing codes and a nurse practitioner wrote narcotic prescriptions without a physician's knowledge, records show. The clinics are under investigation for health care fraud, conspiracy to commit health care fraud, Medicaid provider fraud and other possible charges, according to a search warrant. No charges were filed as of Friday. The St. Augustine Record (Fla.) (12/12)
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Ex-reality show contestant accused of workers' comp fraud
Anita Maxwell, a former reality show contestant, was charged with 14 felony counts of health insurance fraud, according to the California Department of Insurance. Maxwell is accused of making over $40,000 in false workers' compensation claims for supposedly injuring her back, neck and shoulder while helping a patient at the Cedars-Sinai Health System, according to the department. The Washington Times/The Associated Press (12/11)
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Policy & Regulatory News
$33M from spending bill will go to fight abuse of pain drugs
Sen. Tom Harkin, D-Iowa, assisted in securing $33 million in the federal spending bill to treat people addicted to prescription pain drugs and to curb abuse. The money will fund the CDC's push against abuse at the state level, widen access to drug treatment programs and buy emergency devices to treat overdoses. The Hill (12/11)
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Bill to boost access to new antibiotics introduced in U.S.
Legislation to streamline the review of antibiotics was introduced by Sens. Orrin Hatch, R-Utah, and Michael Bennet, D-Colo. The Promise for Antibiotics and Therapeutics for Health Act would allow the FDA to expedite approval of antibacterials for "an identifiable, limited patient population upon determining that the drug treats a serious or life-threatening condition and addresses an unmet need." Regulatory Focus (12/11), Modern Healthcare (subscription required)/Vital Signs Blog (12/11), PharmaTimes (U.K.) (12/11)
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Tips, Trends and Game Changers
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Tools & Technology
Ore. health care provider reports data breach
A data breach affecting some of the patients of Corvallis Clinic in Oregon was reported after a password-protected but unencrypted laptop was stolen from the car of an employee while at a conference in Portland last month. Data compromised in the incident included patient names, birth dates and reasons for visiting their providers. The provider indicated that no financial data or Social Security numbers were on the laptop. BeckersHospitalReview.com (12/12)
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EHR adoption higher among rural practices
Data on more than 270,000 office-based physician sites showed EHR adoption among rural practices was 56%, compared with 49% among urban practices. The findings will appear in the Journal of the American Medical Informatics Association. BeckersHospitalReview.com (12/11), DailyYonder.com (Austin, Texas) (12/10)
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Medical News
CDC: More than half of Americans have yet to get a flu shot
The CDC reported that only 39.7% of U.S. adults and 42% of youths have received a flu shot so far this flu season, and some people said they may skip it following reports that the current vaccine is only partially effective against the H3N2 strain. The CDC and infectious disease providers encouraged the public to still get the flu shot, saying partial protection is better than none. DoctorsLounge.com/HealthDay News (12/11), PhysiciansBriefing.com/HealthDay News (12/11)
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Superbugs could cause 10M extra deaths a year by 2050, experts warn
A review of antimicrobial-resistant infections requested by U.K. Prime Minister David Cameron predicts superbugs will cause at least 10 million more deaths a year by 2050 -- up from 700,000 deaths worldwide each year in 2014. The researchers warn that action is needed to stem the rise of superbugs and develop new antibiotics that are effective against such pathogens. Common treatments and procedures such as chemotherapy, caesarean sections and transplant surgeries would be dangerous or impossible without effective antibiotics. BBC (12/11)
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