Legal

As happens often with advances in the way medicine is practiced—and billed for—telemedicine has now reached a level of acceptance sufficient for widespread fraud to become an issue. The U.S. Department of Justice has levied charges of fraud totaling more than $6 billion against 345 people in 51 federal districts, with $4.5 billion of that sum connected to telemedicine billing. It’s the DOJ’s biggest fraud roundup ever. Those charged in the telemedicine sweep 86 defendants, …

One man’s trash is another man’s treasure trove of personal medical information—and the failure of one walk-in clinic in North Carolina to realize that has the operation being investigated by state health officials. Discarded medical records were found in a dumpster outside the recently closed facility in Wilmington, along with hazardous materials such as hypodermic needles. Police declined to file charges, but the dumpster was hauled away and the matter is now in the hands …

One evening last week a man presented to a Columbus, OH urgent care center after an altercation in which he was shot in the abdomen. Local news reports say it was over some sort of “transaction” that the victim declined to close. Gunfire and the life-threatening injury ensured. Ultimately, the man was transported from the urgent care center to the hospital, but the disposition isn’t what should make this case interesting to you. Urgent care …

One U.S.-based urgent care operator is paying a heavy price after pleading guilty to healthcare fraud and engaging in monetary transactions derived from unlawful activity. The company, which was first accused of inflating reimbursement rates by ordering unnecessary tests and systematically exaggerating the complexity of procedures several years ago, has now copped to the charges and has to pay a $12.5 million fine. That’s the amount the prosecution says equates to the bogus charges between …

You did everything you could to provide excellent, timely, ethical care for that patient with chest pain—to no avail. Now you’re being sued. Are you ready to defend yourself and your practice in court, with the entire enterprise riding on the outcome? JUCM Senior Clinical Editor Michael Weinstock, MD will preside over a virtual mock trial during the third annual Adena Thought Leaders Summit (ATLS) on Wednesday, September 9 from 10 am to 12:20 pm, Eastern. …

When President Trump declared a national state of emergency due to the COVID-19 pandemic, the Centers for Medicare and Medicaid Services instituted changes in their licensure requirements, as detailed in the COVID-19 Emergency Declaration Health Care Providers Fact Sheet. While CMS is deferring to individual states on specifics—including on all staff licensure, certification, or registration—the agency is waving many requirements in order to allow healthcare facilities the freedom to make decisions based on the conditions …

Patient confidentiality is rightly one of the cornerstones of the medical profession. If we want patients to be forthcoming, they need to feel confident that they can be completely open with their providers without their most private information being shared. However, when policies designed to protect patients instead become obstacles to administering care it’s time to take a hard look at those policies. That’s exactly what the Department of Health and Human Services has done …

Some patients are more forthcoming than others when it comes to acknowledging pain, or how long a given symptom has been present. You should know, though, that there’s precedent for an urgent care provider being held liable for taking that at face value in a malpractice case. Just this week an urgent care center in Idaho was hit with a multimillion dollar judgment after being sued by a patient who had injured his back while …

Not along ago, we shared the story of a Grosse Pointe, MI urgent care operator that was losing patients due to an overflow parking situation in the retail center where they were located. They were allotted a certain number of spots according to the terms of their lease, but those spaces were too often used by patrons of a neighboring athletic facility. Beaumont Urgent Care thought putting up signs indicating which parking spaces were “theirs” …