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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Let’s delve into Stark law and how it impacts the delivery of healthcare. Stark Law is a set of United States federal laws that prohibit physician self-referral, specifically a referral by a physician of a Medicare or Medicaid patient to an entity providing designated health services (“DHS”) if the physician (or an immediate family member) has a financial relationship with that entity. This weeks article…

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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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Healthcare is expensive. I think we can all agree with that statement. Lets take a look at this excerpt from a Washington post letter to the editor, “The real villians in the health-care cost crisis” resonates with you as a doctor. Once again, doctors and hospitals are called the bad guys in the discussion regarding the…

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In the final part of this series we look into how the office of the inspector general responded to the 2015 report. While there is one recommendation that the OIG did not agree with you can see how they agreed with most of the recommendations overall. This is really one of the documents that shows…

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Patient Options has been examining the OIG of September 2015 and how the government investigates fraud. This post will bring us to the Conclusions and recommendations that the OIG has come to after sifting through all the data. As you read the following pay attention that in 2013 they found that 20% or 1 in…

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We have covered what the OIG was looking into chiropractors. Now lets peak at what they have found…   In 2013, $76 million of the Medicare payments for chiropractic services were questionable Of the $502 million that Medicare paid in 2013 for chiropractic services, $76.1 million was for claims that were questionable based on our…

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For the third part of this series, Patient Options breaks down the OIG report detailing the red flags the OIG used to detect fraud.. This article will list the areas of concern that they found tended to be fraudulent. METHODOLOGY This study is national in scope and is based primarily on paid Medicare claims for…

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Patient Options is bringing you the background of why chiropractors are on the Office of the Inspector Generals hit list for areas of fraud in government spending. In this multi-part series we summarize the report that came out in 2015 that guides their fraud investigation. In this post we bring you the background and basis…

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