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
To analyze and improve access to vast amounts of data across multiple programs, the Centers for Medicare & Medicaid Services has formed an office of enterprise data and analytics and hired its first chief data officer to oversee it.
States are turning to data analytics to improve efforts to thwart healthcare fraud and other crimes poaching government-funded programs, according to The Pew Charitable Trusts.
From upcoding to kickbacks to sales scam accusations, recent news clusters around a theme of executive involvement in proven and allegfed healthcare fraud.
Implementing the federal False Claims Act resulted in $5.69 billion in recoveries in fiscal 2014, nearly $3 billion of it linked to whistleblower lawsuits, WOWT NBC News reported. Underlying these cumulative results, recent headlines describe the workings of the law in fraud cases successfully and unsuccessfully brought.
Many illegal online outlets distribute dangerous and addictive drugs without a valid prescription or medical supervision, and this contributes to drug abuse, customer endangerment and increased healthcare costs.
The Texas state office responsible for countering Medicaid fraud is on the verge of signing a $90 million contract with an analytics firm that has limited experience with the program, according to the Austin American-Statesman.
CareAll Management, LLC, one of Tennessee's largest home healthcare providers, agreed to pay $25 million plus interest to resolve allegations of filing false and upcoded Medicare and Medicaid claims, the Department of Justice announced.
Hospitals that received manufacturer credits for replacing cardiac medical devices didn't to pass the savings along to Medicare through required claims adjustments, an Office of Inspector General audit found.
The federal government has expanded undercover operations, with staff from at least 40 agencies assuming false identities to expose corruption, The New York Times reported.