Evan Sweeney

Articles by Evan Sweeney

As fraud crackdown grows, so does need for corporate compliance

With federal investigators devoting more time and resources towards uncovering fraud schemes involving false claims or kickbacks, corporate compliance programs have never been more important.


Florida fraud case highlights concerns surrounding Medicare Advantage upcoding

In what is believed to be the first case of its kind in South Florida, prosecutors are pursuing criminal fraud charges against a physician that overcharged Medicare Advantage plans. The case has pulled the health plan into the spotlight as it attempts to stave off spending cuts.

Advancements in biometrics could help fight medical identity theft, fraud

As the healthcare industry regroups following the Anthem hack that exposed personal information of 80 million members, new biometrics technology is initiating a push to help secure medical information.

GAO adds VA to list of programs at high risk of fraud, waste and abuse

The Government Accountability Office has updated its "High-Risk Series," adding the Department of Veterans Affairs health system to a growing list of federal programs that are vulnerable to fraud, waste and abuse.

DOJ seeks to double its healthcare fraud enforcement budget

A fact sheet released by the U.S. Department of Justice outlines its budget requests for fiscal year 2016 that includes $43 million in additional funding to address violent crime, drugs and healthcare fraud.

New Mexico toes the thin line between overzealous detection and legitimate fraud prevention

The New Mexico attorney general has finally released the full 355-page behavioral health audit, 19 months after 15 providers were charged with credible allegations of fraud and had their Medicaid funding cut off. But the audit offers no real proof that overbilling or fraud legitimately exists and the whole situation shows there is a thin line between a fervent witch-hunt and well-balanced scrutiny.

Ambulance fraud masterminds brought to justice

Ambulance fraud contributes to as much as $350 million in fraudulent payments each year. This week, some of those fraudulent schemes were exposed--and the perpetrators face harsh sentences.

Anthem hack opens multiple inroads to healthcare fraud

Over the past several years, IT experts have been frantically directing their attention towards healthcare, clamoring for the industry to improve cybersecurity. Last week's Anthem hack has brought many of those concerns to life. While many have pointed to the immediate financial impact of the hack, consequences surrounding medical fraud could leave a lasting impression.

Medtronic settles two false claims cases totaling more than $4 million

The third-largest medical device company in the world has agreed to pay $4 million to settle two separate lawsuits stemming from allegations tied to overbilling and off-label promotion of a neurostimulation product.

Fake doctor snatches millions from Medicare in phony prescriptions

For years, Alejandra Collazo posed as a licensed physician or a nurse practitioner, using the stolen identities of real physicians to forge prescriptions in a scam that prosecutors estimate cost Medicare more than $8 million. Now she'll spend 17 years in prison for her part in the scheme.