Healthcare fraud happens all the time but the most classic case of fraud is charging for something and not performing the service. Let’s look at the at the recent arraignment of Primera healthcare executives in Atlanta Georgia. Tim Darnell from the ATL based paper patch writes in his article, “Primera Medical Group Execs Charged With…

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As a physician you have taken an oath to serve your patients to the best of your ability. In the environment of healthcare it is very easy to commit fraud, whether it be intentional or unintentional, it happens. One way to make sure that you land on the radar for an audit is to just…

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$80 Million dollars out of one chiropractic practice. If that does not raise red flags. We are not sure what does. It certainly taints the chiropractic profession but can be found in other healthcare professions. This article comes to us via the New York Post by Kaja Whitehouse, “Feds claim chiropractor brothers bilked patients out…

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Keep an eye on your billing companies. If you use a billing company you will want to read this story coming out of Miami Florida. The Miami Herald originally ran this article, Their company did medical billing. Now, four of them are headed for federal prison by David J. Neal. This is a pretty sobering situation for…

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MFN

What is a most favored nations clause and why is it relevant to healthcare? Put simply it means that the insurer is getting the best price that the doctor is willing to give. How do many people violate this? Cash discounts. Lets look into the details straight from Evan Sznol’s Issue Brief: Most Favored Nation…

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HDL labs is being accused of fraud to the tune of $84 million dollars by Cigna healthcare. Healthcare fraud comes with a hefty bill for any healthcare organisation but lets get some nice excerpts out of the article, “HDL sued for $84 million, accused of fraud” by Burl Rolett for RichmondBizSense.com. Cigna, a Connecticut-based insurer,…

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