Journal of Urgent Care Medicine

Feds Charge Hundreds—Including Doctors and Nurses—with $1.3 Billion in Healthcare Fraud

The U.S. departments of Health and Human Services (HHS) and Justice (DOJ) have announced charges against 412 defendants in the largest healthcare fraud action yet by the Medicare Fraud Strike Force. Among those charged are 115 doctors, nurses, and other licensed medical professionals. More than 120 of the defendants are charged with taking part in prescribing and distributing opioids, as well as other narcotics. All told, the alleged fraud schemes amount to $1.3 billion in …

DOJ Sweep Underscores Need for Toeing the Line in Medicare Practices

Physicians and nurses were charged along with business owners after the Department of Justice moved in on scores of clinics that were allegedly involved in fraudulently collecting fees from Medicare and Medicaid. The DOJ says more than 300 people were charged in healthcare fraud schemes involving $900 million in false billings. Sixty suspects were allegedly linked to schemes involving Medicare Part D, which is the fastest-growing component of Medicare, overall. According to court documents, the …

Aetna-Humana Merger Bears Close Scrutiny from the Justice Department

The Department of Justice (DOJ) Antitrust Division has vowed to look “very, very carefully” at the implications of the proposed merger between Aetna and Humana. At the heart of their consideration will be how less competition among insurers will affect the price and availability of care for consumers. If the deal is ultimately approved by the government, there will be only three large, national insurance providers. A growing number of states are raising concerns about …