Increased funding for healthcare fraud and abuse oversight highlights a growing need for healthcare organizations to take a proactive approach to corporate compliance and risk assessment.
Applying pattern recognition software to multiple databases offers an efficient and frequently effective way for investigators to root our potential fraud.
More than 2 million Americans were victims of medical identity theft in 2014, a 22 percent increase from the previous year, contributing to a gradual upward trend over the past five years, according to a study published by the Medicare Identity Fraud Alliance.
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.
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.
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.
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.
Weeks after a no-bid contract scandal that embroiled the Texas Health and Human Services Commission (HHSC) and the state's Office of the Inspector General, the state has hired a new inspector general, initiated sweeping changes aimed at changing the way the HHSC investigates fraud and offered up legislation that alters the way contacts are awarded throughout the state.
A new Office of Inspector General (OIG) report raises concerns that hospice care in assisted living facilities (ALF) creates the potential for abuse.
Information technology is paving the way for advanced data analytics, but organizations need to do more to learn from that data, identify abnormal trends and progress to the next level of premptive fraud prevention.