By Douglas M. Nadjari

Marking what may well prove to be the onset of unprecedented scrutiny of Medicaid claims in this state, New York’s recently enacted its own version of the false Claims allowings those with knowledge of alleged fraud in state funded programs to bring a lawsuit, reap profits and, do so in the name of the State of New York.

By Douglas M. Nadjari

In response to media coverage of dramatic adverse outcomes following office-based procedures, New York has enacted a new law which will require: (i) the accreditation of all facilities where outpatient surgical (and other invasive) procedures are performed and (ii) the reporting of certain adverse outcomes to state authorities. The new law represents a dramatic change for practitioners performing procedures under general anesthesia, conscious sedation, and/or deep sedation.

By Douglas M. Nadjari

Government regulators have failed to keep stride with technological advances in telemedicine. Indeed, despite the many real and benefits, its practice is still fraught with legal danger, even for well qualified and scrupulous practitioners.

By Douglas M. Nadjari

A study conducted by the American Academy of Family Physicians (“AAFP”) identified a variey of conditions which were most likely to result in malpractice claims or disciplinary proceedings by state licensing authorities.

By Douglas M. Nadjari

The Office of Professional Medical Conduct (“OPMC”) is the arm of the New York State Department of Health (“DOH”) that is responsible for policing the medical profession and meting out professional discipline. An OPMC investigation is fraught with danger and physicians should be aware of how the system works and simple measure they may take to protect themselves.

By Douglas M. Nadjari

In order to avoid criminal prosecution, the orthopedic device manufacturers entered into what is known as “Deferred Prosecution Agreements” (DPA’s”) with the Government that require the corporations to became “informants” and publish lists of physicians to whom they made cash payments, provided plane tickets, lodging, food or other gifts and other evidence to support kick-back cases against the doctors. Thus, while the physicians remain at risk of prosecution, the manufacturers have been promised that criminal charges will be dropped if they “name names” and begin to behave like good corporate citizens.

By Douglas M. Nadjari

The article contains practical suggestions for(1) minimizing the risk of fraud investigations and (2) reacting to proactive government investigations of your practice.

By Douglas M. Nadjari

The author identifies health acre audit "red-flags and offers suggestions to avoid the ris of government audits and combatting demands for repayment.

By Michael J. Schoppmann

On October 8, 2008, without great fanfare within the physician community, The Centers for Medicare & Medicaid Services (CMS) has taken the next steps in the agency's “comprehensive efforts” to identify “improper Medicare payments and fight fraud, waste and abuse” in the Medicare program by awarding contracts to four permanent Recovery Audit Contractors (RACs) designed to “guard the Medicare Trust Fund.”

By Michael J. Schoppmann

In announcing the recent “landmark” empowerment of the Office of Professional Medical Conduct (“OPMC”), Governor David Paterson described new legislation as bringing “important changes to our system of disciplining physicians ensuring that cases of misconduct are uncovered, reported and acted upon.”