[ Tuesday, January 09, 2007 ]


HIPAA fraud and theft: The US 3rd Circuit has reversed a lower court ruling relating to the fraud provisions of HIPAA . A worker at a methadone clinic managed to steal about $500,000 over 4 years by pilfering from the clinic till (can you say "accounting controls"? I knew you could). On the health care fraud side (not what we usually talk about here), there are two avenues of criminal prosecution: for theft from a health care program, or fraud against a health care program. In this case, it was clearly theft, but the government pursued the case against the worker under the fraud provisions. The 3rd circuit said that was a stretch, and vacated the sentence. Presumably, the feds will re-charge under the theft provisions.

Jeff [9:17 AM]

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