What Happens if I Am Accused of Billing Fraud as a Doctor?

Doctors have a lot on their plates. Rather obviously, their primary concern is the well-being of their patients. Fortunately, most doctors in New York City and throughout the country are dedicated to ensuring their patients are provided with only the best care possible. However, once a doctor is done treating a patient, his job is […]

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What Happens if I am Being Unfairly Audited and How Do I Defend Myself?

When a medical professional finds out that they are being audited, it can be a burdensome time in their life. This may happen if they are accused of overbilling their patients. In these situations, it is important to retain the services of a New York medical defense attorney who can guide you through the process […]

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NYS Medical Fraud Complaints

In New York State, fraud in medicine is taken very seriously. When a physician or another medical professional is accused of acting fraudulently, the New York State Board for Professional Medical Conduct will have to investigate the complaint thoroughly and determine penalties. In some extreme cases, a medical professional who is found guilty of committing fraud […]

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Medicaid Audits: What Are They and What Could They Mean For Your Practice

Physicians and other healthcare professionals may be subject to Medicaid audits during their tenure as medical professionals. Medicaid audit contractors may audit a healthcare professional based on allegations of over-payment or other fraudulent conduct.  Sometimes, a simple error in your billing can raise a red flag and result in an audit. Medicaid Integrity Program The […]

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412 People Charged Federally with Health Care Fraud

The “largest health care fraud takedown operation in American history” took place today, according to Attorney General Jeff Sessions, prosecutors announced that 400 individuals were charged in $1.3 billion in false billing, opioid scams, and health insurance fraud. With America facing a massive opioid epidemic, it is alarming that over 120 medical professionals were found […]

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Medical Clinics in Brooklyn Facing Narcotic and Medicaid Fraud

Seven medical practitioners in Brooklyn are facing charges with a combination of 477 offenses related to medical misconduct. Many of these offenses are very serious and include the criminal sale of a prescription for a controlled substance, health care fraud, scheme to defraud Medicare and Medicaid, unlawfully selling prescriptions, and more. Several physicians and their […]

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What Can a Physician Expect in a Medicare Billing Audit in New York?

I represent physicians who are being accused of overbilling Medicare or other HMO institutions and this happens quite frequently and can be very dangerous. I did one about five or six months ago where the claim was the physician had billed the procedures he was doing incorrectly and the HMO wanted $51,000 back from him. […]

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What Occurs When An HMO Accuses You Of Inaccurate Billing Practices?

Most physicians have contracts with HMOs to render health care to the members of those HMOs.  The contracts set forth, among other things, the approved billing practices of that HMO.  You, as the provider who is doing the billing, must know exactly what you can bill for and what supporting documentation you require in your records […]

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