Health Care Fraud Enforcement Continues to Rock Pharmacy Industry

pharmacy fraud

pharmacy fraudBy: Karen Davila

Yet again, the fraud enforcement arm of the DOJ strikes out against fraud in the pharmacy industry.  Two new cases shed continuing light on the ongoing fraud.

Announced last week by the DOJ, the owner/operator of five pharmacies in New York pled guilty to charges stemming from a scheme to defraud Medicare and Medicaid by billing for prescription drugs that were not dispensed, not prescribed, not medically necessary or dispensed when the pharmacy had no authority to dispense the prescription drugs.  This blatant disregard for the law was magnified when the owner/operator used the ill-gotten gains of her scheme to purchase luxury items like cars and jewelry.  Nothing screams “come and get me” like openly flaunting the money taken from the government.Continue reading

Is Your Office Utilizing An Outdated Advanced Beneficiary Notice of Non-Coverage Form?

medicare abn

medicare abnBy: Zach Simpson

Does your office treat Medicare or Medicaid beneficiaries? If so, this article is vital to you and your staff. The first question that I want all of you to ask yourself is if your practice treats Medicare or Medicaid beneficiaries do you know what an ABN is, and why they are vital for your practice? The acronym ABN stands for Advance Beneficiary Notice of Non-coverage. ABNs safeguard your practice’s right to collect on non-covered services (other than statutorily excluded services) from patients who have Medicare or Medicaid. Multiple organizations I have worked with throughout my career had never been informed about ABNs or had never been properly educated on how utilize them. This article is intended to provide you and your practice with the most recent information regarding the renewed ABN form that became mandatory for use on January 1, 2021.

As of January 1, 2021, a new Fee-for-Service Advanced Beneficiary Notification of Non-coverage became effective until it expires on June 30, 2023. In the event that your practice has been utilizing the same ABN forms for years then listen up.Continue reading

Attorney Steven Boyne Joins Florida Healthcare Law Firm in Delray Beach, Florida

florida healthcare law firm managed care attorneyJune 1, 2020 – Florida Healthcare Law Firms adds experienced attorney Steven Boyne to the team to assist with human resource law, corporate and transactional law, as well as telemedicine, healthcare tech and cyber breaches.

Florida Healthcare Law Firm has announced that they have added Steven Boyne to the team. Steven brings over twenty plus years experience working with different types of healthcare entities from Air Ambulances to large healthcare insurance companies, and everything in between. Steven specializes in areas including specific healthcare business human resource issues, telemedicine and HIPAA, strategic disaster planning for healthcare providers, business interruption insurance, health insurance and air ambulances.

“Positioning your healthcare business to be proactive is one of the most important things you can do. Who would have imagined we’d see a global pandemic in our lifetime? Being prepared for ‘interruptions’ help keep your business afloat when disaster strikes, especially when it comes to finances. Steven’s experience in large health insurance companies brings a wealth of knowledge and expertise that will help individual practitioners be just as prepared as the big guys. And, as technology grows in the healthcare industry, Steven is on board to help with his tech expertise,” Florida Healthcare Law Firm COO Autumn Piccolo says. Founder and President, Jeff Cohen, goes on to say that, “We advise many clients on telemedicine and telehealth laws. Steven’s passion for tech is a great addition for current and future clients. His unique firsthand knowledge on cyberbreaches, tech software and security systems is hyper-specific, which will benefit healthcare business owners.Continue reading