Acting U.S. Attorney General Todd Blanche launched the National Fraud Enforcement Division on April 7, consolidating the Justice Department’s fragmented fraud units into a single, centralized division with an aggressive mandate: protect more than $1 trillion in taxpayer-funded program spending…
ASC Coding, Billing & Collections
A Southern California man who operated a network of medical clinics has been sentenced to 216 months in federal prison for running a drug trafficking ring that sold thousands of illegal oxycodone prescriptions for cash, the Justice Department said in…
A Buffalo, N.Y.-area radiologist who sued his former practice and its acquirer in 2025 is now facing a countersuit from eight former colleagues seeking at least $250,000 in damages, Buffalo Business First reported April 7. Gregory Ball, MD, filed a…
A physician advocacy group is calling on CMS to include safeguards for small independent practices as the agency ramps up its fraud, waste and abuse enforcement efforts, according to an April 6 news release from the Physicians Advocacy Institute shared…
A Texas physician has been indicted on charges of operating a cash-only clinic in Houston to sell prescriptions for controlled substances, the Justice Department said in an April 2 news release. James Robles, MD, of Weslaco, Texas, allegedly conspired to…
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Eight defendants, including three nurses, a chiropractor and a purported psychologist, have been arrested on federal charges alleging they schemed to defraud the healthcare system out of more than $50 million, the Justice Department said in an April 2 news…
Steubenville, Ohio-based Trinity Hospital has agreed to pay $1.7 million to resolve allegations of improper financial relationships with two referring physicians in violation of the Stark law, the Justice Department said in an April 2 news release. Between 2014 and…
An Atlanta-based urology practice and its physician owner have agreed to pay $14 million to resolve False Claims Act allegations of billing federal healthcare programs for medically unnecessary and unperformed procedures, the Justice Department said in an April 2 news…
A bipartisan group of lawmakers has introduced the Provider Reimbursement Stability Act, legislation aimed at modernizing the Medicare Physician Fee Schedule to address decades of declining physician reimbursement, according to a March 31 news release. The bill was introduced by…
A bill introduced in Congress on March 20 would tie ASC annual payment updates directly to the hospital outpatient department fee schedule increase factor. Currently, ASC payment updates and HOPD payment updates follow different formulas, a gap that historically has…