Practice Management
An urgent care operator in upstate New York has agreed to pay $110,000 to settle charges that it submitted false claims to Medicare. The U.S. Attorney for the region alleged that between January 2013 and October 2015 the company billed over 99% of its Medicare fees as if services had been provided or supervised directly by a physician, even though at least some of them had been provided by advanced practice providers (ie, nurse practitioners …
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Violations of the Health Insurance Accountability and Portability Act are serious business, but they may not be sufficient grounds to sue violators, absent other circumstances, according to a decision just reached by a federal judge. A plaintiff in Washington, DC had charged that LabCorp left her protected health information (PHI) in plain sight at a local hospital, where it could be viewed by others not authorized to see it. That has been accepted as fact …
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Blue Cross and Blue Shield says thousands of physicians continually break evolving North Carolina laws regarding prescriptions for opiates—but acknowledges the difficulties both of keeping track of those laws on the physicians’ part and enforcing them on the state’s part. The challenge may be especially great in regard to the NC STOP Act, which limits opioid prescriptions to 5 days for first-time patients with short-term pain (or 7 days if the patient had surgery). The …
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Just under a year ago, we told you eClinicalWorks had been fined $155 million for violating the False Claims Act. In addition to the fine, the company was supposed to help customers switch to other vendors at no cost to the customer, or provide customers who chose to stay with free updated versions of eClinicalWorks software. Unfortunately, while the fine has been paid and the whistleblower who brought the situation to light got his money, …
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Wahidullah Medical Corporation, which does business as Redwood Urgent Care and Laboratory, has filed an antitrust suit against St. Joseph Health, alleging that the system has an “entrenched monopoly” that it leverages to prohibit patients from using nonaffiliated lab services. Besides damaging Redwood’s business, the suit claims that St. Joseph’s tactics allow them to charge exorbitant prices that cost patients and insurers more than they’d be paying otherwise. Redwood alleges that St. Joseph Health prevents …
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No-see opiate prescriptions have cost an urgent care physician in Burlington County, NJ his medical license—which he willfully surrendered in order to avoid paying penalties and fees totaling over $127,000. The state had already suspended his license temporarily after accusing him of prescribing narcotic pain medications to patients he didn’t examine over a 5-year period. If he violates the consent order he agreed to, he will have to pay the money immediately and face additional …
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An unknown man and woman delivered a second man with two gunshot wounds to an urgent care center in Kitsap County, WA last Friday—and then sped away, leaving law enforcement to wonder if they were simply good Samaritans, witnesses, or somehow involved in the shooting. The victim was treated in the urgent care center and then taken to a nearby hospital with non–life-threatening injuries. It remains to be seen how involved the urgent care center’s …
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Connecticut is the latest state to decide that healthcare providers can be sued for breaches of patient confidentiality under the Health Insurance Portability and Accountability Act of 1996 (HIPAA). The Connecticut Supreme Court set the precedent when it decided that one patient’s breach of confidentiality and negligence claims against a provider could move forward. In essence, the decision paves the way for patients to use HIPAA as a standard of care and to sue providers …
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Urgent care providers were not named among those most likely to be sued in Medscape’s recent Malpractice Report 2017, but a look at the research is likely to offer some insights that could help them lower their risk for landing in court. “Failure to diagnose/delayed diagnosis” was the reason for 31% of the lawsuits against physicians in the survey—the most prevalent among all causes mentioned. “Complications from treatment/surgery” was the second-most common answer (27%). Procedural …
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An urgent care center in Florida is being forced to shut down, not because it couldn’t draw enough patients or provided bad care, but because of a highly charged disagreement over the nature of its start-up funds. Here’s what everyone agrees on: A Florida woman provided substantial funds to help a new urgent care center get going 2 years ago. After that, it gets harder to separate fact from fiction in the case of a …
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