Fraud Investigation

Latest Headlines

Latest Headlines

Internal fraud investigations are privileged, appeals court rules

The U.S. Court of Appeals for the District of Columbia Circuit last week reversed a ruling requiring a government contractor to release in-house fraud investigation reports, according to the District-based law firm Wiley Rein.

More fraud investigation tips from Deloitte's Mike Little

FierceHealthPayer: Anti-Fraud talked to Deloitte's Michael E. Little for expert advice on how special investigations units can improve their anti-fraud casework. Little shares additional fraught fighting insights in this final segment of a two-part interview. 

Reporter's Notebook: 4 takeaways from the NHCAA fraud training conference

Industry experts focused on improving the healthcare fraud investigators' clinical understanding and offered legal advice and compliance tips for special investigation unit leaders at this week's National Health Care Anti-Fraud Association's annual training conference in Orlando, Fla.

Bill would tax insurers to fund anti-fraud efforts

Insurers operating in California could see an increase in taxes to fund the state's anti-fraud efforts if a bill passed by the state legislature becomes law.

Prosecution is key to fraud prevention

When it comes to fraud prevention and detection, Health Care Services Corp. (HCSC) takes a hard line against criminals. "Our goal is to prosecute fraudsters," said Sharon Green, senior manager of special investigations for HCSC-owned Blue Cross Blue Shield plans in Illinois, New Mexico, Oklahoma and Texas told FierceHealthPayer.

Insurance contractor pays $2M to settle Medicaid fraud

The primary contractor for Kentucky's Passport Health Plan will pay more than $2 million in damages to the state Medicaid program to settle a fraud investigation, reports the Louisville