Scott Novick, former owner of Florida-based Pacific Pharmacy and pain clinic American Pain Management, was sentenced to six years and six months in prison plus three years of supervised release and was ordered to forfeit about $1.4 million after pleading guilty to conspiracy to commit health care fraud for his involvement in a $2.2 million Medicare fraud scheme. Novick admitted to using his clinic and pharmacy to submit approximately $2.2 million worth of false claims to Medicare for pain management services and controlled substance prescriptions that were not eligible for reimbursement, according to the plea deal.
There’s a new paradigm for payment integrity Payers are facing increasing problems with improper payments, cutting into their resources for process improvements and high-quality care for members. Many are stuck with departmental silos and outdated technology, but a new paradigm is emerging to improve payment integrity. Read more.
Johnny Di Blasi, a doctor with clinics in Pooler and Braselton, Ga., was sentenced to two years and nine months in prison after entering a guilty plea to conspiracy to unlawfully dispense controlled substances. Court records showed Di Blasi illegally prescribed narcotics, including amphetamines and opioids, to nonpatients for over a year.
Pennsylvania doctors Krishan Aggarwal and Cherian John, who were both connected with Redirections Treatment Advocates, an addiction treatment center with clinics in Ohio, West Virginia and Pennsylvania, have been acquitted on all charges related to allegations of illegally prescribing the opioid addiction drug Suboxone. Aggarwal and John were previously charged with conspiracy, health care fraud and unlawfully distributing Suboxone.
Brahndi Miller, a former pharmacy technician, was charged with obtaining a controlled substance by fraud, intent to distribute and embezzlement on allegations she stole more than 2,200 highly addictive alprazolam pills while working for a Meijer store pharmacy in Warren, Mich. Police said Miller was caught in the pharmacy's security footage stealing boxes of alprazolam pills in three incidents between May and June of this year.
Researchers have developed a laser technology called the Cytophone that can look beneath the skin to detect and blast away circulating tumor cells under the skin, while also being able to spot blood clots as the cells circulate. The system, which is more than 1,000 times more sensitive than current approaches, was found to successfully detect tumor cells in 27 of 28 patients, often in 10 seconds.
Keep tabs on the single-most important annual health care anti-fraud event. Coders, CFEs, CPA and compliance officers can all earn necessary continuing education credit at the 2019 Annual Training Conference (ATC), Oct. 15-18 in Nashville, Tenn. For credits offered, agendas, and to register, visit the ATC website.
Fighting the Opioid Crisis at the Source. This webinar will explore anti-fraud approaches on the provider side of the epidemic, starting at the source: physicians who prescribe opioids and pharmacies that dispense them. Using real-world examples, SAS' John Maynard will explore the supply side of the opioid epidemic. Register now.