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Pharmacist Duty to Their Patients.
In Philadelphia, RiteAide pharmacy is closing. This means many patients’ prescriptions will be sold to a competitor looking to increase their patient lists. Yes, pharmacy’s prescription customers are patients to whom the pharmacy owes a duty. https://reader.inquirer.com/infinity/article_popover_share.aspx?guid=ba4ab71d-ab46-4375-beae-5892b4dd64d9&share=true&appcode=PHLINQ I have written about pharmacies corresponding responsibility in light of the DEA regulations of dispensing prescriptions. https://phila-criminal-lawyer.com/professional-licensing-issues/corresponding-responsibility/ Call…
Read MoreComplex healthcare fraud scheme boils down to two things — money and jail.
HARRISBURG – The United States Attorney’s Office for the Middle District of Pennsylvania announced that Rodney L. Yentzer, age 55, formerly of Carlisle, Pennsylvania and currently in Chuluota, Florida, was sentenced to 42 months imprisonment on charges of conspiracy to commit health care fraud, conspiracy to commit money laundering, and theft of public money. He…
Read MoreLegal and tax professionals are not above the law
Attorneys are not above the law and must ethically and honestly represent their clients. They cannot in that representation commit or help the client commit criminal offenses. Bucks County attorney Alan Kane has been sentenced to a year and a day in prison in connection with fraud schemes involving a client, according to federal prosecutors.…
Read MorePharmacy Utilization Review and “Worthless Service” Provider Fraud Claims
If you own a pharmacy and dispense medications prescribed by a physician and paid through a government health system, be careful. All prescriptions billed must be purchased and dispensed. You can not bill the US Government (state based medicaid or medicare programs) for prescriptions that were neither purchased nor dispensed. CMS audits through states’ medicare…
Read MoreNursing Home Admin Steals Elderly Residents, Deceased Residents’ Estates for Her Own Financial Benefit
Mia Hardy, 58, was arrested and charged by indictment with eight counts of wire fraud, arising from an alleged scheme to defraud the residents of two senior living facilities, residents’ heirs, and the facilities themselves. Hardy was employed first at Living Facility #1 and Senior Living Facility #2. Both used a resident fund management service…
Read MoreOIG Debarment Letters — What To Do!
Did you receive an OIG debarment letter? Are you a nurse prosecuted because of Operation Nightingale? If you are in healthcare, you need to be able to participate in medicare and medicaid to work! I respond on behalf of my clients to any and every the Office of Inspector General’s prospective letter seeking to exclude…
Read MoreAddiction Center Fraud — Improper Prescribing and DEA Violations
3 convicted in $8M addiction treatment fraud scheme –…. Creativity rules the day here!. Court documents and trial evidence show that Dr. José Alzadon, Michael Bregenzer, and Barbie Vanhoose, orchestrated their health care fraud scheme through Kentucky Addiction Centers (KAC), which operated in multiple locations. Alzadon, KAC’s medical director, improperly prescribed Suboxone as set forth…
Read MoreDUI Arrests — This Will Change Her Life
Getting arrested for a DUI will affect your life if not handled properly. This news article focuses on a local mayor arrested for DUI with children in her car. https://eedition.inquirer.com/infinity/article_popover_share.aspx?guid=bd47ca0e-b9f8-43d4-a113-6040b5147d6c&share=true This is a major issue. In NJ she could be fired, lose her pension, and possibly be subject to a child welfare investigation. If this…
Read MoreHEALTH INSURERS CHARGED WITH PRICE FIXING BOTH INSURANCE PREMIUMS AND REIMBURSEMENT RATES
If you work for a large company, you probably participate in a health insurance plan through your payroll benefits. In the Philadelphia region that plan probably is BC/BS. The insurance premiums you pay as a large, medium, or small company are set by the insurance company with little or no competition. If you are a…
Read MoreCMS audit and claw back of $2 Billion denied by federal master.
A federal judicial master’s critique of CMS’ audit case against a health insurer, “A mere possibility of an overpayment is not enough for the government to carry its burden.” The problem with the government’s allegations is that the government knew of the very chart review practices which it now claims United prevented it from learning,…
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