Compliance: Develop a Culture of Disclosure

Developing a culture of transparency that promotes and sustains disclosure (speaking up) can yield advantages beyond merely decreasing misconduct. When employees feel empowered to speak up, they are more inclined to report issues related to safety, care, and to contribute service improvement suggestions, among other things. My firm, H2 Healthcare, has a robust compliance practice. … Read more

DOJ Gets Aggressive in Pursuit of Telehealth Fraud

It was only a matter of time before cases involving telehealth fraud/False Claims Act cases became public.  This week, two press releases from the DOJ illustrated how aggressive the agency has become in the pursuit of telehealth related fraud. I suspect more, larger in implication (dollar value, geographic spread), will drop publicly in the next … Read more

Medicare, DOJ, Fraud and the Eclipse?

Happy Eclipse Monday! The post title is meant as a bit of fun but there is a bit of relevancy as well. Billing fraud occurs via a process of hiding what actually has transpired (or should have) with the care of a patient. The most typical fraud is overbilling or charging the government for care … Read more

RehabCare, Therapy Fraud and Lessons Not Quite Learned

This last week the Department of Justice and CMS announced a $125 million settlement with RehabCare, a subsidiary of Kindred Healthcare, regarding improper Medicare billing.  As in virtually all cases of a similar nature involving false or improper billing to the Medicare program, this matter began with a whistleblower suit (insiders establishing False Claims Act violations … Read more