Insurance carriers have already begun using artificial intelligence to deny health insurance claims. A new lawsuit in Minnesota identifies United Health as using algorithms to deny the health insurance claims of elderly and disabled insureds, When claims are denied, necessary treatment is delayed – increasing the likelihood of serious injuries and death. The lawsuit, filed […]
And I keep track of it here on my blog. Just punch in #QualityFraud in the search bar on The Daily Blog on my website. A hospice medical director was sentenced to four years in prison and ordered to pay $18 million for his role in submitting more than $150 million in bogus Medicare claims […]
I have litigated similar issues regarding the duty a hospital owes to relatives of a patient, intentional infliction of emotional distress, wrongful death, and immunity. Here is a link to the reported appeals decision in my case. These are difficult cases, trying for all involved. Press attention can help but can also add to the […]
Doctors who prescribe to people they’ve never met and care they never give. These claims go back to a Civil War era law designed to prevent the Government from being overcharged for military supplies. Now, the DOJ brings in billions of dollars every year for healthcare fraud. Here’s the link Physicians facing prison, fines, for […]
After lobbying legislatures for “tort reform” for decades, the number of medical malpractice claims – especially what they used to call “frivolous” claims – has gone down. Has that lowered rates for physicians? Of course not. But instead of accepting responsibility, the insurance industry now blames “nuclear claims” and other imaginary foes to explain their […]
This takes unlicensed practice to another, putting it on steroids. Unanswered in this story is how many patients were harmed by these unscrupulous academics and the fraudsters they set loose. Two nursing school operators in the Fort Lauderdale area have fessed up to peddling fake diplomas to thousands of students who could then avoid completing […]
Like the insured persons in the story below, follow your instincts when it comes to insurance claims you think have been improperly denied. If you suspect something, they probably are improperly denied. The rejection of van Terheyden’s claim was typical for Cigna, one of the country’s largest insurers. The company has built a system that […]
Patients need to understand the risks and potential problems associated with telehealth visits to avoid additional injuries. Medical malpractice can become more of a danger than ever. UNDERSTANDING TELEHEALTH AND THE RISKS OF MEDICAL MALPRACTICE I had a case involving teleradiology services provided to an internal medicine practice from hundreds of miles away. The level […]
Link to the DOJ announcement below: FOR IMMEDIATE RELEASE Wednesday, June 5, 2019 Opioid Manufacturer Insys Therapeutics Agrees to Enter $225 Million Global Resolution of Criminal and Civil Investigations
The World Health Organization (WHO) in 2019 raised the alarm while calling for urgent action to reduce patient harm in healthcare. The United Nations (UN) specialized agency stated that medical malpractice results in 2.6 million deaths annually. “Most of these deaths are avoidable. The personal, social and economic impact of patient harm leads to […]
