Most of this wouldn't be happening if Govt wasn't laying out your money for these fraudsters in the first place.
A Miami physician was indicted for his role in a $20 million fraud scheme in which he is accused of writing prescriptions for unnecessary services after taking kickbacks from home health agencies in the area, according to the Department of Justice.
Enforcement officials in Jacksonville, Florida, are relying on data analytics to uncover fraud, waste and abuse, a method that has already paved the way for several multi-million dollar settlements this year, according to the St. Augustine Record.
The national nursing home pharmacy PharMerica Corp. agreed to pay $9.25 million to resolve claims that it took kickbacks from Abbott Laboratories to promote the anti-seizure medication Depokate, according to the Department of Justice.
A national wound care provider, Healogics, is facing allegations from former employees that the company billed for unnecessary procedures, implicating clincs and hospital partners in 29 different states, according to the Jacksonville Business Journal.
The issue of including Social Security numbers of Medicare beneficiary cards has been discussed for more than four decades, including repeated warnings from the Government Accountability Office. Despite those warnings, the Centers for Medicare & Medicaid Services has failed to take even incremental steps to remove the identifying numbers, contributing to pervasive identity theft that exploits seniors and leads to millions in healthcare fraud schemes.
Expert testimony at aSenate Committee on Aging hearing outlined how identity theft can lead to multi-million dollar fraud schemes--and the preventative measures that can protect personal health information.
Scammers commonly referred to as "marketers" are taking advantage of Medicaid beneficiaries throughout Chicago, offering cash kickbacks or free services, while billing for services that were never provided, according to WBEZ Chicago.
A prominent New Orleans businesswoman and owner of Abide Home Care Services Inc. pleaded guilty, along with three others, to orchestrating a $30 million Medicare fraud scheme, according to the U.S. Attorney's Office in the Eastern District of Louisiana.
A much-anticipated review of the Delaware's Medicaid program revealed $11 million in potential fraud, waste, and abuse over the last three years, according to the Associated Press.
The federal government spent an estimated $124.7 billion in 2014 inimproper payments across 22 government agencies, most of which came from Medicare and Medicaid programs, according to expert testimony from a senior GAO official.
Two multi-million dollar cases against two ophthalmologists, including the headline-grabbing Salomon Melgen, have thrown the specialty into the regulatory hot seat. Add Melgen's high-profile case to payment data that lists Medicare payments to ophthalmologists that reach eight figures and an OIG report that identified $171 million in questionable claims, and you've got a recipe for additional federal scrutiny, plus potentially more fraud cases involving ophthalmologists.
Last week's Fraud and Compliance Forum, hosted by the American Health Lawyers Association, outlined current and future fraud enforcement trends straight from the mouths of OIG officials.
The government isn't doing enough to prevent improper chiropractic payments, particularly claims involving "maintenance therapy," according to a new OIG report, particularly claims involving "maintenance therapy."
With more large-scale, multi-million dollar fraud schemes surfacing across the country, enforcement officials are utilizing Medicare Fraud Strike Force teams to dismantle entire fraud operations. Rob Howard, assistant special agent in charge with the FBI in Detroit, explains how fraud enforcement officials discover and unravel large-scale schemes.
A cardiologist in Ohio has been convicted for overbilling Medicare $7.2 million for unnecessary cardiac procedures including stents, catheterizations, nuclear stress tests, and recommending patients for cardiac bypass surgery that wasn't medically necessary, according to the U.S. Attorney's Office for the Northern District of Ohio. Meanwhile, a Kentucky cardiologist is awaiting trial after pleading not guilty to 27 counts of fraud and making false statements tied to unnecessary cardiac stents.
Medicare spent more than $30 million during the first half of 2012 on ambulance transports for patients that appear to be ghosts on paper, according to a new report released by the Office of Inspector General Tuesday.
Last year, David Hickton, U.S. Attorney for the District of Western Pennsylvania, requested agents from the Department of Health and Human Services Office of Inspector General to help root out healthcare fraud that was becoming more prevalent in the region. They never showed, so this year he's decided to take matters into his own hands by creating a homegrown fraud task force, according to the Pittsburgh Post-Gazette.
Last week's Medical Identity Fraud Alliance survey offered an important reminder that the fight against medical identity theft and fraud needs an equal dose of humans and technology, and that budget dollars should reflect and equal balance between IT and fraud personnel. Although predictive analytics offers exciting possibilities in the world of fraud prevention, these systems should be navigated by critically thinking humans.
Lingering problems from the previous Texas Health and Human Services Commission administration have forced the state to offer reduced settlement packages to nearly 100 dental providers accused off overbilling Medicaid, according to The Houston Chronicle.
Stuart Bowen inherited a difficult job when he was appointed inspector general of the Texas Health and Human Services Commission, but nine months later, he's making notable progress.