S.C. man sentenced in $100M DME fraud case | N.C. doctor given sentence for sharing DEA credentials | Sentence handed down in Va. doctor's oxycodone case
March 22, 2024
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Andrew Chmiel of Mt. Pleasant, S.C., has been sentenced to nine years in prison for his role in a nearly $100 million telehealth-based durable medical equipment fraud scheme. Court documents showed that Chmiel operated at least 10 DME firms across the US, which he and his co-conspirators ultimately used to submit fraudulent claims to Medicare for braces that were medically unnecessary or were obtained through illegal bribes and kickbacks.
Full Story: Department of Justice (3/20),  The Post and Courier (Charleston, S.C.) (tiered subscription model) (3/19) 
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Law Enforcement & The Courts
Wendell Randall, a doctor from Millers Creek, N.C., has been sentenced to 18 months in prison after admitting to conspiring to use the Drug Enforcement Administration registration number of another person for distributing controlled substances. Between 2017 and 2020, Randall -- who was affiliated with L5 Medical Holdings -- allowed unqualified medical providers to use his DEA registration number to prescribe Suboxone in his name, despite not seeing the patients, prosecutors said.
Full Story: Department of Justice (3/21),  WDBJ-TV (Roanoke, Va.) (3/21) 
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Kirsten Van Steenberg Ball, a primary care physician from Arlington, Va., has been sentenced to 10 years in prison after being convicted of illegally distributing millions of oxycodone pills. According to court documents, Ball, who operated a medical practice out of her home, directed her office manager to recruit people who could be patients and recipients of controlled substances, even though they showed signs of drug dependence, abuse, diversion and addiction.
Full Story: Department of Justice (3/20),  The Daily Progress (Charlottesville, Va.) (3/22) 
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Ohio man to serve prison sentence for pandemic relief fraud
(Pixabay)
Terrence Pounds of Holland, Ohio, has been sentenced to 94 months in prison for fraudulently obtaining more than $4.2 million in COVID-19 pandemic relief funds. From March 2020 to December 2020, Pounds and his co-conspirators orchestrated a scheme to receive loans from the Economic Injury Disaster Loan program and the Paycheck Protection Program using false information in dozens of applications.
Full Story: Department of Justice (3/20) 
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Policy & Regulatory News
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Tools & Technology
Physicians using an AI tool to help draft responses to patients reported feeling less burned out even though the tool did not reduce the amount of time they spent, according to a study in JAMA Network Open. The 162 doctors participating in the study also said the large language model helped reduce clerical burden.
Full Story: Becker's Hospital Review (3/20) 
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Smartphone app aims to identify jaundice in babies
(Pixabay)
Intermountain Health has partnered with digital health company Picterus to develop an app that would help parents determine whether their baby has jaundice and alert health care providers. The app, which uses a smartphone camera alongside a laminated card to measure bilirubin levels, is being tested on about 300 term babies and 100 preterm babies and compared with traditional blood draws.
Full Story: HealthLeaders Media (3/20) 
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Health Insurance Industry News
The CMS said the weight loss drug Wegovy would be covered for Medicare beneficiaries who are prescribed the medication for lowering heart attack and stroke risk and that state Medicaid programs would be required to cover the drug to prevent heart disease among people with obesity. The agency's announcement makes Wegovy available for Medicare price negotiations under the Inflation Reduction Act.
Full Story: Reuters (3/21) 
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Medical News
NHCAA News
The Annual Training Conference (ATC) is the nation's premier training event for the fraud-fighting industry. The ATC Committee is already preparing for this year's program and is looking for high-quality submissions from the subject matter experts on the front lines of fighting fraud. Visit our Call For Presentations page for more information and to submit your idea.
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NHCAA's platinum, premier and supporting members are leading providers of products and services to the health care anti-fraud industry, are valued partners who support our mission and have demonstrated outstanding commitment to the fight against health care fraud. Visit our Become a Member page for more information and to apply.
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