Pharmacy board warns of fraudulent prescriptions for controlled substances The California State Board of Pharmacy recently warned pharmacies of an uptick in fraudulent California security prescription forms for controlled substances. The pharmacy board is encouraging pharmacies to take appropriate precautions to verify the legitimacy of prescriptions written by prescribers who have been identified as victims of this fraud. The pharmacy board maintains a list by county of prescribers who have reported stolen or fraudulent California security prescription forms. Pharmacies that receive prescriptions from a provider on this list have been advised to verify the prescription by contacting the provider's ... November 16, 2016 General Drug Prescribing, Fraud and Abuse 0 0 Comment Read More »
Educate office staff to avoid fraud and abuse In February 2015, the California Medical Association (CMA) issued a fraud alert to warn its members about clinical laboratory payments to referring physicians that may trigger fraud and abuse concerns. Some clinical labs have been offering physicians cash and gift incentives for blood draws of Medicare patients. CMA has continued to receive reports about these anti-kickback violations, which have led to several recent physician arrests in New Jersey, Virginia and other states. Furthermore, physicians' employees have also been implicated in these alleged bribes, including clerical staff and physician assistants. ... July 6, 2015 General Fraud and Abuse 0 0 Comment Read More »
OIG issues fraud alert regarding physician compensation arrangements The Office of Inspector General (OIG) in the Department of Health and Human Services released a Fraud Alert in early June to caution physicians who may be engaged in fraudulent compensation arrangements. The anti-kickback statute prohibits arrangements that result in "improper remuneration" for physicians, such as accepting payment in exchange for referrals. The OIG Alert follows a recent settlement between the OIG and 12 physicians involved in "questionable" medical directorships and office staff arrangements with a chain of diagnostic centers in Texas. Physician compensation allegedly took into account the volume ... June 26, 2015 General U.S. Department of Health and Human Services, Fraud and Abuse 0 0 Comment Read More »
Fraud alert: recognizing relationships that may trigger fraud and abuse concerns for physicians The laws regarding fraud, abuse and anti-kickback violations can be complicated and difficult for physicians to navigate. However, it is increasingly important that physicians be aware of relevant prohibitions to avoid being implicated in a potentially fraudulent scheme. The California Medical Association (CMA) has received reports that some clinical laboratories, especially those testing for cardiovascular markers, are offering physicians cash incentives for blood draws of Medicare patients. Accepting such incentives could put physicians afoul of laws governing fraud and abuse. Anti-kickback laws prohibit physicians from offering or receiving anything of value ... February 18, 2015 General Fraud and Abuse, Self-Referral, Clinical Laboratories 0 0 Comment Read More »
CMS announces new rules to curb Medicare fraud The Centers for Medicare and Medicaid Services (CMS) announced new rules will improve CMS’ ability to deny or revoke the enrollment of entities and individuals that pose a program integrity risk to Medicare. According to a press release, the “new safeguards are designed to prevent physicians and other providers with unpaid debt from re-entering Medicare and remove providers with patterns or practices of abusive billing." These changes are expected to save more than $327 million annually. CMS announced it has already removed nearly 25,000 providers from Medicare. Its strategy for ... December 16, 2014 Medicare CMS, Fraud and Abuse, Medicare, Centers for Medicare and Medicaid Services 0 0 Comment Read More »
CMS warns of fraudulent DME suppliers The Centers for Medicare and Medicaid Services (CMS) sent a letter this week to physicians asking them to pay attention to solicitations they receive from durable medical equipment (DME) suppliers and report any suspicious activity to the U.S. Department of Health and Human Services' Office of the Inspector General (OIG). According to CMS, most fraudulent solicitations are obvious in their wording or their attempts to get physicians to approve unnecessary medical equipment and supplies. These marketing schemes by DME suppliers can include: •Unsolicited orders for medical equipment or supplies, often with wording ... January 31, 2014 General Centers for Medicare and Medicaid Services, CMS, Fraud and Abuse, Quality of Care 0 0 Comment Read More »
