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You Would Hire this Doctor – Dr. Salomon Melgen Convicted of 67 Criminal Counts of Medicare Fraud

OIG Exclusion Search Results: No Records. FACIS Level 3 Search Results:  17 Records from 2012 to 2017 including news releases and disciplinary actions. Today, a federal jury in South Florida convicted Dr. Salomon Melgen of sixty-seven criminal counts related to his participation in a health care fraud scheme involving the filing of false claims and…

Be Nice or Be Gone

“Be nice or be gone!” This is a phrase that could be used on a poster placed in the surgeon’s lounge or medical staff office, or simply and anonymously sent to that one physician on your staff who really “just doesn’t get it.” Prevention is the very best of all actions a medical staff can…

Verisys Appoints Scott Bagwell to Its Board of Directors

Former Experian Health President Brings Wealth of Industry Experience Alexandria, VA, May 8, 2017 – Verisys Corporation (“Verisys” or the “Company”), a leading provider of technology solutions and primary-source data on health care professionals and businesses, has added Scott Bagwell, former President of Experian Health and a health care technology industry veteran, to its board…

Blood Testing Laboratory to Pay $6 Million To Settle Allegations of Kickbacks and Unnecessary Testing

WASHINGTON – Quest Diagnostics Inc. has agreed to pay $6 million to resolve a lawsuit by the United States on allegations that Berkeley HeartLab Inc., of Alameda, California, violated the False Claims Act by paying kickbacks to physicians and patients to induce the use of Berkeley for blood testing services and by charging for medically…

The Early Bird has Flown the Coop

New regulations on accessing the Social Security Administration – Death Master File (SSA-DMF) went into effect in November 2016. Unfortunately many organizations underestimated what was entailed in the June 2016 change and are now feeling pressure to be compliant. Organizations must now demonstrate security controls for systems that handle and process DMF data. Mandating that…

Multi-Million Dollar Health Care Fraud Scheme Involving Sober Homes and Alcohol and Drug Addiction Treatment Centers

Drug use and prostitution encouraged at substance abuse treatment centers accused of fraudulent insurance claims.  FL – April 26, 2017 – In one of the most blatant fraudulent insurance claims schemes, four defendants, including two sober home owners, the clinical director of a substance abuse treatment center, and a sales representative for multiple diagnostic laboratories…

Medicare Bilked for $100 Million in New Jersey Test-Referral Scheme

Newark, N.J. – April 18, 2017 – The HHS OIG, FBI, IRS, and U.S. Postal Inspection Service have collaborated in what could be the largest number of medical professionals prosecuted in a bribery case. With some $100 million in false payments by Medicare, this test-referral scheme involved physicians taking bribes for referring blood samples to…

Hospice Companies To Pay $12.2 Million To Settle False Kickbacks

DALLAS – April 18, 2017 – In a massive kickback scheme, International Tutoring Services, LLC, f/k/a International Tutoring Services, Inc., and d/b/a Hospice Plus; Goodwin Hospice, LLC; Phoenix Hospice, LP; Hospice Plus, L.P.; and Curo Health Services, LLC f/k/a Curo Health Services, Inc. have agreed to pay $12.21 million to resolve allegations that they violated…

A Tool for Practical Compliance: The HCCA – OIG Compliance Resource Guide

Data quality is the most important element of a compliance practice. FACIS ® is the gold standard of health care data. The result of a Compliance Effectiveness Roundtable held January 17, 2017 in Washington DC is the, “Measuring Compliance Program Effectiveness – A Resource Guide” (https://oig.hhs.gov/compliance/101/files/HCCA-OIG-Resource-Guide.pdf). Participants of the round table included compliance professionals and…

Pharmacist Pleads Guilty To Conspiracy To Pay Healthcare Kickbacks

Tampa, FL – April 12, 2017 – Acting United States Attorney W. Stephen Muldrow announces that Carlos Mazariegos (40, St. Petersburg) has pleaded guilty to conspiracy to commit healthcare fraud. He faces a maximum penalty of five years in federal prison. According to court documents, Mazariegos was a licensed pharmacist who co-owned Lifecare Pharmacy in…