January 15, 2021
NHCAA SmartBrief
Top Story
Alex Fleyshmakher, son of a former co-owner of a Union City, N.J.-based pharmacy, entered a guilty plea to conspiring to violate the federal anti-kickback statute and conspiring to defraud the IRS. Authorities said Fleyshmakher and others paid kickbacks and bribes to health care professionals in order to steer prescriptions to the Prime Aid Pharmacies from 2008 to August 2017.
Full Story: Department of Justice (1/14),  Daily Voice (1/14) 
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Law Enforcement & The Courts
Paul Purdy and Valdet Seferovic, former employees at Beaumont Hospital, and Zafar Khan, owner of Wholesale Medical & Surgical Suppliers of America, are facing wire fraud and conspiracy charges as part of an 18-count indictment. Authorities said the defendants stole medical devices and/or supplies from the hospital and then resold them through the internet.
Full Story: Department of Justice (1/14),  The Detroit News (free content) (1/14) 
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Rodney Stevenson, operator of EM General in Michigan, was charged with wire fraud, mail fraud and money laundering. Authorities said Stevenson, through his company, purported to sell N95 masks with N99 filters between February 2020 to March 2020, resulting to the company making approximately $3.5 million in sales to more than 25,000 customers despite delivering almost none of the masks.
Full Story: Department of Justice (1/14) 
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Katherine Prosper of Maine was sentenced to four years of probation with a condition of home confinement not to exceed six months and was ordered to pay $89,864 in restitution after pleading guilty to Social Security fraud and making false statements. Court records show Prosper, a Supplemental Security Income recipient, inaccurately reported the presence of her husband in her household in order keep her eligibility to receive payment benefits from the Social Security Administration.
Full Story: Department of Justice (1/14) 
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Policy & Regulatory News
Tools & Technology
Medical specialist societies are well positioned to improve medical data interchange by setting standards on clinical equivalence for commonly used lab tests in their particular field, thus enabling the reconciliation of data from different sources, write Julia Adler-Milstein, Aaron Neinstein and Russell Cucina. Risks, benefits and financial costs of integrating data must be balanced, but even a conservative approach that brings incremental improvement in data integration would be a tremendous gain, they write.
Full Story: Health Affairs Blog (1/13) 
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The Sequoia Project is recruiting health IT professionals at health departments and information exchanges for a new workgroup "to apply the lessons learned to improve timely access to information to support emergency preparedness for the future," says workgroup facilitator Debbie Condrey. Workgroup members will focus on interoperability, regulatory issues, data privacy, funding and best practices.
Full Story: EHR Intelligence (1/13),  Healthcare IT News (1/13) 
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Medical News
Fraudsters always take advantage of consumers during difficult times. However, it's easier than you think to spot dishonest health care and insurance practices. NHCAA has developed a few simple tips for consumers in order to avoid becoming a victim of a health insurance scam or fraud.
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As technology advances and fraudsters find new ways to game the system, fighting health care fraud, waste and abuse has become a daunting task. Stay ahead of the game with NHCAA's Fraud Solution Resources page. From Medicaid fraud prevention to FWA detection and reporting, these white papers will give you knowledge to stay ahead of the curve. Learn more.
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Editor's Note
SmartBrief will not publish Monday
In observance of Martin Luther King Jr. Day in the US, SmartBrief will not publish Monday. Publication will resume Tuesday.
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Connect deeply with others. Our humanity is the one thing that we all have in common.
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philanthropist, advocate for women and girls
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