Flower Mound Doctor Named in “One of the Largest Health Care Fraud Schemes Ever”

Federal authorities have charged 35 individuals in a fraudulent genetic testing operation that resulted in $2.1 billion in losses, including a Flower Mound physician. The defendants are associated with numerous telemedicine companies and cancer genetic testing laboratories that fraudulently billed Medicare. Dr. Daniel R. Canchola of Flower Mound Texas was charged for referring Medicare patients for unnecessary “cancer screening” tests, and received kickbacks and bribes for the orders. Canchola allegedly made the orders without seeing or having a relationship with patients, and beneficiaries often never received their testing results. He is allegedly responsible for $69 million in fraudulent claims to… Full Story

How Three North Texas Docs Allegedly Defrauded the Federal Government

Three local physicians are caught up in the 58-person health care fraud indictment across the state of Texas for their relationships with marketing companies and compounding pharmacies. The charges say the doctors received kickbacks for writing prescriptions for patients covered by the Department of Defense health care program even though the doctors never saw the patients. Dallas has been a frequent target for health fraud investigations, and the region is coming off another kickback/marketing scheme in the Forest Park trial this winter. Dallas is one of the more expensive cities in the country to receive healthcare, and is a hotbed… Full Story

Expert: How Bedside Manner Affects the Bottom Line

In the age of Big Data and electronic health records, it is easy to forget that the heart of the relationship between a patient and a health care provider is based on trust and personal interaction during the course of treatment. Mistakes inevitably happen in the workplace, but the patient’s relationship with the provider before they occur goes a long way in determining how that patient will react to inherently negative situations. For example, positive interactions between patients and healthcare providers can help control risk of complaints and malpractice actions that are detrimental to the provider’s reputation and financial bottom… Full Story

Federal Charges for 58 Texans in $66 Million Healthcare Fraud and Opioid Takedown

A coordinated effort across the state by the Justice Department has resulted in charges against 58 people across the state for health care fraud and “pill mill” networks resulting in $66 million in losses and 6.2 million pills. Amongst the charged are 16 doctors or medical professionals, and 20 who were charged for diverting opioids. Billing schemes for unnecessary prescription drugs focused on Medicare, Medicaid, TRICARE, Department of Labor-Office of Worker’s Compensation Programs, and private insurance companies were targeted in the investigation. The drugs were often never purchased or given to those for whom they were intended. The charges are… Full Story

Physician Consolidation Leads to Higher Prices, Study Says

A study in from Rice University researchers in the Journal of General Internal Medicine shows that patients spend more when treated by doctors that bill through hospital-owned practices. The past couple decades have seen independent physician practices become more and more scarce, with the fractured industry moving increasingly toward consolidation. The first wave was spurred by large health systems acquiring independent practices, but now Wall Street is a major player in physician acquisition. As practices are rolled into larger organizations, competition decreases, with fewer players fighting for patients. Independent practitioners have little bargaining power with insurance companies for higher reimbursement rates,… Full Story

TMA Foundation Names Two Local Physicians to Board of Trustees

Two Dallas-area physicians have joined the Texas Medical Association Foundation Board of Trustees. The foundation supports statewide and local initiatives that focus on health and awareness, including programs that increase on immunizations, wearing bicycle helmets, and healthy physical activity. Dr. Justin Bishop, a medical resident in physical medicine and rehabilitation at Baylor College of Medicine in Dallas, will serve a one year term on the board. Bishop won the TMA Medical Student Section Student of the Year award in 2014 and served on the TMA Board of Trustees as a representative of the TMA Medical Student Section and the TMA… Full Story

Meet the New TMA Physician Leaders From North Texas

Seventeen North Texas physicians will assume leadership positions at this week’s Texas Medical Association Fall Conference. They were appointed or elected to various boards, councils, and committees and look at healthcare issues to make policy recommendations to support the 53,000 physicians and medical students in the TMA, the nation’s largest medical association. See below to learn about all the new appointments. Dr. John T. Carlo, a public health and preventive care specialist, will be on TMA’s Council on Legislation, which monitors and develops strategies on pending legislation and advocates for legislation at the state and national levels. Dr. Wendy M.… Full Story

Catalyst Health Network’s New Chief Medical Officer

Dr. Jeffrey Bullard will be the Chief Medical Officer for the Catalyst Health Network, a nonprofit network of physicians who coordinate care and share data and best practices. Bullard focuses on integrative medicine, behavioral health, and family medicine, and advocates for enhancing primary care through technology. He designed MaxHealth Family, Internal and Sports Medicine in Colleyville, which addresses everything from nutrition and mental health to sports medicine and chronic disease. He also founded Acuity Brain Center, which addresses mental and brain health needs with technology. “I’ve spent my life working to enrich the lives of patients and the primary care physicians who… Full Story

Report: The Emergence of Clinical Supergroups

Physicians, dentists and vision-care specialists are teaming up to form supergroups as they strive to meet the growing demands for greater value, innovation, and technology while attempting to maintain independence. Law Firm Polsinelli released a white paper addressing the development and examining the movement. Historically, small-group or solo practices have been the norm for physicians, but the report indicates that such traditional clinician practice models are often unable to capitalize on changing payment systems, so consolidation within a supergroup can provide relief from various pressures such as decreasing fee for service  compensation. Other challenges include increasing financial demands on growing… Full Story

Grapevine Physician Suspended For Non-therapeutic Prescriptions

The Texas Medical Board has suspended a Grapevine physician for improperly operating a pain clinic and engaging in consistent non-therapeutic medicine. The board found that his treatment fell below standard for several patients seeking treatment for chronic pain. Dr. Alok Pratap Kushwaha’s medical license has been temporarily suspended with notice for being a threat to public welfare. He is not able to engage in the treatment of any chronic pain and must give up any DEA controlled substances. He is also unable to delegate his prescriptive authority to other physician assistants or nurse practitioners. As the opioid crisis continues to… Full Story