Dive Brief:
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The state of California charged 26 doctors, pharmacists and business owners in a $40 million fraudulent medical billing and kickback operation, according to the California Department of Insurance. More than 13,000 patients and at least 27 insurance companies were victims in the scheme.
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Tanya Moreland King and her husband Christopher King, both of Beverly Hills who own Monarch Medical Group, Inc., King Medical Management, Inc., and One Source Laboratories, Inc., allegedly put together an insurance fraud scheme that recruited doctors and pharmacists to prescribe unnecessary treatment for workers’ compensation insurance patients. Two Irvine pharmacists allegedly conspired with the Kings to sell more than $1 million in compound creams that were not approved by the FDA.
- That’s not the only healthcare news in California. The California Department of Health issued 17 penalties for 14 hospitals for being noncompliant with licensing requirements that could have led to patient deaths. The incidents took place between 2012 and 2016. The biggest fines went to Queen of the Valley Medical Center in Napa County. The state fined the facility three times for a total of $225,000 for three separate 2013 incidents, according to the California Department of Public Health.
Dive Insight:
Those charged in the alleged kickback operation included 21 physicians, ranging in age from 38 to 76 years old. These weren’t new doctors, but veteran physicians who reportedly got involved in the scheme.
While that case involved alleged criminal kickbacks, the other news out of California dealt with the health and safety of patients and hospitals reportedly not following established policies and procedures regarding patient treatment.
The kickback may send people to prison, but not following proper policies and procedures will cause a hospital to pay fines and may harm its reputation. Most importantly, those errors can cost patients their lives or cause serious damage to their health.