Jane Antonio

Biography for Jane Antonio

Jane Antonio is the editor of FierceHealthPayer: AntiFraud. She joined the FierceHealthPayer team after a 27-year career in health insurance, where her most recent role was director of corporate compliance and ethics. Jane worked closely with Special Investigations Units designing and delivering employee anti-fraud training. This followed years of investigating Medicare fraud, waste and abuse cases and recovering program overpayments. Jane holds an M.A. in substance abuse counseling from Rhode Island College and a B.A. in English from Stonehill College in Easton, Mass. She enjoys reading and long outdoor walks. Contact Jane at [email protected]

Articles by Jane Antonio

The double-edged sword of investigational treatment

It can be hard convincing people that insurance shouldn't pay for all healthcare services. Investigational or experimental treatment is a prime example. Most insurers have medical policies...

Fraud allegations involving respiratory care resolved in 2 states

A recent false claims settlement and perpetrator sentencing highlight the issue of alleged and proven fraud linked to respiratory therapy.

CMS launches ambulance precertification program

The Centers for Medicare & Medicaid Services have imposed preauthorization requirements on non-emergency ambulance trips in three states to control skyrocketing utilization and improper Medicare payments linked to this benefit. 

False Claims Act enforcement continues in high gear

The federal government obtained $5.69 billion in settlements and judgments from civil cases involving false claims and fraud this year, and about 40 percent of that total involved healthcare programs, former HHS Inspector General Richard Kusserow reported. 

Hospice fraud cases catching eye of federal investigators

Hospice fraud allegations keep drawing the eye of federal investigators, as evidenced by a recent conviction and the government's intervention in a False Claims Act lawsuit.

Hospital staff caught snooping, putting privacy and identity at risk

News ripped from recent headlines focuses on privacy violations and medical identity theft by hospital employees in three states.

$63M Medicare fraud trial ends in stalemate

After a trial lasting nearly one month, a Miami federal jury couldn't reach a unanimous verdict in the case of a psychiatrist and three therapists charged with a $63 million Medicare fraud conspiracy, the Miami Herald reported.

Meeting the challenge of healthcare fraud, and what that makes of us

This is a reflection on some of the problems we face as fraud fighters and who we may become as a result of efforts to solve them. I learned early on that we'll never completely eliminate...

Pursuing those who take the money and run

Stories of healthcare fraud fugitives--captured and at large--have pervaded recent news.

11 charged with recruiting foreigners in $25M enrollment scam

Authorities charged 11 south Florida residents with defrauding Medicare and Medicaid by enrolling ineligible people living in Nicaragua and the Dominican Republic, the FBI announced.