I.A. Khair of New Jersey ran an ambulance company called K&S Invalid Coach. Presumably, “Invalid” was pronounced IN-va-lid, with the emphasis on the first syllable. Maybe it should have been pronounced in-VAL-id, with the emphasis on the second syllable. Why? Because by running the company Khair …
Where’s the Crime in Providing Free Medical Care?
June 28, 2016 Leave a Comment
Can it be a crime to provide free medical care? That’s the question presented by a post-conviction motion by the so-called King of Nursing Homes, Dr. V. Kuchipudi. Dr. K was convicted on nine counts of violating the Anti-Kickback Statute (AKS) and one count of conspiracy for an arrangement with now-defunct …
When Inside Knowledge Is a Handicap to a Whistleblower
June 27, 2016 Leave a Comment
Here’s a riddle: The whistleblower is a former employee of the defendant, with inside knowledge of the operations at the heart of his qui tam suit. How can that inside knowledge be a handicap in pressing his claim? A June 21 decision by a Massachusetts federal court provides an answer and an …
Site-Neutral Billing Exemptions
May 23, 2016 Leave a Comment
The Balanced Budget Bill Act of 2015 has a site-neutral billing provision relating to off-campus hospital outpatient departments (HOPDs). Those are facilities away from the hospital campus but certified as part of the hospital and therefore qualified to receive a facility fee, like the hospital itself. …
Biblical Name No Shield Against Fraud Charge
May 9, 2016 Leave a Comment
On May 2 a New Orleans federal jury found that Psalms 23 DME, LLC—its Biblical name notwithstanding--was part of a fraud scheme that illegally billed Medicare $3.2 million. In 2013 the government indicted Psalms 23 owner Tracy Brown and a colleague for a fraud scheme that involved billing Medicare for …
There Is Such a Thing as Being Too Careful
April 26, 2016 Leave a Comment
According to The New York Times, Medicare may be punishing hospitals—and academic medical centers (AMCs) in particular—for being too careful. That’s how Northwestern Memorial Hospital’s chief medical officer sees the practical effect of Medicare’s policy of reducing payments to the hospitals with the …