Compliance & Legal
Feds claim Vicki S. House, executive director of Nurses' Registry and Home Health, paid three local physicians who referred patients to Nurses' Registry.
The multimillion dollar fine is more than the hospital's annual revenue and is believed to be the largest ever applied to a community hospital.
Hospitals allegedly conspired to carve out marketing territories in the state to limit competition between the facilities and keep consumers from learning about competing providers.
The healthcare industry is now getting the scrutiny that financial institutions and other publicly traded companies have experienced, said Phil Bezanson, a partner at Bracewell & Giuliani in Houston.
Due to the multitude of diverse yet wide-spread requirements, staying compliant can be overwhelming, particularly for smaller facilities and medical practices with limited time and resources to spend.
The dedicated litigation team will focus on the smaller entities such as individual physicians and executives in civil penalties and exclusion cases.
Insurers can focus on optimizing individual plans with cost-comparison and provider-choice tools and value-based benefit designs, expert says.
The King v. Burwell ruling means more than six million residents in the 34 states with federal exchanges can keep their tax subsidies for healthcare insurance under the Affordable Care Act.
According to the U.S. Department of Justice, DaVita devised a scheme to maximize the amount of drugs it waste, billing Medicare for the price of the dose and the waste.
Conspiracy to commit health care fraud, violations of the anti-kickback statutes, money laundering and aggravated identity theft among charges that resulted in several healthcare providers being suspended.